Interactions with other drugs

Brigatinib/Brigatinib (Brigatinib), as a selective ALK inhibitor, is increasingly used in the treatment of ALK-positive non-small cell lung cancer, and its interaction mechanism with other drugs has gradually become a key variable affecting efficacy and safety.

Since brigatinib is mainly metabolized by liver metabolizing enzymes, especiallyCYP3A subtype, any drug that can affect the activity of this enzyme may change the concentration of brigatinib in the body and cause fluctuations in drug efficacy. Drugs that can enhance the activity of CYP3A may accelerate the metabolism of brigatinib, causing its concentration to decrease, thereby weakening the effect of inhibiting the ALK signaling pathway; while some CYP3A inhibitors may increase the exposure level of brigatinib in the body, leading to an increased incidence of adverse reactions, including changes in blood pressure, increase in creatinine, respiratory discomfort, etc.

In addition, brigatinib also affects a variety of transmembrane transporters. For example, when certain P-gp substrate drugs are used together with brigatinib, their distribution pattern in the body may change, thereby increasing or decreasing the effective concentration of the drug, making the clinically observed response uncertain. Therefore, it is usually recommended to conduct a comprehensive assessment of the patient's medication background before treatment, especially when cardiovascular drugs, antiviral drugs, antiepileptic drugs, lipid-lowering drugs, and hormonal drugs are involved. The possibility of interaction needs to be considered in advance.

Judging from clinical practice experience, the innate metabolism characteristics of brigatinib determine that its concomitant drugs must be precisely controlled in combination treatment regimens to avoid excessive exposure or insufficient efficacy due to interactions. Physicians usually adjust concomitant medications based on the enzymatic properties of the drug, including reducing the dose of certain drugs, delaying the administration time, or directly switching to alternative drugs with less interaction.

Reference materials:https://www.alunbrig.com/