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Dexamethasone + Levofloxacin + Osimertinib

Major 16 published sources

This interaction is documented in this data source.

Dexamethasone + Levofloxacin
Checked as Dexamethasone + Levofloxacin
Osimertinib
Checked as Osimertinib

2 documented mechanisms

This source documents more than one distinct mechanism for this pair. Each is shown with its own effect, advice and sources rather than merged into one.

  1. Mechanism 1: Synergy

    Major

    via Levofloxacin and Osimertinib

    What happens

    Osimertinib may cause dose-related prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong the QT interval may result in additive effects and increased risk of ventricular arrhythmias including torsade de pointes and sudden death.

    What to do

    Caution is recommended if osimertinib is used in combination with other drugs that can prolong the QT interval. ECG and serum electrolytes, including potassium, magnesium and calcium, should be monitored before starting osimertinib therapy and periodically during treatment.

    5 sources

    1. "Product Information. Tagrisso (osimertinib)." Astra-Zeneca Pharmaceuticals, Wilmington, DE.
    2. Warrington SJ, Ankier SI, Turner P "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology 15 (1986): 31-7
    3. "Product Information. Fycompa (perampanel)." Eisai Inc, Teaneck, NJ.
    4. Gilman AG, Rall TW, Nies AS, Taylor P, eds. "Goodman and Gilman's the Pharmacological Basis of Therapeutics. 8th ed." New York, NY: Pergamon Press Inc. (1990):
    5. "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc, Rockville, MD.

  2. Mechanism 2: Metabolism

    Moderate

    via Dexamethasone and Osimertinib

    What happens

    Coadministration with inducers of CYP450 3A4 may decrease the plasma concentrations of osimertinib, which has been shown in vitro to be primarily metabolized by the isoenzyme. Reduced therapeutic efficacy of osimertinib may occur. However, no pharmacokinetic data are available from drug interaction studies.

    What to do

    The potential for diminished pharmacologic effects of osimertinib should be considered during coadministration with CYP450 3A4 inducers. Alternative treatments may be required if an interaction is suspected.

    11 sources

    1. "Product Information. Tagrisso (osimertinib)." Astra-Zeneca Pharmaceuticals, Wilmington, DE.
    2. "Product Information. Diabinese (chlorpropamide)." Pfizer US Pharmaceuticals, New York, NY.
    3. Skillman TG, Feldman JM "The pharmacology of sulfonylureas." Am J Med 70 (1981): 361-72
    4. Jerntorp P, Almer LO "Chlorpropamide-alcohol flushing in relation to macroangiopathy and peripheral neuropathy in non-insulin dependent diabetes." Acta Med Scand 656 (1981): 33-6
    5. "Product Information. Glucotrol (glipizide)." Pfizer US Pharmaceuticals, New York, NY.
    6. "Position Statement: evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes related complications. American Diabetes Association." Diabetes Care 25(Suppl 1) (2002): S50-S60
    7. Hartling SG, Faber OK, Wegmann ML, Wahlin-Boll E, Melander A "Interaction of ethanol and glipizide in humans." Diabetes Care 10 (1987): 683-6
    8. Barnett AH, Spiliopoulos AJ, Pyke DA, et al "Metabolic studies in chlorpropamide-alcohol flush positive and negative type 2 (non-insulin dependent) diabetic patients with and without retinopathy." Diabetologia 24 (1983): 213-5
    Show all 11 sources
    1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
    2. "Product Information. Diabeta (glyburide)." Hoechst Marion-Roussel Inc, Kansas City, MO.
    3. Jerntorp P, Almer LO, Holin H, et al "Plasma chlorpropamide: a critical factor in chlorpropamide-alcohol flush." Eur J Clin Pharmacol 24 (1983): 237-42

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