What drugs should not be taken with Revumenib-Revuforj?

Revumenib (Revumenib)-Revuforj, as the first menin inhibitor on the market, has shown significant efficacy in the treatment of acute leukemias (including AML and ALL) carrying KMT2A rearrangements or NPM1 mutations. However, this type of targeted drugs are highly sensitive to drug interactions in clinical use. If used improperly together, they may affect the efficacy or even increase toxic reactions. Therefore, it is important to understand how revimenib interacts with other medications.

The main metabolic pathway of revimenib relies on the liver cytochromeP450 enzyme system (CYP3A4). Therefore, any drug that strongly inhibits or induces CYP3A4 may interfere with the plasma concentration of revimenib. First of all, strong CYP3A4 inhibitors (such as ketoconazole, clarithromycin, itraconazole, grapefruit juice, etc.) will significantly increase the concentration of revimenib in the body, which may lead to an increased risk of toxic reactions, such as arrhythmia, abnormal liver function or decreased blood count. It is clinically recommended to avoid the combined use of these drugs.

On the contrary, Strong CYP3A4 inducers (such as rifampicin, carbamazepine, phenytoin, St. John's wort, etc.) may reduce the plasma concentration of revimenib, reduce the efficacy, and increase the risk of treatment failure. Therefore, these drugs should be avoided as much as possible during treatment. If the patient must take corresponding anti-epileptic drugs or anti-infective drugs, the doctor should make dose adjustments or drug substitutions.

In addition, caution should be exercised when revimenib is used concurrently with drugs that prolong the QT interval (such as certain antiarrhythmic drugs, quinolone antibiotics, and some antidepressants). Because revimenib itself may mildly affect cardiac repolarization function, if the effect is superimposed, it may cause the risk of arrhythmia. Doctors usually recommend regular EKG monitoring to ensure safety.

It is worth mentioning that Revemenib should not be taken at the same time as high-fat dietary supplements or strongly alkaline antacids, because these factors will interfere with the drug absorption rate or change the gastrointestinalpH environment, thereby affecting bioavailability.

Reference materials:https://www.drugs.com/monograph/revumenib.html