Which drugs should not be taken together with crizotinib?

Crizotinib, as a drug targeting specific types of lung cancer, has significant efficacy, but special attention needs to be paid to its interactions with other drugs during use.

1.CYP3AStrong inhibitor: When crizotinib is combined with cytochromeP450(CYP)3A are used together, the plasma concentration of crizotinib will increase, which may increase the risk of adverse reactions. Including: clarithromycin, indinavir, itraconazole, ketoconazole, nefazodone, nelfinavir, ritonavir, saquinavir, troleandomycin and voriconazole, etc.

2.CYP3AStrong inducers: These drugs will reduce the plasma concentration of crizotinib, which may weaken its efficacy.

Including carbamazepine, phenobarbital, phenytoin, rifampicin, rifabutin, etc.

3.Drugs that are easily altered by crizotinib (CYP3Asubstrates): Crizotinib can inhibit it in vivo or in vitro CYP3A, therefore special caution is required when used in combination with certain CYP3A substrates with a narrow therapeutic index. Including alfentanil, cyclosporine, dihydroergotamine, ergotamine, fentanyl, pimozide, quinidine, sirolimus and tacrolimus, etc.

4.Drugs that can prolong the QT interval: Crizotinib itself can prolong the QT/QTc interval. Combination with drugs that can also prolong the QT interval may increase the risk of arrhythmia. Usually include some antiarrhythmic drugs, antidepressants and certain antibiotics.

5.Drugs that can cause bradycardia: Since crizotinib can cause bradycardia, concomitant use with drugs that can also cause bradycardia should be avoided. Such as metoprolol, bisoprolol, verapamil, clonidine and digoxin, etc.

In addition to the above drugs, patients should also avoid ingesting grapefruit or grapefruit juice while taking crizotinib, as they may also affect the metabolism of crizotinib.