Cancer Drug Interactions from Radboud UMC and University of Liverpool

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Drug interactions between oncolytics

No drug-drug interactions between oncolytic drugs are assessed in this interaction checker. Standard combinations of oncolytic drugs that are co-administered have been investigated in phase II and/or III studies on safety and efficacy outcomes. Therefore, the coadministration of these standard combinations of oncolytics are considered to be safe. If treatment with combinations of oncolytics is required due to concurrent multiple malignancies, contact the (hospital) pharmacist to discuss the potential interactions between oncolytics.

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Drug combinations may have been assessed either by study or within the product label, or an interaction may have been predicted based on the metabolic profiles of the drugs.

These drugs should not be coadministered

Potential clinically significant interaction that is likely to require additional monitoring, alteration of drug dosage or timing of administration.

Potential interaction likely to be of weak intensity. Additonal action/monitoring or dosage adjustment is unlikely to be required

No clinically significant interaction expected

There are no clear data, actual or theoretical, to indicate whether an interaction will occur

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Do Not Coadminister

Paclitaxel

Grapefruit juice

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied. Grapefruit juice is known to inhibit CYP3A4 enzymes and may increase concentrations of paclitaxel. The clinical relevance of this interaction is unknown. Therefore, coadministration is contraindicated.

Description:

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Potential Weak Interaction

Paclitaxel

Tropisetron

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a pharmacokinetic interaction is unlikely. Tropisetron is metabolised mainly by CYP2D6. Tropisetron is also a substrate of P-gp. Paclitaxel does not inhibit or induce CYPs or P-gp. However, a thorough QT study with paclitaxel has not been performed. In a prospective study, the QTc interval was significantly prolonged (p < 0.001) after treatment with paclitaxel. The net effect on QT prolongation has not been reported. Therefore, it is unknown whether a warning is in place when paclitaxel is coadministered with QT prolonging drugs, such as tropisetron. ECG monitoring should be considered.

Description:

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No Interaction Expected

Methotrexate

Doxepin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Doxepin is metabolised to nordoxepin (a metabolite with comparable pharmacological activity as the parent compound) mainly by CYP2C19. Doxepin and nordoxepin are both metabolised by CYP2D6. Methotrexate does not inhibit or induce CYPs.

Description:

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No Interaction Expected

Methotrexate

Diazepam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Diazepam is metabolised to nordiazepam (by CYP3A4 and CYP2C19) and to temazepam (mainly by CYP3A4). Temazepam is mainly glucuronidated. Methotrexate does not inhibit or induce CYPs or UGTs.

Description:

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No Interaction Expected

Methotrexate

Tropisetron

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tropisetron is metabolised mainly by CYP2D6 and is a substrate of P-gp. Methotrexate does not inhibit or induce CYPs or P-gp.

Description:

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No Interaction Expected

Paclitaxel

Doxepin

Quality of Evidence: Very Low

Summary:

Description:

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No Interaction Expected

Methotrexate

Grapefruit juice

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Grapefruit juice is known to inhibit CYP3A4 enzymes. Methotrexate is not metabolised by CYPs.

Description:

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No Interaction Expected

Paclitaxel

Diazepam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Diazepam is metabolised to nordiazepam (by CYP3A4 and CYP2C19) and to temazepam (mainly by CYP3A4). Temazepam is mainly glucuronidated. Paclitaxel does not inhibit or induce CYPs or UGTs.

Description:

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