Drug interactions of Crizotinib

1. Effect of Other Drugs on Crizotinib

Strong or Moderate CYP3A Inhibitors

Concomitant use of crizotinib with strong CYP3A inhibitors increases crizotinib plasma concentrations, which may increase the risk of adverse reactions of Crizotinib. Avoid  concomitant use of strong CYP3A inhibitors. If concomitant use of strong CYP3A inhibitors is unavoidable, reduce the Crizotinib dosage. Avoid grapefruit or grapefruit juice which may also increase plasma concentrations of crizotinib. Use caution with concomitant use of moderate CYP3A inhibitors.

Strong CYP3A Inducers

Concomitant use of crizotinib with strong CYP3A inducers decreases crizotinib plasma concentrations, which may decrease the efficacy of Crizotinib. Avoid concomitant use of  strong CYP3A inducers.

2. Effect of Crizotinib on Other Drugs

CYP3A Substrates

Concomitant use of crizotinib increases plasma concentrations of CYP3A substrates, which may increase the risk of adverse reactions of these substrates. Avoid concomitant use of Crizotinib with CYP3A substrates where minimal concentration changes may lead to serious adverse reactions. If concomitant use of Crizotinib is unavoidable, decrease the CYP3A substrate dosage in accordance with approved product labeling.

3. Drugs That Prolong the QT Interval

Crizotinib can prolong the QT/QTc interval. Avoid concomitant use of Crizotinib with drugs that prolong the  QT interval.

4. Drugs That Cause Bradycardia

Crizotinib can cause bradycardia. Avoid concomitant use of Crizotinib with drugs that cause bradycardia  (e.g., beta-blockers, non-dihydropyridine calcium channel blockers, clonidine, and digoxin).

from FDA，2023.09