(for hematology and oncology aspects), and T.B. Search for other works by this author on:
This eMedTV article looks at drug interactions with pravastatin and also covers the risk of developing muscle problems when certain drugs are combined. A.H., N.W., T.B., and L.A.D. are the sole authors of this review article. Statins (such as atorvastatin, pravastatin, and lovastatin), a third class of medications used to lower cholesterol levels, may reduce the antioxidant activity of vitamin E. On the other hand, the combination of vitamin E supplements with statins may help protect blood vessels from dysfunction. These results must be translated into treatment adjustment recommendations for the clinical oncology practice, where these drugs are administered on a daily basis in patients receiving various co-medications.
Regular updates will be mandatory and so is the prospective reporting of unexpected clinical observations.Targeted cancer therapies have been designed to interact with particular proteins associated with tumor development or progression. TKIs are prescribed for prolonged periods, often in patients with comorbidities. and L.A.D.
Work on the cardiovascular drug interactions and TKIs has been done following a request from the Swiss GIST Patients Association (Correspondence: Laurent A. Decosterd, Division of Clinical Pharmacology – Laboratory, BH18 – Lab 218-226, Centre Hospitalier Universitaire Vaudois and University of Lausanne, CH-1011 Lausanne, Switzerland; e-mail: In the past decade, many tyrosine-kinase inhibitors have been introduced in oncology and haemato-oncology. Search for other works by this author on: Interactions involving azoles and immunosuppressants. We review here the available evidence and pharmacologic mechanisms of interactions between imatinib, dasatinib, and nilotinib and widely prescribed co-medications, including known inhibitors or inducers of cytochromes P450 or drug transporters. Pantoprazole is used to treat certain conditions in which there is too much acid in the stomach.
Aspirin, ASA; Citric Acid; Sodium Bicarbonate: (Moderate) Administer antacids at least 2 hours before or 2 hours after oral itraconazole to minimize the potential for an interaction.
Protonix; Descriptions.
“Absence of interaction” means that a clinical study concluded to the absence of interaction (reference number), and “—” means that no interaction is either reported or theoretically expected.TKIs in general can cause thrombocytopenia, which is usually of no clinical relevance. Strong inhibition, such as achieved with ketoconazole, caused a 40% increase of imatinib exposure in healthy volunteers.Concomitant administration of imatinib with inhibitors of both CYP3A4 and Pgp increase not only plasma but also intracellular imatinib concentrations.
11/9/2007
Switzerland: Compendium Suisse des médicaments 2010 [updated 2010; cited 2010].P-glycoprotein and breast cancer resistance protein influence brain distribution of dasatinib.Clinical pharmacokinetics of the BCR-ABL tyrosine kinase inhibitor nilotinib.Clinical pharmacokinetics of tyrosine kinase inhibitors.Pharmacokinetic/pharmacodynamic correlation and blood-level testing in imatinib therapy for chronic myeloid leukemia.Tyrosine kinase inhibitors concentration monitoring in chronic myeloid leukemia.A phase I study of single-agent nilotinib or in combination with imatinib in patients with imatinib-resistant gastrointestinal stromal tumors.Cardiovascular drug interactions with tyrosine kinase inhibitors.UpToDate.com 2010 [homepage] Waltham: UpToDate [updated 2010; cited 2010].Cancercare.on.ca [homepage]. Most of the interactions outlined in We advise the reader to regularly monitor for updates about this topic. A study showed that St John's wort does not alter the protein binding of imatinib over a wide range of concentrations in vivo.Interactions of potential clinical relevance can occur with calcium channel blockers such as verapamil and diltiazem, substrates of CYP3A4, which circulating levels are increased when associated with imatinib.Imatinib is also known to inhibit the O-glucuronidation of acetaminophen, possibly inducing hepatotoxicity and liver failure.Finally, physicians should be aware that patients with hypothyroid conditions who receive imatinib need increased levothyroxine doses.Dasatinib is metabolized in an active derivative and other inactive metabolites by the CYP3A4 isoenzyme and was also reported to be a substrate of BCRP and Pgp.In healthy subjects receiving ketoconazole, systemic exposure (AUC) to dasatinib was increased by 5-fold.Inhibitors of both CYP3A4 and Pgp will increase not only plasma but also intracellular concentrations of dasatinib; this is expected for verapamil,Concomitant administration of the CYP3A4 inducer rifampicin leads to a reduction of 80% in dasatinib exposure.Moreover, the solubility of dasatinib appears to be pH dependent.