Recommendations and considerations for drug interactions1

Drug Interactions* With Akynzeo®

Agents Interaction Exposure Recommendation/
consideration
Dexamethasone Yes
Dexamethasone
Lower dexamethasone dosage
Midazolam Yes
Midazolam
Potential effects should be considered
Chemotherapeutic agents metabolized by CYP3A4 Yes
Agent
Caution and careful monitoring
Strong CYP3A4 inducers Yes
AKYNZEO
Avoid use with AKYNZEO
Strong CYP3A4 inhibitors Yes
AKYNZEO
No dosage adjustment necessary
CYP3A4 substrates Yes
Agent
Avoid use with AKYNZEO for one week OR consider dose reduction
Serotonergic drugs Yes Potential for serotonin syndrome Caution and careful monitoring for symptoms of serotonin syndrome
Oral contraceptives No
CYP2C9 substrates
(eg, warfarin)
No

*Drug interactions shown here are based on in vitro or in vivo studies of AKYNZEO capsules, netupitant, fosnetupitant, or palonosetron. Please see the Full Prescribing Information for AKYNZEO for data supporting these recommendations.

CINV
=chemotherapy-induced nausea and vomiting.