Ivosidenib interactions

Food & lifestyle

• grapefruit juice

  Major

  Metabolism

  Grapefruit juice may increase the plasma concentrations of ivosidenib. 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.

  What to do: Ivosidenib may be administered with or without food, but should not be administered with a high-fat meal. Patients should avoid consumption of grapefruit and grapefruit juice during treatment with ivosidenib.

  1 source

  1. "Product Information. Tibsovo (ivosidenib)." Agios Pharmaceuticals, Inc. (2018):

Conditions

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

• Liver Failure

  Moderate

  The pharmacokinetics of ivosidenib in patients with severe renal impairment (eGFR <30 mL/min/1.73m2,), renal impairment requiring dialysis, moderate hepatic impairment (total bilirubin 1.5 to 3.0 times the ULN and any value for AST), or severe hepatic impairment (total bilirubin greater than 3.0 times the ULN and any value for AST) is unknown. Caution is advised if using in these patients.

  1 source

  1. "Product Information. Tibsovo (ivosidenib)." Agios Pharmaceuticals, Inc. (2018):

• Long QT Syndrome

  Moderate

  Patients treated with ivosidenib can develop QTc prolongation and ventricular arrhythmias. Concomitant use of ivosidenib with drugs known to prolong the QTc interval (e.g., antiarrhythmic medicines, fluoroquinolones, triazole antifungals, 5-HT3 receptor antagonists) and CYP3A4 inhibitors may increase the risk of QTc interval prolongation. Conduct monitoring of electrocardiograms (ECGs) and electrolytes. In patients with congenital long QTc syndrome, congestive heart failure, electrolyte abnormalities, or those who are taking medications known to prolong the QTc interval, more frequent monitoring may be necessary. Treatment should be interrupted or dose reduced if QTc increases to greater than 480 msec. Permanently discontinue ivosidenib in patients who develop QTc interval prolongation with signs or symptoms of life-threatening arrhythmia.

  1 source

  1. "Product Information. Tibsovo (ivosidenib)." Agios Pharmaceuticals, Inc. (2018):