Enzalutamide: Understanding and Managing Drug Interactions to Improve Patient Safety and Drug Efficacy

IF 4 2区 医学 Q1 PHARMACOLOGY & PHARMACY Drug Safety Pub Date : 2024-04-12 DOI:10.1007/s40264-024-01415-7
Brandon W. Lennep, Jesse Mack, Srinivasu Poondru, Elizabeth Hood, Brooke D. Looney, Monique Williams, Judeth J. Bianco, Alicia K. Morgans
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Abstract

Enzalutamide is an oral androgen receptor signaling inhibitor utilized in the treatment of men with prostate cancer. It is a moderate inducer of the cytochrome P450 (CYP) enzymes CYP2C9 and CYP2C19, and a strong inducer of CYP3A4. It was also shown to be a mild inhibitor of the efflux transporter P-glycoprotein in patients with prostate cancer. Enzalutamide is primarily metabolized by CYP3A4 and CYP2C8. The risk of enzalutamide drug interactions arises primarily when it is coadministered with other drugs that interact with these CYPs, including CYP3A4. In this review, we begin by providing an overview of enzalutamide including its dosing, use in special populations, pharmacokinetics, changes to its prescribing information, and potential for interaction with coadministered drugs. Enzalutamide interactions with drugs from a wide range of medication classes commonly prescribed to patients with prostate cancer are described, including oral androgen deprivation therapy, agents used to treat a range of cardiovascular diseases, antidiabetic drugs, antidepressants, anti-seizure medications, common urology medications, analgesics, proton pump inhibitors, immunosuppressants, and antigout drugs. Enzalutamide interactions with common vitamins and supplements are also briefly discussed. This review provides a resource for healthcare practitioners and patients that will help provide a basis for the understanding and management of enzalutamide drug–drug interactions to inform decision making, improve patient safety, and optimize drug efficacy.

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恩杂鲁胺:了解和管理药物相互作用,提高患者安全和药物疗效
恩杂鲁胺是一种口服雄激素受体信号抑制剂,用于治疗男性前列腺癌。它是细胞色素 P450(CYP)酶 CYP2C9 和 CYP2C19 的中度诱导剂,也是 CYP3A4 的强诱导剂。研究还表明,恩杂鲁胺对前列腺癌患者的外排转运体 P 糖蛋白有轻度抑制作用。恩杂鲁胺主要通过CYP3A4和CYP2C8代谢。恩杂鲁胺药物相互作用的风险主要出现在与其他与这些CYPs(包括CYP3A4)相互作用的药物联合用药时。在本综述中,我们首先概述了恩杂鲁胺,包括其剂量、在特殊人群中的使用、药代动力学、处方信息的变化以及与联合用药发生相互作用的可能性。介绍了恩杂鲁胺与前列腺癌患者常用药物的相互作用,包括口服雄激素剥夺疗法、治疗各种心血管疾病的药物、抗糖尿病药物、抗抑郁药物、抗癫痫药物、常见的泌尿科药物、镇痛药、质子泵抑制剂、免疫抑制剂和抗痛风药物。此外,还简要讨论了恩杂鲁胺与常见维生素和补充剂的相互作用。本综述为医疗从业人员和患者提供了一个资源库,有助于为理解和处理恩杂鲁胺药物间相互作用提供依据,从而为决策提供信息、提高患者安全性并优化药物疗效。
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来源期刊
Drug Safety
Drug Safety 医学-毒理学
CiteScore
7.60
自引率
7.10%
发文量
112
审稿时长
6-12 weeks
期刊介绍: Drug Safety is the official journal of the International Society of Pharmacovigilance. The journal includes: Overviews of contentious or emerging issues. Comprehensive narrative reviews that provide an authoritative source of information on epidemiology, clinical features, prevention and management of adverse effects of individual drugs and drug classes. In-depth benefit-risk assessment of adverse effect and efficacy data for a drug in a defined therapeutic area. Systematic reviews (with or without meta-analyses) that collate empirical evidence to answer a specific research question, using explicit, systematic methods as outlined by the PRISMA statement. Original research articles reporting the results of well-designed studies in disciplines such as pharmacoepidemiology, pharmacovigilance, pharmacology and toxicology, and pharmacogenomics. Editorials and commentaries on topical issues. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in Drug Safety Drugs may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances.
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