Myborte Drug Interactions

Drugs Metabolized by Hepatic Microsomal Enzymes: Bortezomib may inhibit cytochrome P-450 (CYP) microsomal isoenzyme 2C19; potential pharmacokinetic interaction (increased exposure to drugs metabolized by CYP2C19). Bortezomib is a poor inhibitor of CYP1A2, CYP3A4, CYP2C9, and CYP2D6 and does not induce CYP1A2 or CYP3A4 in vitro.
Drugs Affecting Hepatic Microsomal Enzymes: In vitro studies indicate that bortezomib is a substrate mainly for CYP1A2, CYP3A4, and CYP2C19; the manufacturer states that patients receiving bortezomib with CYP3A4 inhibitors (e.g., ketoconazole, ritonavir) or inducers should be closely monitored for potential toxicities or reduced efficacy associated with such concomitant therapy.
A 35% increase in mean bortezomib area under the concentration-time curve (AUC) was observed when the drug was administered concomitantly with ketoconazole, a potent CYP3A inhibitor, in 12 patients. However, concomitant administration of bortezomib and omeprazole, a potent inhibitor of CYP2C19 had no effect on bortezomib exposure in a study in 17 patients.
Melphalan and Prednisone: A 17% increase in mean bortezomib AUC was reported when the drug was administered concomitantly with melphalan and prednisone in 21 patients. However, the manufacturer states that this increase is unlikely to be clinically relevant.
Oral Antidiabetic Agents: In clinical studies, hypoglycemia and hyperglycemia have been reported in patients with diabetes mellitus who received bortezomib concomitantly with oral antidiabetic agents. If bortezomib is used concomitantly with oral antidiabetic agents, blood glucose concentrations should be monitored carefully and dosage of the antidiabetic agent adjusted as necessary.
Hypotensive Agents: Potential interaction (increased risk of hypotension) when bortezomib is used with drugs that can cause hypotension. Dosage adjustment of hypotensive agents may be necessary.