Which Drugs Interact with Ivosidenib?

Ivosidenib is mainly metabolized by the CYP3A4 enzyme. Co-administration with drugs that affect the activity of this enzyme may significantly alter the plasma concentration of ivosidenib, requiring careful evaluation and the implementation of appropriate management measures.

Which Drugs Interact with Ivosidenib?

Listed below are some examples of clinically significant interactions (with a focus on the risk of QT interval prolongation):

Chloroquine

Ivosidenib, a drug with the highest risk of QT interval prolongation, may enhance the QTc-prolonging effect of chloroquine.

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

Citalopram

Ivosidenib, a drug with the highest risk of QT interval prolongation, may enhance the QTc-prolonging effect of citalopram. Co-administration should be avoided.

Clarithromycin

Ivosidenib, a drug with the highest risk of QT interval prolongation, may enhance the QTc-prolonging effect of clarithromycin. Co-administration should be avoided.

Clofazimine

Ivosidenib, a drug with the highest risk of QT interval prolongation, may enhance the QTc-prolonging effect of clofazimine.

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

The above are only typical examples. Actual drug interactions may involve a broader range of drug classes (e.g., antacids, hormonal drugs, etc.). During treatment with ivosidenib, patients should proactively inform their physicians of all medications they are taking (including prescription drugs, over-the-counter drugs, traditional Chinese medicines and dietary supplements), and strictly follow the doctor's advice for dosage adjustment and monitoring.

Severe Adverse Reactions of Ivosidenib

Contact your healthcare provider immediately if you experience any of the following symptoms:

Differentiation Syndrome (applicable only to patients with AML or MDS): Fever, sudden weight gain, difficulty breathing, chest pain, swelling of the legs.

Cardiac Arrhythmias: Irregular heartbeat, blurred vision, dizziness, fainting, loss of consciousness.

What is the Indication of Ivosidenib?

1. For the treatment of acute myeloid leukemia (AML) with IDH1 mutation:

2. Applicable to newly diagnosed adult patients aged 75 years or older, or adult patients who cannot tolerate intensive chemotherapy.

3. Applicable to adult patients with relapsed cancer after prior treatment (relapsed or refractory AML).

4. For the treatment of relapsed or refractory myelodysplastic syndromes (MDS) with IDH1 mutation in adult patients.

5. For the treatment of advanced or metastatic cholangiocarcinoma with IDH1 mutation in adult patients who have received prior treatment.