Abemaciclib interactions

Food & lifestyle

• grapefruit juice

  Moderate

  Metabolism

  Grapefruit juice may increase the plasma concentrations of abemaciclib. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit. Inhibition of hepatic CYP450 3A4 may also contribute. The interaction has not been studied with grapefruit juice, but has been reported for other CYP450 3A4 inhibitors.

  What to do: Abemaciclib may be administered with or without food. Patients should avoid consumption of grapefruit and grapefruit juice during treatment with abemaciclib.

  1 source

  1. "Product Information. Verzenio (abemaciclib)." Lilly, Eli and Company (2017):

Conditions

Conditions in which Abemaciclib needs care, as documented in this source.

• Liver Diseases

  Major

  The dosing frequency of abemaciclib should be reduced to once daily when it is administered to patients with severe hepatic impairment (Child-Pugh C). No dosage adjustments are necessary for patients with mild or moderate hepatic impairment (Child-Pugh A or B). Hepatotoxicity has been reported with the use of abemaciclib. It is recommended to monitor liver function tests prior to the start of therapy, every 2 weeks for the first 2 months, monthly for the next 2 months, and as clinically indicated. Dose interruption, dose reduction, dose discontinuation, or delay in starting treatment cycles is recommended for patients who develop persistent or recurrent Grade 2, or Grade 3 or 4, hepatic transaminase elevation.

  1 source

  1. "Product Information. Verzenio (abemaciclib)." Lilly, Eli and Company (2017):

• Diarrhea

  Moderate

  Diarrhea, sometimes associated with dehydration and infection, has occurred in patients receiving abemaciclib. Diarrhea incidence was greatest during the first month of abemaciclib dosing. Care should be exercised when treating patients with symptoms of diarrhea. Treatment discontinuation may be required for Grade 3 or 4 diarrhea, or diarrhea that requires hospitalization. Resume treatment at the next lower dose once toxicity resolves to <= Grade 1 diarrhea.

  1 source

  1. "Product Information. Verzenio (abemaciclib)." Lilly, Eli and Company (2017):

• Lung Diseases

  Moderate

  The use of certain multikinase inhibitors has been associated with pulmonary toxicity. Serious cases of interstitial lung disease (ILD), including fatal cases and interstitial pneumonitis or pulmonary fibrosis have been reported. Caution is recommended when using these agents in patients with a history of interstitial pneumonitis or pulmonary fibrosis or those patients presenting with acute onset of new or progressive unexplained pulmonary symptoms such as dyspnea, cough, and fever pending diagnostic evaluation. If ILD is confirmed, permanently discontinue these agents and institute appropriate measures. Immediately withhold treatment in patients diagnosed with ILD/pneumonitis and permanently discontinue therapy if no other potential causes of ILD/pneumonitis have been identified.

  7 sources

  1. "Product Information. Vandetanib (vandetanib)." Astra-Zeneca Pharmaceuticals (2011):
  2. "Product Information. Zelboraf (vemurafenib)." Genentech (2011):
  3. "Product Information. Xalkori (crizotinib)." Pfizer U.S. Pharmaceuticals Group (2011):
  4. "Product Information. Mekinist (trametinib)." GlaxoSmithKline (2013):
  5. "Product Information. Zykadia (ceritinib)." Novartis Pharmaceuticals (2014):
  6. "Product Information. Zydelig (idelalisib)." Gilead Sciences (2014):
  7. "Product Information. Alecensa (alectinib)." Genentech (2015):

• Lung Diseases, Interstitial

  Moderate

  Patients treated with abemaciclib have reported severe, life-threatening, or fatal interstitial lung disease (ILD) and/or pneumonitis. It is recommended to monitor patients for pulmonary symptoms indicative of ILD/pneumonitis such as, hypoxia, cough, dyspnea, or interstitial infiltrates on radiologic exams. Dose interruption or dose reduction is recommended for patients who develop persistent or recurrent Grade 2 ILD/pneumonitis. Permanently discontinue therapy in all patients with Grade 3 or 4 ILD or pneumonitis.

  1 source

  1. "Product Information. Verzenio (abemaciclib)." Lilly, Eli and Company (2017):

• Neutropenia

  Moderate

  Neutropenia, including febrile neutropenia has occurred in patients receiving abemaciclib. Care should be exercised when prescribing this agent to patients with preexisting neutropenia. It is recommended to monitor complete blood counts prior to the start of therapy, every 2 weeks for the first 2 months, monthly for the next 2 months, and as clinically indicated. Dose interruption, dose reduction, or delay in starting treatment cycles is recommended for patients who develop Grade 3 or 4 neutropenia.

  1 source

  1. "Product Information. Verzenio (abemaciclib)." Lilly, Eli and Company (2017):

• Venous Thromboembolism

  Moderate

  Venous thromboembolic events have been reported with the use of abemaciclib. Care should be exercised when using this agent in patients with risk factors or history of venous thromboembolic events. It is recommended to monitor patients for signs and symptoms of venous thrombosis and pulmonary embolism and treat as medically appropriate.

  1 source

  1. "Product Information. Verzenio (abemaciclib)." Lilly, Eli and Company (2017):

Therapeutic duplication

Drug classes that overlap with Abemaciclib, so taking both doubles up the same effect. This source publishes no per-row citations for duplication.

• cdk 4/6 inhibitors

  The recommended maximum number of medicines in the 'CDK 4/6 inhibitors' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'CDK 4/6 inhibitors' category.

  Example product in the source data (US market): Letrozole/ribociclib