Brigatinib interactions

Food & lifestyle

• grapefruit juice

  Moderate

  Metabolism

  Grapefruit juice may increase the plasma concentrations of brigatinib. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit. In general, the effect of grapefruit juice is concentration-, dose- and preparation-dependent, and can vary widely among brands. Certain preparations of grapefruit juice (e.g., high dose, double strength) have sometimes demonstrated potent inhibition of CYP450 3A4, while other preparations (e.g., low dose, single strength) have typically demonstrated moderate inhibition.

  What to do: Brigatinib may be taken with or without food. Patients should avoid consumption of grapefruit and grapefruit juice during treatment with brigatinib.

  1 source

  1. "Product Information. Alunbrig (brigatinib)." Ariad Pharmaceuticals Inc (2017):

Conditions

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

• Kidney Diseases

  Moderate

  Following a single dose of 90 mg, unbound brigatinib systemic exposure was 86% higher in subjects with severe renal impairment [creatinine clearance (CrCl) 15 to 29 mL/min] compared to subjects with normal renal function. It is recommended to reduce dose by approximately 50% (i.e., from 180 mg to 90 mg, or from 90 mg to 60 mg) in these patients. No dose adjustment is recommended for patients with mild or moderate renal impairment [creatinine clearance (CrCl) 30 to 89 mL/min].

  1 source

  1. "Product Information. Alunbrig (brigatinib)." Ariad Pharmaceuticals Inc (2017):

• Liver Diseases

  Moderate

  Following a single dose of 90 mg, unbound brigatinib systemic exposure was 37% higher in subjects with severe hepatic impairment (Child-Pugh C) compared to subjects with normal hepatic function. It is recommended to reduce the dose by approximately 40% (i.e., from 180 mg to 120 mg, 120 mg to 90 mg, or from 90 mg to 60 mg) in these patients. No dose adjustment is recommended for patients with mild hepatic impairment (Child-Pugh A) or moderate hepatic impairment (Child-Pugh B).

  1 source

  1. "Product Information. Alunbrig (brigatinib)." Ariad Pharmaceuticals Inc (2017):

• Lung Diseases

  Moderate

  Severe, life-threatening, and fatal pulmonary adverse reactions consistent with interstitial lung disease (ILD)/pneumonitis have occurred with the use of brigatinib. It is recommended to monitor for new or worsening respiratory symptoms (e.g., dyspnea, cough, etc.), particularly during the first week of initiating this drug. Withhold brigatinib in any patient with new or worsening respiratory symptoms, and promptly evaluate for ILD/pneumonitis or other causes of respiratory symptoms (e.g., pulmonary embolism, tumor progression, and infectious pneumonia). Dose modifications or permanent discontinuation may be necessary.

  1 source

  1. "Product Information. Alunbrig (brigatinib)." Ariad Pharmaceuticals Inc (2017):