Venetoclax with Amiodarone Interaction Details


Brand Names Associated with Venetoclax

  • Venclexta®
  • Venetoclax

Brand Names Associated with Amiodarone

  • Amiodarone
  • Cordarone®
  • Pacerone®

Medical Content Editor
Last updated Feb 27, 2024


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Interaction Effect

Increased exposure to venetoclax


Interaction Summary

Avoid concomitant use of venetoclax and a P-glycoprotein (P-gp) inhibitor due to the potential for increased venetoclax exposure. A single dose of rifampin given with venetoclax, a P-gp substrate, increased the venetoclax Cmax and AUC. If coadministration of venetoclax and a P-gp inhibitor is required, reduce the venetoclax dosage by at least 50% and closely monitor patients for venetoclax toxicity. Upon discontinuation of the P-gp inhibitor, wait 2 to 3 days before resuming the venetoclax dosage used prior to initiation of the inhibitor[1].


Severity

Major


Onset

Unspecified


Evidence

Theoretical


How To Manage Interaction

Avoid concomitant use of venetoclax and a P-glycoprotein (P-gp) inhibitor due to the potential for increased venetoclax exposure. If coadministration is required, reduce the venetoclax dosage by at least 50% and closely monitor patients for venetoclax toxicity. Upon discontinuation of the P-gp inhibitor, wait 2 to 3 days before resuming the venetoclax dosage used prior to initiation of the inhibitor[1].


Mechanism Of Interaction

Inhibition of P-glycoprotein-mediated efflux of venetoclax


Literature Reports

A) In a pharmacokinetic study in 11 healthy subjects, the administration of venetoclax with a single dose of rifampin 600 mg (OATP1B1/1B3 and P-gp inhibitor) increased the venetoclax Cmax by 106% and the AUC by 78% [1].

References

    1 ) Product Information: VENCLEXTA(TM) oral tablets, venetoclax oral tablets. AbbVie Inc. (per FDA), North Chicago, IL, 2016.

Venetoclax Overview

  • Venetoclax is used alone or in combination with obinutuzumab (Gazyva) or rituximab (Rituxan) to treat certain types of chronic lymphocytic leukemia (CLL; a type of cancer that begins in the white blood cells) or certain types of small lymphocytic lymphoma (SLL; a type of cancer that begins mostly in the lymph nodes). It is also used in combination with either azacitidine (Vidaza), decitabine (Dacogen), or cytarabine as a first treatment for acute myeloid leukemia (AML; a type of cancer that begins in the white blood cells) in people 75 years of age or older, or in adults who have medical conditions that prevents them from being treated with other chemotherapy medications. Venetoclax is in a class of medications called B-cell lymphoma-2 (BCL-2) inhibitors. It works by blocking the action of a certain protein in the body that helps cancer cells survive. This helps to kill cancer cells.

See More information Regarding Venetoclax

Amiodarone Overview

  • Amiodarone is used to treat and prevent certain types of serious, life-threatening ventricular arrhythmias (a certain type of abnormal heart rhythm when other medications did not help or could not be tolerated. Amiodarone is in a class of medications called antiarrhythmics. It works by relaxing overactive heart muscles.

See More information Regarding Amiodarone

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Definitions

Severity Categories

Contraindicated

These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.


Major

This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.


Moderate

This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.


Minor

While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.


Onset

Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.

Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.


Evidence

Level of documentation of the interaction.

Established: The interaction is documented and substantiated in peer-reviewed medical literature.

Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.


How To Manage The Interaction

Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.

It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.


Mechanism Of Interaction

The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.


Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.

Where Does Our Information Come From?

Information for our drug interactions is compiled from several drug compendia, including:

The prescribing information for each drug, as published on DailyMED, is also used. 

Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.

The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.