Interaction between St. John's Wort and Acalabrutinib
Major
Metabolism
| ID | DDInter1708 and DDInter9 |
| Interaction | Coadministration with potent inducers of CYP450 3A4 may significantly decrease the plasma concentrations of acalabrutinib, which is primarily metabolized by the isoenzyme. |
| Management | Concomitant use of acalabrutinib with potent CYP450 3A4 inducers should generally be avoided. If coadministration cannot be avoided, the manufacturer recommends increasing the dosage of acalabrutinib to 200 mg twice daily. |
| References | |
| Alternative for St. John's Wort |
N06A
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| Alternative for Acalabrutinib |
L01X
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Potential Metabolism Interactions
Substrate-Substrate Interaction：If more than one drug is metabolized by the same CYP, it is possible that its metabolism is inhibited because of the competition between the drugs. That means, it can be useful to lower the dosage of the drugs in the drug-cocktail because they remain longer in the organism than in monotherapy.
Inhibitor-Inhibitor Interaction：Combining two or more inhibitors of one CYP, should be compensated by lowering the dosage of these drugs because the metabolism is reduced and the drugs remain longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.
Inhibitor-Substrate Interaction：Combining drugs that have inhibitory effect and are substrates of one particular CYP, should be compensated by lowering the dosage. They rest longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.