What should we pay attention to about the drug interactions of ivonib/Tosuvo?

Ivosidenib is an oral small molecule IDH1 inhibitor, mainly used to treat IDH1-mutated acute myeloid leukemia (AML) and some IDH1-mutated solid tumors. In clinical application, drug interactions are a link that requires special attention, because the metabolic pathway of ivonib is mainly completed through the CYP3A4 enzyme system of the liver. Therefore, when used together with other drugs, it may lead to changes in blood drug concentration, thereby affecting the efficacy or increasing the risk of side effects.

When using ivosidenib, patients need to avoid taking potent CYP3A4 inhibitors at the same time, such as ketoconazole, itraconazole and other antifungal drugs. Such drugs may significantly increase the plasma concentration of ivosidenib and increase the risk of QT interval prolongation, abnormal liver function and other adverse reactions. On the contrary, strong CYP3A4 inducers, such as rifampicin, carbamazepine and other anti-epileptic drugs, will accelerate the metabolism of ivonib and reduce the plasma concentration, which may lead to insufficient drug efficacy and reduce the ability to control IDH1 mutant tumors.

In addition, caution should be exercised when coadministering ivonib with other potential QT prolonging drugs. For example, certain antiarrhythmic drugs, some antibiotics or antipsychotic drugs may increase cardiac risks when used concurrently with ivonib. Therefore, electrocardiogram monitoring and necessary dose adjustments are required before combined use. For patients with abnormal liver function or who use multiple drugs metabolized by liver enzymes at the same time, individualized medication and blood drug concentration monitoring should be carried out under the guidance of a professional doctor.

It is worth noting that there may be mild interactions between ivonib and conventional supportive care drugs such as antiemetics, analgesics, and anti-infective drugs, but in most cases it will not affect the clinical efficacy and only the dose needs to be monitored according to the patient's specific conditions.

Reference: https://www.tibsovo.com/