What are the drug interactions of Trabectedin? How many treatment courses are generally available?
The drug interactions of Trabectedin mainly involve the effects of hepatic enzyme metabolism and specific drug combination risks. It is necessary to pay special attention to the dosage adjustment and contraindications when CYP3A4 inhibitors/inducers, P-glycoprotein modulators, and other drugs are used in combination.
1. Liver drug enzyme related interactions
(1) CYP3A4 inhibitors: Strong inhibitors such as clarithromycin and itraconazole may significantly increase the blood concentration and toxicity of tramadol, and should be avoided in combination or adjusted in dosage.
(2) CYP3A4 inducers: Strong inducers such as rifampicin and carbamazepine may reduce the efficacy of tramadol and should be avoided in combination.
2. Effects of P-glycoprotein modulators
(1) P-gp inhibitors: may increase the absorption of tramadol, toxicity reactions need to be monitored.
(2) P-gp substrate: Caution should be exercised when using it in combination, as tramadol may affect the concentration of other P-gp substrate drugs.
3. Specific drug and food taboos
(1) Grapefruit/Grapefruit Juice: May significantly increase exposure to tramadol by inhibiting CYP3A4, should be avoided during treatment.
(2) Hormonal contraceptive pills: Qubetidine may reduce the efficacy of estrogen/progesterone, and non hormonal contraceptive measures are recommended.
4. Other precautions for interactions
(1) Hepatotoxic drugs: Combination use may worsen liver function damage, and monitoring needs to be strengthened.
(2) Bone marrow suppressive drugs: may enhance hematological toxicity, risk benefit ratio needs to be evaluated.
5. Standard treatment framework
(1) Basic plan: Intravenous infusion of 1.5mg/m ² every 21 days is considered as one treatment cycle, and the first efficacy evaluation is usually conducted 2-3 cycles later.
(2) Continuous standard: Clinical trials have shown a median treatment period of 6-8 cycles, but some patients with good response may last for more than 12 cycles.
6. Indications for termination of treatment course
(1) Disease progression: When imaging confirms tumor growth ≥ 20% or new lesions appear, treatment should be terminated.
(2) Toxicity limitation: The course of treatment should be discontinued when irreversible grade 3-4 hepatotoxicity or sustained hematological toxicity occurs.
Disclaimer：《What are the drug interactions of Trabectedin? How many treatment courses are generally available?》Edited and sorted by Seagull Pharmacy's editors. Please contact us in time if there is any infringement. In addition, the suggestions for drug usage, dosage and disease mentioned in the article are only for medical staff's reference, and can not be used as any basis for medication！