Can venetoclax/venetoclax be combined with posaconazole?

The U.S. Food and Drug Administration (FDA) currently approves the combination of a hypomethylating agent (HMA), azacytidine, or decitabine with venetoclax for acute myeloid leukemia (AML) patients over 75 years of age and those who are not candidates for intensive chemotherapy. Veneclat is a potent and selective B-cell lymphoma 2 (BCL-2) inhibitor. Venetoclax has maintained good efficacy whether used as a monotherapy or in combination with other drugs.

In the early stages of treatment, the risk of fungal infection cannot be ignored. Posaconazole (posaconazole) is usually used as a primary prevention drug and is superior to other azole drugs in preventing invasive fungal infections in neutropenic AML patients. Previous experience with venetoclax in patients with relapsed or refractory AML showed that venetoclax was well tolerated in single doses of 800 and 1200 mg in patients with AML. The drug interaction between venetoclax and posaconazole is well known, but trends in venetoclax serum levels when the two drugs overlap are unclear. Because it is a strong CYP3A4 inhibitor and helps increase the plasma concentration of venetoclax.

There is currently no clear evidence that these two drugs can be used together. Drug combinations usually require rigorous clinical trials and evaluations to ensure safety and effectiveness. In addition, drug-drug interactions may also affect their effects and side effects in the body. Therefore, it is not recommended to combine venetoclax and posaconazole without medical advice and guidance.