HPE CINV Pocket Guide 2018 | Page 71

Possible decrease in efficacy of Parkinson’s treatment. Avoid combination when possible Increased risk of bleeding. Monitor patient for bruises or gastrointestinal bleeding Possible hyperglycaemia. Monitor blood glucose levels more frequently Possible hypokalaemia. Monitor potassium levels Possible hypertension. Adjust dose of antihypertensives if necessary is increased, and the effectiveness might be decreased. 18 It has been suggested that granisetron might be the preferred 5-HT3 RA in elderly patients because CYP2D6, a highly polymorphic enzyme, is not involved in its metabolism, thereby avoiding the risk of AEs (in poor metabolisers, representing 5–10% of Caucasians), or reduced efficacy (in ultra-rapid metabolisers). 13 Although partly metabolised through CYP2D6, ondansetron has not been associated with pharmacokinetic interactions via this isoenzyme. A possible explanation for the lack of CYP2D6 interactions of ondansetron may be that it is metabolised by more than one CYP isoenzyme and therefore no single mechanism dominates its overall metabolism. 13 NK1 RAs This drug class includes aprepitant, its prodrug for intravenous use, fosaprepitant, netupitant (marketed in a fixed combination with palonosetron in NEPA, the first fixed combination antiemetic) and rolapitant. In contrast to 5-HT3 RAs, the DDIs of NK1 RAs are predominantly pharmacokinetic. The interplay between NK1 RAs and CYP450 isoenzymes is complex. Aprepitant is a substrate, a moderate inhibitor and an inducer of CYP3A4, as well as a weak inducer of CYP2C9. Fosaprepitant is biotransformed to aprepitant and exerts the same influence on CYP450 isoenzymes. Aprepitant acts as a CYP3A4 inhibitor within four days of treatment, whereas an inductive effect is observed approximately a week later. Netupitant is a substrate and moderate inhibitor of CYP3A4, whereas rolapitant is hospitalpharmacyeurope.com | 2018 | 71