What are the drug interactions of Ivosidenib?

Ivosidenib has interactions with a variety of drugs, which may affect its efficacy or increase the risk of adverse reactions. Close monitoring and dosage adjustment are required when used in combination.

What are the drug interactions of Ivosidenib?

The three categories of common interactions listed below are only partial representative examples. In actual clinical medication, the patient’s complete medication history shall be comprehensively taken into consideration.

Amiodarone

Ivosidenib, a kinase inhibitor that prolongs the QT interval (highest risk), may enhance the QT interval-prolonging effect of amiodarone.

Management Recommendations: Consider alternative drug combinations. If co-administration is unavoidable, monitor for QT interval prolongation and ventricular arrhythmias. Patients with other risk factors for QT interval prolongation may be at higher risk. Consider adjusting the treatment regimen.

Amisulpride

Ivosidenib, a drug that prolongs the QT interval (highest risk), may enhance the QT interval-prolonging effect of amisulpride.

Management Recommendations: Consider alternative drug combinations. Patients with other risk factors (e.g., advanced age, female gender, bradycardia, hypokalemia, hypomagnesemia, heart disease, and higher plasma drug concentrations) may be at an increased risk of such toxicities. Consider adjusting the treatment regimen.

Azithromycin (Systemic Administration)

Ivosidenib, a drug that prolongs the QT interval (highest risk), may enhance the QT interval-prolonging effect of azithromycin (systemic administration).

Management Recommendations: Consider alternative drug combinations. Patients with other risk factors (e.g., advanced age, female gender, bradycardia, hypokalemia, hypomagnesemia, heart disease, and higher plasma drug concentrations) may be at an increased risk of such toxicities. Consider adjusting the treatment regimen.

For more information about the use of Tibsovo (Ivosidenib), please refer to the package insert or consult your doctor or pharmacist.

How to use Ivosidenib?

Ivosidenib is a prescription drug. Treatment should be initiated and supervised by a physician experienced in cancer therapy.

This product is available as tablets for oral administration.

For the treatment of acute myeloid leukemia (AML): The recommended dosage is once daily, in combination with azacitidine. Administer consecutively for seven days at the start of each 28-day treatment cycle (also referred to as a "course of treatment"). Treatment should continue as long as clinical benefit is observed or the patient can tolerate the medication.

For the treatment of cholangiocarcinoma: The recommended dosage is once daily. Treatment should continue until disease progression or unacceptable toxicity occurs.

How does Ivosidenib work?

Some patients with AML or cholangiocarcinoma have mutations in the gene encoding the IDH1 protein. This mutation leads to abnormal protein function, resulting in the overproduction of a substance called 2-hydroxyglutarate (2-HG). Elevated 2-HG levels induce cellular changes that may contribute to cancer development.

The active ingredient in Tibsovo (Ivosidenib) blocks the activity of the mutated IDH1 protein, thereby reducing 2-HG production. This, in turn, slows down the growth and spread of cancer cells.