Tangerine - Cometriq (Cabozantinib) Interaction

Interaction Details

Cabozantinib is classified as belonging to the following category: Cytochrome P450 3A4 (Cyp3A4) Substrates

In vitro, tangeretin, a constituent of tangerine, induces a 52% increase in the metabolism of midazolam by cytochrome P450 3A4 (CYP3A4). This suggests that tangeretin may stimulate CYP3A4 activity. However, in humans, drinking tangerine juice 200 mL slightly delayed the absorption, but did not affect the metabolism, of midazolam, a CYP3A4 substrate. Theoretically, tangerine juice might increase CYP3A4 activity and decrease levels of drugs metabolized by this enzyme. However, this effect is unlikely.
Some drugs metabolized by CYP3A4 include amitriptyline (Elavil), amiodarone (Cordarone), citalopram (Celexa), felodipine (Plendil), lansoprazole (Prevacid), ondansetron (Zofran), prednisone (Deltasone, Orasone), sertraline (Zoloft), sibutramine (Meridia), and many others.

Interaction Rating

Likelihood of Occurrence

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.

References

• Backman, J. T., Maenpaa, J., Belle, D. J., Wrighton, S. A., Kivisto, K. T., and Neuvonen, P. J. Lack of correlation between in vitro and in vivo studies on the effects of tangeretin and tangerine juice on midazolam hydroxylation. Clin Pharmacol Ther 2000;

Cabozantinib Overview

• Cabozantinib (Cabometyx, Cometriq) is used to treat a number of conditions.

• Cabozantinib (Cabometyx) is used:

  • to treat advanced renal cell carcinoma (RCC; a type of cancer that begins in the cells of the kidneys).

  • in combination with nivolumab (Opdivo) to treat advanced RCC in patients who have not yet received a treatment for RCC.

  • to treat hepatocellular carcinoma (HCC; a type of liver cancer) in people who were previously treated with sorafenib (Nexafar).

  • to treat a certain type of thyroid cancer in adults and children 12 years of age and older that has spread to nearby tissues or to other parts of the body and that has not responded to previous a treatment and cannot be treated with radioactive iodine.

• Cabozantinib (Cometriq) is used:

  • to treat a certain type of thyroid cancer that is getting worse and that has spread to other parts of the body.

• Cabozantinib is in a class of medications called kinase inhibitors. It works by blocking the action of an abnormal protein that signals cancer cells to multiply. This helps slow or stop the spread of cancer cells.

Tangerine - More Interactions

Tangerine interacts with 622 drugs

Interaction Rating Key

These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.