HPE Managing CINV pocket guide 2019 | Page 78

be taken in combination with CYP2D6 substrates such as dextromethorphan, propafenone, tamoxifen, metoprolol, thioridazine and others. CYP2D6 participates in the metabolism of all 5-HT 3 RAs except granisetron, which may make granisetron a better partner for rolapitant than ondasetron. Nevertheless, a single 180mg dose of rolapitant had no effect on the pharmacokinetics of intravenous ondansetron when administered on the same day. By inhibiting breast cancer resistance protein, rolapitant may increase the occurence of AEs in substrates such as methotrexate, sulfasalazine and rosuvastatin. Rolapitant may interact with digoxin and dabigatran via P-gp inhibition. However, the clinical relevance of these interactions is questionable because concomitant use is not frequent. If necessary, monitoring of AEs is recommended. 8,19 Olanzapine Olanzapine antagonises dopamine D2 receptors, and pharmacodynamic interactions with dopamine agonists such as anti-Parkinsonian drugs (levodopa, ropinirole, pramipexole) are expected. 23 Although these DDIs should be avoided in patients treated for Parkinsonism and schizophrenia, it is not clear whether the same recommendation applies when olanzapine is used in a shorter 78 | 2019 | hospitalpharmacyeurope.com course for CINV, which lasts ≤five days and at a lower dose (maximum 10mg). Moreover, olanzapine prolongs the QTc interval and all DDIs described previously between QTc prolonging drugs and 5-HT 3 RAs also apply to olanzapine. Therefore, if olanzapine is used concomitantly with 5-HT 3 RAs, palonosetron may be the preferred choice. Caution should be exercised when olanzapine is co-administered with central nervous system depressants such as benzodiazepines and opioids. However, the interaction with benzodiazepines seems to be route-specific and is more likely if both interacting drugs are administered parenterally. 24 Olanzapine is a CYP1A2 substrate and, as such, susceptible to alterations of the elimination rate when co-administered with CYP1A2 inducers or inhibitors. CYP1A2 inducers such as smoking and carbamazepine may reduce the efficacy of olanzapine but the clinical consequences are probably limited. By contrast, strong CYP1A2 inhibitors such as fluvoxamine and ciprofloxacin may require dose lowering by 25%. 23 Activated charcoal decreases the absorption of orally administered olanzapine and their administration should be separated by at least 2 h. 24 Dexamethasone Dexamethasone DDIs with NK 1 RAs (rolapitant excluded) that