ABSTRACT
Bruton's tyrosine kinase (BTK) plays an essential role in B-cell development, differentiation and B-cell receptor (BCR) signaling. The use of Bruton's tyrosine kinase inhibitors (BTKi) in the treatment of lymphoid malignancies has dramatically increased, owing to both impressive efficacy and ease of administration. However, BTKi have a range of drug-drug and drug-food interactions, which may alter drug efficacy and/or increase toxicity. Healthcare professionals should be aware of the probability of drug interactions with BTKi and make recommendations accordingly. In this article, we discuss the relevant drug-drug and drug-food interactions associated with ibrutinib, acalabrutinib, and zanubrutinib, and provide clinical practice recommendations for managing these interactions based on the available literature.
Subject(s)
Agammaglobulinaemia Tyrosine Kinase/antagonists & inhibitors , Food-Drug Interactions , Hematologic Neoplasms/drug therapy , Lymphoproliferative Disorders/drug therapy , Protein Kinase Inhibitors/pharmacokinetics , Adenine/administration & dosage , Adenine/analogs & derivatives , Adenine/pharmacokinetics , Benzamides/administration & dosage , Benzamides/pharmacokinetics , Citrus paradisi , Citrus sinensis , Comorbidity , Cytochrome P-450 CYP2D6/metabolism , Cytochrome P-450 CYP2D6 Inducers/administration & dosage , Cytochrome P-450 CYP2D6 Inducers/pharmacokinetics , Cytochrome P-450 CYP2D6 Inhibitors/administration & dosage , Cytochrome P-450 CYP2D6 Inhibitors/pharmacokinetics , Cytochrome P-450 CYP3A/metabolism , Cytochrome P-450 CYP3A Inducers/administration & dosage , Cytochrome P-450 CYP3A Inducers/pharmacokinetics , Cytochrome P-450 CYP3A Inhibitors/administration & dosage , Cytochrome P-450 CYP3A Inhibitors/pharmacokinetics , Drug Interactions , Fruit and Vegetable Juices , Hematologic Neoplasms/epidemiology , Humans , Lymphoproliferative Disorders/epidemiology , Piperidines/administration & dosage , Piperidines/pharmacokinetics , Polypharmacy , Protein Kinase Inhibitors/administration & dosage , Pyrazines/administration & dosage , Pyrazines/pharmacokinetics , Pyrazoles/administration & dosage , Pyrazoles/pharmacokinetics , Pyrimidines/administration & dosage , Pyrimidines/pharmacokinetics , Signal TransductionABSTRACT
Aunque la evidencia de la desvenlafaxina en dolor neuropático es escasa, presenta unas características farmacocinéticas interesantes, como son no ser sustrato ni tener actividad sobre la glicoproteína P, y tener un metabolismo que prácticamente no depende del sistema del citocromo P450, lo que limita el riesgo de interacciones farmacocinéticas y los potenciales problemas de tolerabilidad asociados cuando se administra con fármacos que sean inhibidores moderados o potentes del CYP2D6 o con otros sustratos de esta isoenzima. Estas características hacen de la desvenlafaxina un antidepresivo distinto y especialmente útil en algunos subgrupos de pacientes con dolor crónico (como polimedicados y pacientes con insuficiencia hepática), donde la depresión comórbida es frecuente (AU)
Although evidence of desvenlafaxine in neuropathic pain is scarce, it presents some interesting pharmacokinetic properties, as it is not substrate or have activity on P-glycoprotein, and have a metabolism which practically does not depend on cytochrome P450 system, which limits the risk of pharmacokinetic interactions and potential problems associated tolerability when administered with drugs that are CYP2D6 moderate or potent inhibitors or other substrates of this isoenzyme. These characteristics make desvenlafaxine a different antidepressant especially useful in some subgroups of patients with chronic pain (as polypharmacy and patients with liver failure), where comorbid depression is frequent (AU)
