Drug interactions with the tyrosine kinase inhibitors ... · PDF fileDrug interactions with the tyrosine kinase inhibitors imatinib, dasatinib and nilotinib Table from the following

Drug interactions with the tyrosine kinase inhibitors

imatinib, dasatinib and nilotinib

Table from the following article: Haouala A, Widmer N, Duchosal MA, Montemurro M, Buclin T,

Decosterd LA. Drug interactions with the tyrosine kinase inhibitors imatinib, dasatinib, and nilotinib.

Blood 2010. http://dx.doi.org/10.1182/blood-2010-07-294330

Legend:

The Table (in 17 parts) summarizes observed or potential drug interactions between TKIs and

commonly concomitantly prescribed drugs or classical interacting agents (lines) sorted according to

the ATC classification. The arrows ↑↑↑↑ and ↓↓↓↓ indicate an increase or decrease of drug concentration

respectively. Boldface text outlines interactions reported in the literature (reference number), whereas

standard characters represent potential interactions predicted from theoretical considerations (but not

yet reported in the literature). Absence of interaction means that a clinical study concluded to the

absence of interaction (reference number), and a box shaded in grey means that no interaction is

either reported or theoretically expected

Disclaimer:

This table summarizes potential drug interactions between some commonly prescribed drugs (lines)

and three tyrosine kinase inhibtors (columns). Each cell indicates the type of interaction expected

when the drug is taken together with the corresponding tyrosine kinase inhibitor. The data presented

are however only indicative and do not replace clinical judgment necessary when treating patients with

multiple drugs. Not all interactions are expected to have clinical significance and/or to imply dosage

adjustment. It is also of importance to check regularly for updated literature on this topic.

References:

See full article.

Haouala et al Drug interactions with the tyrosine kinase inhibitors imatinib, dasatinib and nilotinib

2

Alimentary tract and metabolism

Imatinib Dasatinib Nilotinib

PPI

Omeprazole • Inhibition of Pgp by omeprazole :

↑↑↑↑ imatinib exposure • ↓↓↓↓ dasatinib absorption

Esomeprazole • Inhibition of Pgp by esomeprazole :

↑↑↑↑ imatinib exposure •↓↓↓↓dasatinib absorption

Pantoprazole • Inhibition of Pgp by pantoprazole:

↑↑↑↑ imatinib exposure • ↓↓↓↓ dasatinib absorption

H2-antagonists

Cimetidine

•Inhibition of CYP 3A4 and Pgp by cimetidine :

↑↑↑↑ imatinib exposure • Inhibition of hOCT1 by cimetidine :

↓↓↓↓ imatinib intracellular exposure

• ↓↓↓↓ dasatinib absorption • Inhibition of CYP 3A4 by cimetidine :

↑↑↑↑ nilotinib exposure

Ranitidine

• Inhibition of Pgp by ranitidine :

↑↑↑↑ imatinib exposure • Inhibition of hOCT1 by ranitidine :


• ↓↓↓↓ dasatinib absorption

Antiemetics

Metoclopramide

• ↑↑↑↑ QT interval

(additive effect)

→→→→ monitor ECG


(additive effect)


Antidiabetic drugs

Insulin

Metformin • Inhibition of hOCT1 by metformin :


Glibenclamide

• Inhibition of CYP 3A4 and 2C9 by imatinib:

↑↑↑↑ glibenclamide exposure • Inhibition of Pgp by glibenclamide :

↑↑↑↑ imatinib exposure

• Inhibition of CYP 3A4 by dasatinib:

↑↑↑↑ glibenclamide exposure • Inhibition of Pgp by glibenclamide :

↑↑↑↑ dasatinib exposure

• Inhibition of CYP 3A4 and 2C9 by nilotinib:

↑↑↑↑ glibenclamide exposure

Acarbose

Rosiglitazone • Inhibition of CYP 2C9 by imatinib:

↑↑↑↑ rosiglitazone exposure

• Inhibition of CYP 2C9 by nilotinib:

↑↑↑↑ rosiglitazone exposure

Pioglitazone


↑↑↑↑ pioglitazone exposure





Nateglinide


↑↑↑↑ nateglinide exposure





Repaglinide • Inhibition of CYP 3A4 by imatinib:


• Inhibition of CYP 3A4 and 2C8 by dasatinib:





3

Blood and blood forming organs


Antiplatelet druga

Clopidogrel


↑↑↑↑ clopidogrel exposure

↓↓↓↓ clopidogrel bioactivation



↓↓↓↓ clopidogrel bioactivation • Thrombocytopenic effect of

dasatinib:

↑↑↑↑ risk of bleeding

• Inhibition of CYP 3A4 by nilotinib:


↓↓↓↓ clopidogrel bioactivation

Anticoagulantsa

Acenocoumarol

• Inhibition of CYP 2C9 by imatinib:

↑↑↑↑ anticoagulation

→→→→ monitor PT/INR

• Thrombocytopenic effect of dasatinib:





Phenprocoumon









Warfarin









Heparin

• Inhibition of Pgp by heparin:




• Inhibition of Pgp by heparin:


Enoxaparin



Nadroparin



Dalteparin




4

Cardiovascular system


Calcium channel blockers

Verapamil

• Inhibition of CYP 3A4 and Pgp by imatinib:

↑↑↑↑ verapamil exposure • Inhibition of CYP 3A4 and Pgp by

verapamil:



↑↑↑↑ verapamil exposure • Inhibition of CYP 3A4 and Pgp by

verapamil:


• Inhibition of CYP 3A4 and Pgp by

nilotinib: ↑↑↑↑ verapamil exposure

• Inhibition of CYP 3A4 by verapamil:


Diltiazem

• Inhibition of CYP 3A4 by

imatinib: ↑↑↑↑ diltiazem exposure

• Inhibition of CYP 3A4 and Pgp by diltiazem:



↑↑↑↑ diltiazem exposure • Inhibition of CYP 3A4 and Pgp by

diltiazem: ↑↑↑↑ dasatinib exposure


↑↑↑↑ diltiazem exposure • Inhibition of CYP 3A4 by

diltiazem:


Nifedipine

• Inhibition of CYP 3A4 by imatinib:

↑↑↑↑ nifedipine exposure



• Inhibition of CYP3A4 by nilotinib:


Amlodipine


↑↑↑↑ amlodipine exposure





NO precursors

Molsidomine

Isosorbid mononitrate (ISMN)


↑↑↑↑ ISMN exposure





Isosorbid dinitrate (ISDN)


↑↑↑↑ ISDN exposure


↑↑↑↑ ISDN exposure



Nitroglycerine

HMG-CoA reductase inhibitors

Simvastatin


↑↑↑↑ simvastatin exposure

• Inhibition of Pgp by simvastatin:




• Inhibition of Pgp by simvastatin:


•Inhibition of CYP 3A4 by nilotinib:


Pravastatin

Atorvastatin


↑↑↑↑ atorvastatin exposure

• Inhibition of Pgp by atorvastatin:




• Inhibition of Pgp by atorvastatin:




Rosuvastatin

Antiarrhythmic drugs

Amiodarone


↑↑↑↑ amiodarone exposure • Inhibition of CYP3A4 and Pgp by

amiodarone:

↑↑↑↑ imatinib exposure Inhibition of hOCT1 by amiodarone :



↑↑↑↑ amiodarone exposure • Inhibition of CYP 3A4 and Pgp by

amiodarone:


• Inhibition of Pgp and CYP 3A4 by

nilotinib: ↑↑↑↑ amiodarone exposure • Inhibition of CYP 3A4 by

amiodarone:


•↑↑↑↑ QT interval (additive effect)

=> monitor ECG

Quinidine


↑↑↑↑ quinidine exposure

• Inhibition of Pgp by quinidine:

↑↑↑↑ imatinib exposure • Inhibition of hOCT1 by quinidine :




• Inhibition of Pgp by quinidine:





5


Diuretics

Furosemide • Absence of interaction

Torasemide • Inhibition of CYP 2C9 by imatinib:

↑↑↑↑ torasemide exposure


↑↑↑↑ torasemide exposure

Hydrochlorothiazide

Spironolactone

• Inhibition of Pgp by spironolactone:


• Inhibition of Pgp by spironolactone:


Beta blockers

Metoprolol

• Inhibition of CYP 2D6 by imatinib:

↑↑↑↑ metoprolol exposure

• Inhibition of Pgp by metoprolol:


• Inhibition of CYP 2D6 by nilotinib:

↑↑↑↑ metoprolol exposure

Bisoprolol


↑↑↑↑ bisoprolol exposure





Carvedilol

• Inhibition of CYP 2C9 and 2D6 by imatinib:

↑↑↑↑ carvedilol exposure • Inhibition of Pgp by carvedilol:


• Inhibition of Pgp by carvedilol:


• Inhibition of CYP 2C9 and 2D6 by nilotinib:

↑↑↑↑ carvedilol exposure

Atenolol • Absence of interaction

ACE inhibitors

Captopril


↑↑↑↑ captopril exposure • Inhibition of Pgp by captopril:


• Inhibition of Pgp by captopril:



↑↑↑↑ captopril exposure

Enalapril


↑↑↑↑ enalapril exposure • Inhibition of Pgp by enalapril:


• Inhibition of Pgp by enalapril:

↑↑↑↑dasatinib exposure


↑↑↑↑ enalapril exposure

Ramipril

Lisinopril

• Inhibition of Pgp by imatinib:

↑↑↑↑ lisinopril exposure • Inhibition of Pgp by lisinopril:


• Inhibition of Pgp by lisinopril:


AT II receptor

blockers

Losartan

• Inhibition of CYP 2C9 and 3A4 by imatinib:

losartan exposure and

↓↓↓↓ losartan bioactivation • Inhibition of Pgp by losartan:



↑↑↑↑ losartan exposure

• Inhibition of Pgp by losartan:


• Inhibition of CYP 2C9 and 3A4 by nilotinib:

↑↑↑↑ losartan exposure and

↓↓↓↓ losartan bioactivation

Candesartan

Cardiac

glycosides

Digoxin • ↓↓↓↓ digoxin absorption

(unknown mechanism)


(additive effect)



(additive effect)


• Inhibition of Pgp by nilotinib:

↑↑↑↑ digoxin exposure


6

Hormonal preparations


Corticosteroids

Prednisone

Dexamethasone

• Induction of CYP 3A4 by dexamethasone :

↓↓↓↓ imatinib exposure


↓↓↓↓ dasatinib exposure


↓↓↓↓ nilotinib exposure

Betamethasone

Thyroid therapy

Levothyroxine

• Induction of UGTs by imatinib :

↓↓↓↓ levothyroxine • Inhibition of CYP 3A4 by

levothyroxine:


• Inhibition of CYP 3A4 by levothyroxine:


• Inhibition of CYP 3A4 by levothyroxine:


Carbimazole

Antineoplastic

agents

Cyclophosphamide

• Inhibition of CYP 2D6 and 3A4 by imatinib:

↑↑↑↑ cyclophosphamide exposure

↓↓↓↓ cyclophosphamide bioactivation


↑↑↑↑ cyclophosphamide exposure

↓↓↓↓ cyclophosphamide bioactivation

• Induction of CYP 2B6 by nilotinib:

↓↓↓↓ cyclophosphamide exposure

↑↑↑↑ cyclophosphamide bioactivation

Antiestrogen

agent

Tamoxifen

• Inhibition of CYP 2D6 and 3A4 by imatinib:

↑↑↑↑ tamoxifen exposure

↓↓↓↓ tamoxifen bioactivation




• Inhibition of CYP 2D6 and 3A4 by nilotinib:




7

Anti-infectives


Penicillins

Amoxicillin

Flucloxacillin

Cephalosporins

Céfuroxime

Cefpodoxime

Ceftriaxone

Macrolides

Clarithromycin

• Inhibition of CYP 3A4 and Pgp by clarithromycin:


• Inhibition of CYP 3A4 and Pgp by clarithromycin:


• Inhibition of CYP 3A4 by clarithromycin:


Azithromycin

Erythromycin

• Inhibition of CYP 3A4 and Pgp by erythromycin:


• Inhibition of CYP 3A4 and Pgp by erythromycin:


• Inhibition of CYP 3A4 by erythromycin:


Tertracyclines

Doxycyclin

Quinolones

Ciprofloxacin

• Inhibition of Pgp by ciprofloxacin:



(additive effect)


• Inhibition of Pgp by ciprofloxacin:



(additive effect)


Levofloxacin

• Inhibition of Pgp by levofloxacin:

↑↑↑↑ imatinib exposure • Inhibition of hOCT1 by

levofloxacine :



(additive effect)


• Inhibition of Pgp by levofloxacin:



(additive effect)


Norfloxacin


(additive effect)



(additive effect)


Sulfonamides

Co-trimoxazole


↑↑↑↑ co-trimoxazole


↑↑↑↑ co-trimoxazole


8


Azoles

Itraconazole

• Inhibition of CYP 3A4 and Pgp by itraconazole:


• Inhibition of CYP 3A4 and Pgp by itraconazole:


• Inhibition of CYP 3A4 by itraconazole:


Fluconazole

• Inhibition of CYP 3A4 and Pgp by fluconazole:


• Inhibition of CYP 3A4 and Pgp by fluconazole:



(additive effect)


• Inhibition of CYP 3A4 by fluconazole:



(additive effect)


Voriconazole

• Inhibition of CYP 3A4 by voriconazole:





(additive effect)





(additive effect)


Ketoconazole

• Inhibition of CYP 3A4 and Pgp by ketoconazole:


• Inhibition of CYP 3A4 and Pgp by ketoconazole:



(additive effect)


• Inhibition of CYP 3A4 by ketoconazole:



(additive effect)


Allylamine

Terbinafine


↑↑↑↑ terbinafine exposure





Nitroimidazole

Metronidazole

Antiviral/Nucleoside analog Aciclovir • Absence of interaction

Valaciclovir • Absence of interaction

Ganciclovir

• Inhibition of hOCT1 by ganciclovir :


Valganciclovir

• Inhibition of hOCT1 by ganciclovir :


Antimycobacterials

Rifampicine

• Induction of CYP 3A4 by rifampicine:






Isoniazide

Ethambutol


9


Protease inhibitors

Ritonavir

• Inhibition of CYP 3A4 and Pgp by ritonavir:



(additive effect)


• Inhibition of CYP 3A4 by ritonavir:



(additive effect)


Saquinavir


↑↑↑↑ saquinavir exposure • Inhibition of hOCT1 by saquinavir :



↑↑↑↑ saquinavir exposure

• Inhibition of CYP 3A4 and Pgp by nilotinib:

↑↑↑↑ saquinavir exposure

Darunavir

• Inhibition of CYP 3A4 by darunavir:






Atazanavir


↑↑↑↑ atazanavir exposure





Tipranavir


↑↑↑↑ tipranavir exposure

• Inhibition of CYP 3A4 by tipranavir:










Indinavir


↑↑↑↑ indinavir exposure • Inhibition of hOCT1 by indinavir :



↑↑↑↑ indinavir exposure


↑↑↑↑ indinavir exposure

Nucleoside and

nucleotide reverse

transcriptase inhibitors

Lamivudine

• Inhibition of hOCT1 by lamivudine :


Emtricitabine

Zidovudine

Non-nucleoside reverse transcriptase

inhibitors

Efavirenz


↑↑↑↑ efavirenz exposure • Induction of CYP 3A4 by

efavirenz:



↑↑↑↑ efavirenz exposure • Induction of CYP 3A4 by efavirenz:



↑↑↑↑ efavirenz exposure • Induction of CYP 3A4 by efavirenz:


Nevirapine


↑↑↑↑ nevirapine exposure • Induction of CYP 3A4 by

nevirapine:



↑↑↑↑ nevirapine exposure • Induction of CYP 3A4 by nevirapine:



↑↑↑↑ nevirapine exposure • Induction of CYP 3A4 by nevirapine:


Etravirine

• Inhibition of CYP 2C9 and 3A4 by imatinib:

↑↑↑↑ etravirine exposure

• Induction of CYP 3A4 by etravirine:






• Inhibition of CYP 2C9 and 3A4 by nilotinib:





10


Antimalarial drugs

Quinine


↑↑↑↑ quinidine exposure • Inhibition of CYP 2D6 and Pgp by

quinidine:


• Inhibition of hOCT1 by quinine :



dasatinib:





nilotinib:


Chloroquine

• Inhibition of Pgp by chloroquine:


• Inhibition of hOCT1 by chloroquine :


• Inhibition of Pgp by chloroquine:



(additive effect)



(additive effect)


Mefloquine


↑↑↑↑ mefloquine exposure • Inhibition of Pgp by mefloquine:



dasatinib:

↑↑↑↑ mefloquine exposure

• Inhibition of Pgp by mefloquine:



(additive effect)


• Inhibition of CYP 3A4 and Ppg by nilotinib:

↑↑↑↑ mefloquine exposure


(additive effect)


Proguanil

• Inhibition of CYP 2C19 and Pgp by imatinib:

↑↑↑↑ proguanil exposure

↓↓↓↓ proguanil bioactivation

Atovaquone

Doxycycline


11

Immunomodulating agents


Immunosuppressants

Ciclosporin


↑↑↑↑ ciclosporin exposure

• Inhibition of Pgp and CYP 3A4 by ciclosporin:



dasatinib:

↑↑↑↑ ciclosporin exposure • Inhibition of CYP3A4 and

Pgp by ciclosporin:


•Inhibition of CYP 3A4 and

Pgp by nilotinib:

↑↑↑↑ ciclosporin exposure • Inhibition of CYP3A4 by

ciclosporin:


Tacrolimus


↑↑↑↑ tacrolimus exposure • Inhibition of Pgp by tacrolimus:



↑↑↑↑ tacrolimus exposure • Inhibition of Pgp by

tacrolimus:



↑↑↑↑ tacrolimus exposure

Sirolimus


↑↑↑↑ sirolimus exposure





Everolimus


↑↑↑↑ everolimus exposure





Mycophenolate mofetil

Methotrexate

Azathioprine


12

Musculo-skeletal system


NSAIDs

Aspirin



Ibuprofen


↑↑↑↑ ibuprofen exposure

• Inhibition of CYP 2C8 by dasatinib:


• Inhibition of CYP 2C8 and 2C9 by nilotinib:


Mefenacid


↑↑↑↑ mefenacid exposure



• Inhibition of CYP 2C8 and 2C9 by nilotinib:


Metamizole

• Induction of CYP 3A4 by metamizole:


• Induction of CYP 3A4 by metamizole :


• Induction of CYP 3A4 by metamizole :


Diclofenac


↑↑↑↑ diclofenac exposure • Inhibition of Pgp by

diclofenac:



↑↑↑↑ diclofenac exposure

• Inhibition of Pgp by diclofenac:


• Inhibition of CYP 2C8 and 2C9 and by nilotinib:

↑↑↑↑ diclofenac exposure

Antigout

preparations

Allopurinol


13

Nervous system


SSRI

Fluoxetine


↑↑↑↑ fluoxetine exposure


(additive effect)



(additive effect)


Fluvoxamine


↑↑↑↑ fluvoxamine exposure


↑↑↑↑ fluvoxamine exposure

Paroxetine

• Inhibition of CYP 2D6 by

imatinib:

↑↑↑↑ paroxetine exposure


nilotinib:

↑↑↑↑ paroxetine exposure

Citalopram

• Inhibition of CYP 3A4 and 2D6 by imatinib:

↑↑↑↑ citalopram exposure



• Inhibition of CYP 3A4 and 2D6 by nilotinib:


Sertraline


↑↑↑↑ sertraline exposure





SSNRI

Venlafaxine


↑↑↑↑ venlafaxine exposure




(additive effect)





(additive effect)


Duloxetine


imatinib:

↑↑↑↑ duloxetine exposure


nilotinib:

↑↑↑↑ duloxetine exposure

Tetracyclic

agent

Mirtazapine

• Inhibition of CYP 3A4 and

2D6 by imatinib:

↑↑↑↑ mirtazapine exposure


dasatinib:


• Inhibition of CYP 3A4 and 2D6 by nilotinib :


Tricyclic agents Trimipramine


↑↑↑↑ trimipramine exposure


(additive effect)



(additive effect)



↑↑↑↑ trimipramine exposure

Amitriptyline


↑↑↑↑ amitriptyline exposure




(additive effect)





(additive effect)


Phenothiazines

Levomepromazine


imatinib:

↑↑↑↑ levomepromazine exposure


↑↑↑↑ levomepromazine exposure


14


Z-drugs

Zolpidem


↑↑↑↑ zolpidem exposure





Zaleplon


↑↑↑↑ zaleplon exposure





Zopiclon


↑↑↑↑ zopiclon exposure





Benzodiazepines

Alprazolam


↑↑↑↑ alprazolam exposure





Bromazepam


↑↑↑↑ bromazepam exposure




nilotinib:


Clonazepam


↑↑↑↑ clonazepam exposure




nilotinib:


Oxazepam

Lorazepam

Diazepam


↑↑↑↑ diazepam exposure





Midazolam


↑↑↑↑ midazolam exposure • Inhibition of Pgp by midazolam:

↑↑↑↑ imatinib exposure • Inhibition of hOCT1 by

midazolam :



↑↑↑↑ midazolam exposure • Inhibition of Pgp by midazolam:



↑↑↑↑ midazolam exposure

Barbiturates

Phenobarbital

• Inhibition of CYP 2C9 and 2C19 by imatinib:

↑↑↑↑ phenobarbital exposure • Induction of CYP 3A4 by

phenobarbital:


• Induction of CYP 3A4 by phenobarbital:



↑↑↑↑ phenobarbital exposure • Induction of CYP 3A4 by

phenobarbital:



15


Antipsychotic agents

Haloperidol


↑↑↑↑ haloperidol exposure


↑↑↑↑ haloperidol exposure


(additive effect)



(additive effect)


Clozapine


↑↑↑↑ clozapine exposure





Olanzapine

Risperidone


↑↑↑↑ risperidone exposure


(additive effect)



(additive effect)


Antiseizure drugs

Phenytoin

• Induction of CYP 3A4 by phenytoin :






Valproic acid

• Inhibition of CYP 2C9 and 2C19 by imatinib:

↑↑↑↑ valproic acid exposure • Inhibition of CYP 3A4 by valproic

acid:


• Inhibition of CYP 3A4 by valproic acid :



↑↑↑↑ valproic acid exposure • Inhibition of CYP 3A4 by

valproic acid :


Carbamazepine

• Induction of CYP 3A4 and Pgp by carbamazepine:


• Induction of CYP 3A4 and Pgp by carbamazepine:


• Induction of CYP 3A4 by carbamazepine:


Lamotrigine

Gabapentin

Topiramate

• Induction of CYP 3A4 by topiramate :






Levetiracetam

Antimaniac

drug

Lithium

Aminoketone

Bupropion

• Induction of CYP 2B6 by nilotinib:

↓↓↓↓ bupropion exposure

↑↑↑↑ bupropion bioactivation


16


Opioids

Morphine

Tramadol

• Inhibition of CYP 3A4 and 2D6 by imatinib :

↑↑↑↑ tramadol exposure

↓↓↓↓ tramadol bioactivation

• Inhibition of CYP 3A4 by dasatinib :




↓↓↓↓ tramadol bioactivation

Methadone


imatinib :

↑↑↑↑ methadone exposure • Inhibition of Pgp by

methadone:

↑↑↑↑ imatinib exposure.


(additive effect)


↑↑↑↑ methadone exposure • Inhibition of Pgp by methadone:

↑↑↑↑ dasatinib exposure.

• Inhibition of CYP 3A4 by nilotinib :

↑↑↑↑ methadone exposure • Induction of CYP 2B6 by

nilotinib:

↓↓↓↓ methadone exposure


(additive effect)

Hydromorphone

Oxycodone

• Inhibition of CYP 3A4 and 2D6 by imatinib :

↑↑↑↑ oxycodone exposure

↓↓↓↓ oxycodone bioactivation





↓↓↓↓ oxycodone bioactivation

Buprenorphine

• Inhibition of CYP 3A4 by imatinib :

↑↑↑↑ buprenorphine exposure





Other

Acetaminophen

• Inhibition of o-glucuronidation by imatinib :

↑↑↑↑ acetaminophen exposure

Antimigraine

preparations Dihydroergotamine


↑↑↑↑ dihydroergotamine exposure





Sumatriptan


17

Respiratory system


H1-antagonists

Cetirizin • Inhibition of Pgp by nilotinib:

↑↑↑↑ cetirizin exposure

Levocetirizin • Inhibition of Pgp by nilotinib:

↑↑↑↑ cetirizin exposure

Loratadin

• Inhibition of CYP 3A4 by imatinib :

↑↑↑↑ loratadin exposure



• Inhibition of Pgp by nilotinib:


Fexofenadin

Anti asthma drugs

Salbutamol

Theophylline


18

Miscellaneous


St John’s wort

• Induction of CYP 3A4 by St John’s wort:






Grapefruit

• Inhibition of CYP 3A4 and Pgp by grapefruit:


• Inhibition of CYP 3A4 and Pgp by grapefruit:


• Inhibition of CYP 3A4 by grapefruit:


Licorice

• Inhibition of CYP 3A4 by licorice:






a TKIs in general can cause thrombocytopenia, which is usually of no clinical relevance, please take that into consideration when coadministrating with anticoagulant medication.

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Drug interactions with the tyrosine kinase inhibitors ... · PDF fileDrug interactions with the tyrosine kinase inhibitors imatinib, dasatinib and nilotinib Table from the following