Venetoclax(continued)
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to decrease the exposure
tovenetoclax. Avoid.rStudy
▶Antifungals, azoles(fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure tovenetoclax. Avoid
moderate inhibitors of CYP3A4 or adjustvenetoclaxdose.
rStudy
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure tovenetoclax. Avoid potent
inhibitors of CYP3A4 or adjustvenetoclaxdose.rStudy
▶Aprepitantis predicted to increase the exposure tovenetoclax.
Avoid moderate inhibitors of CYP3A4 or adjustvenetoclax
dose.rStudy
▶Bosentanis predicted to decrease the exposure tovenetoclax.
Avoid.rStudy
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure tovenetoclax. Avoid moderate
inhibitors of CYP3A4 or adjustvenetoclaxdose.rStudy
▶Ciclosporinis predicted to increase the exposure tovenetoclax.
Avoid or monitor for toxicity.rTheoretical
▶Cobicistatis predicted to increase the exposure tovenetoclax.
Avoid potent inhibitors of CYP3A4 or adjustvenetoclaxdose.
rStudy
▶Venetoclaxslightly increases the exposure tocoumarins
(warfarin).oStudy
▶Crizotinibis predicted to increase the exposure tovenetoclax.
Avoid moderate inhibitors of CYP3A4 or adjustvenetoclax
dose.rStudy
▶Efavirenzis predicted to decrease the exposure tovenetoclax.
Avoid.rStudy
▶Enzalutamideis predicted to decrease the exposure to
venetoclax. Avoid.rStudy
▶Grapefruit juiceis predicted to increase the exposure to
venetoclax. Avoid.rTheoretical
▶HIV-protease inhibitorsare predicted to increase the exposure
tovenetoclax. Avoid potent inhibitors of CYP3A4 or adjust
venetoclaxdose.rStudy
▶Idelalisibis predicted to increase the exposure tovenetoclax.
Avoid potent inhibitors of CYP3A4 or adjustvenetoclaxdose.
rStudy
▶Imatinibis predicted to increase the exposure tovenetoclax.
Avoid moderate inhibitors of CYP3A4 or adjustvenetoclax
dose.rStudy
▶Lapatinibis predicted to increase the exposure tovenetoclax.
Avoid or monitor for toxicity.rTheoretical
▶Venetoclaxpotentially decreases the efficacy oflive vaccines.
Avoid.rTheoretical
▶Macrolides(azithromycin)decrease the exposure tovenetoclax.
nStudy
▶Macrolides(clarithromycin)are predicted to increase the
exposure tovenetoclax. Avoid potent inhibitors of CYP3A4 or
adjustvenetoclaxdose.rStudy
▶Macrolides(erythromycin)are predicted to increase the
exposure tovenetoclax. Avoid moderate inhibitors of CYP3A4
or adjustvenetoclaxdose.rStudy
▶Mitotaneis predicted to decrease the exposure tovenetoclax.
Avoid.rStudy
▶Netupitantis predicted to increase the exposure tovenetoclax.
Avoid moderate inhibitors of CYP3A4 or adjustvenetoclax
dose.rStudy
▶Nevirapineis predicted to decrease the exposure tovenetoclax.
Avoid.rStudy
▶Nilotinibis predicted to increase the exposure tovenetoclax.
Avoid moderate inhibitors of CYP3A4 or adjustvenetoclax
dose.rStudy
▶Ranolazineis predicted to increase the exposure tovenetoclax.
Avoid or monitor for toxicity.rTheoretical
▶Rifampicinis predicted to decrease the exposure tovenetoclax.
Avoid.rStudy
▶St John’s Wortis predicted to decrease the exposure to
venetoclax. Avoid.rStudy
▶Vemurafenibis predicted to increase the exposure to
venetoclax. Avoid or monitor for toxicity.rTheoreticalVenlafaxine→seeTABLE 13p. 850 (serotonin syndrome),TABLE 9
p. 849 (QT-interval prolongation),TABLE 11p. 849 (CNS depressant
effects),TABLE 4p. 847 (antiplatelet effects)
▶Abirateronepotentially increases the exposure tovenlafaxine.
rTheoretical
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure tovenlafaxine.o
Study→Also seeTABLE 9p. 849
▶Cobicistatis predicted to increase the exposure tovenlafaxine.
oStudy
▶H 2 receptor antagonists(cimetidine)slightly increase the
exposure tovenlafaxine.nStudy
▶Venlafaxineslightly increases the exposure tohaloperidol.
rStudy→Also seeTABLE 9p. 849→Also seeTABLE 11p. 849
▶HIV-protease inhibitorsare predicted to increase the exposure
tovenlafaxine.oStudy→Also seeTABLE 9p. 849
▶Idelalisibis predicted to increase the exposure tovenlafaxine.
oStudy
▶Macrolides(clarithromycin)are predicted to increase the
exposure tovenlafaxine.oStudy→Also seeTABLE 9p. 849
▶Tacrolimuspotentially increases the risk of serotonin
syndrome when given withvenlafaxine.rAnecdotal
Verapamil→see calcium channel blockers
Verteporfin
GENERAL INFORMATIONCaution on concurrent use with other
photosensitising drugs.
Vigabatrin→see antiepileptics
Vilanterol→see beta 2 agonists
Vildagliptin→seeTABLE 14p. 850 (antidiabetic drugs)
Vinblastine→see vinca alkaloids
Vinca alkaloids→seeTABLE 1p. 847 (hepatotoxicity),TABLE 15p. 850
(myelosuppression),TABLE 19p. 851 (ototoxicity),TABLE 12p. 850
(peripheral neuropathy),TABLE 5p. 847 (thromboembolism),TABLE 9
p. 849 (QT-interval prolongation)
vinblastine.vincristine.vindesine.vinflunine.vinorelbine..▶Antiarrhythmics(dronedarone)are predicted to increase the
exposure tovinca alkaloids.rTheoretical→Also seeTABLE 9
p. 849
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to decrease the exposure
tovinflunine. Avoid.rTheoretical→Also seeTABLE 12p. 850
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to decrease the exposure
tovinorelbine. Use with caution or avoid.rTheoretical→
Also seeTABLE 12p. 850
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to decrease the exposure
tovinca alkaloids(vinblastine, vincristine, vindesine).r
Theoretical→Also seeTABLE 1p. 847→Also seeTABLE 12p. 850
▶Antifungals, azoles(fluconazole, isavuconazole, itraconazole,
ketoconazole, posaconazole, voriconazole)are predicted to
increase the exposure tovinca alkaloids.rTheoretical→
Also seeTABLE 1p. 847→Also seeTABLE 9p. 849
▶Antifungals, azoles(miconazole)are predicted to increase the
concentration ofvinca alkaloids. Use with caution and adjust
dose.oTheoretical
▶Aprepitantis predicted to increase the exposure tovinca
alkaloids.rTheoretical
▶Asparaginasepotentially increases the risk of neurotoxicity
when given withvincristine.Vincristineshould be taken
3 to 24 hours beforeasparaginase.rAnecdotal→Also see
TABLE 1p. 847→Also seeTABLE 15p. 850
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure tovinca alkaloids.rTheoretical
▶Cobicistatis predicted to increase the exposure tovinca
alkaloids.rTheoretical
▶Crisantaspasepotentially increases the risk of neurotoxicity
when given withvincristine.Vincristineshould be taken
3 to 24 hours beforecrisantaspase.rAnecdotal→Also see
TABLE 1p. 847→Also seeTABLE 15p. 850
▶Crizotinibis predicted to increase the exposure tovinca
alkaloids.rTheoretical→Also seeTABLE 15p. 850→Also see
TABLE 9p. 8491008 Venetoclax—Vinca alkaloids BNFC 2018 – 2019
Interactions|Appendix 1A1