Drug interactions
Brexpiprazole + Fedratinib
Severity: Major
Brexpiprazole and Fedratinib: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Fedratinib inhibits CYP3A4 and CYP2D6, the two main pathways for brexpiprazole clearance, which can substantially raise brexpiprazole exposure. This may increase sedation, orthostasis and other dose-related adverse effects.
What this interaction means in plain words
Brexpiprazole and Fedratinib can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Brexpiprazole belongs to Central Nervous System; Fedratinib belongs to Oncology.
Why it happens
Inhibition of CYP3A4 and CYP2D6 by fedratinib reduces brexpiprazole metabolism.
What to do
Reduce the brexpiprazole dose, with labeling advising about half the usual dose with a strong inhibitor of either pathway and a quarter if both pathways are inhibited. Monitor for adverse effects and return to the usual dose after fedratinib is stopped.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Brexpiprazole
Other interactions of Fedratinib
- Fedratinib + Thioridazine Contraindicated
- Amobarbital + Fedratinib Major
- Apalutamide + Fedratinib Major
- Carbamazepine + Fedratinib Major
- Chloramphenicol + Fedratinib Major
- Cimetidine + Fedratinib Major
Frequently asked questions
Can I take Brexpiprazole with Fedratinib?
MediHelp rates the interaction as major. Brexpiprazole and Fedratinib can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Fedratinib inhibits CYP3A4 and CYP2D6, the two main pathways for brexpiprazole clearance, which can substantially raise brexpiprazole exposure. This may increase sedation, orthostasis and other dose-related adverse effects.
How serious is the interaction between Brexpiprazole and Fedratinib?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce the brexpiprazole dose, with labeling advising about half the usual dose with a strong inhibitor of either pathway and a quarter if both pathways are inhibited. Monitor for adverse effects and return to the usual dose after fedratinib is stopped.
What other medicines interact with Brexpiprazole?
MediHelp also lists interactions of Brexpiprazole with, for example, Alfentanil, Amisulpride, Apalutamide. The full list is on the Brexpiprazole page.
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