Drug interactions of Gilteritinib

1 Effect of Other Drugs on XOSPATA  

Combined P-gp and Strong CYP3A Inducers  

Concomitant use of XOSPATA with a combined P-gp and strong CYP3A inducer decreases gilteritinib exposure which  may decrease XOSPATA efficacy. Avoid concomitant use of XOSPATA with  combined P-gp and strong CYP3A inducers.  

Strong CYP3A Inhibitors  

Concomitant use of XOSPATA with a strong CYP3A inhibitor increases gilteritinib exposure. Consider alternative therapies that are not strong CYP3A inhibitors. If the concomitant use of these inhibitors is  considered essential for the care of the patient, monitor patient more frequently for XOSPATA adverse reactions.  Interrupt and reduce XOSPATA dosage in patients with serious or life-threatening toxicity.  

2 Effect of XOSPATA on Other Drugs  

Drugs that Target 5HT2B Receptor or Sigma Nonspecific Receptor  

Concomitant use of gilteritinib may reduce the effects of drugs that target the 5HT2B receptor or the sigma nonspecific  receptor (e.g., escitalopram, fluoxetine, sertraline). Avoid concomitant use of these drugs with XOSPATA unless their use  is considered essential for the care of the patient.  

P-gp, BCRP, and OCT1 Substrates  

Based on in vitro data, gilteritinib is a P-gp, breast cancer resistant protein (BCRP), and organic cation transporter 1  (OCT1) inhibitor. Coadministration of gilteritinib may increase the exposure of P-gp, BCRP, and OCT1 substrates, which  may increase the incidence and severity of adverse reactions of these substrates.  For P-gp, BCRP, or OCT1 substrates where small concentration changes may lead to serious adverse reactions, decrease  the dose or modify the dosing frequency of such substrate and monitor for adverse reactions as recommended in the  respective prescribing information.

FDA,2022.01