Venclexta Drug Interactions

Effects of Other Drugs on VENCLEXTA: Strong or Moderate CYP3A Inhibitors or P-gp Inhibitors: Concomitant use with a strong or moderate CYP3A inhibitor or a P-gp inhibitor increases venetoclax C_max and AUC_0-INF [see Pharmacology: Pharmacokinetics under Actions], which may increase VENCLEXTA toxicities, including the risk of TLS [see Tumor Lysis Syndrome under Precautions].
Concomitant use with a strong CYP3A inhibitor at initiation and during the ramp-up phase in patients with CLL is contraindicated [see Contraindications].
In patients with CLL taking a steady daily dosage (after ramp-up phase), consider alternative medications or adjust VENCLEXTA dosage and monitor more frequently for adverse reactions [see Dosage Modifications for Adverse Reactions and Dosage Modifications for Drug Interactions under Dosage & Administration].
In patients with AML, adjust VENCLEXTA dosage and monitor more frequently for adverse reactions [see Dosage Modifications for Adverse Reactions and Dosage Modifications for Drug Interactions under Dosage & Administration].
Resume the VENCLEXTA dosage that was used prior to concomitant use with a strong or moderate CYP3A inhibitor or a P-gp inhibitor 2 to 3 days after discontinuation of the inhibitor [see Dosage Modifications for Adverse Reactions and Dosage Modifications for Drug Interactions under Dosage & Administration].
Avoid grapefruit products, Seville oranges, and starfruit during treatment with VENCLEXTA, as they contain inhibitors of CYP3A.
Strong or Moderate CYP3A Inducers: Concomitant use with a strong CYP3A inducer decreases venetoclax C_max and AUC_0-INF [see Pharmacology: Pharmacokinetics under Actions], which may decrease VENCLEXTA efficacy. Avoid concomitant use of VENCLEXTA with strong CYP3A inducers or moderate CYP3A inducers.
Effect of VENCLEXTA on Other Drugs: Warfarin: Concomitant use of VENCLEXTA increases warfarin C_max and AUC_0-INF [see Pharmacology: Pharmacokinetics under Actions], which may increase the risk of bleeding. Monitor international normalized ratio (INR) more frequently in patients using warfarin concomitantly with VENCLEXTA.
P-gp Substrates: Concomitant use of VENCLEXTA increases C_max and AUC_0-INF of P-gp substrates [see Pharmacology: Pharmacokinetics under Actions], which may increase toxicities of these substrates. Avoid concomitant use of VENCLEXTA with a P-gp substrate. If a concomitant use is unavoidable, separate dosing of the P-gp substrate at least 6 hours before VENCLEXTA.