Drug interactions
Brigatinib + Phenytoin
Severity: Major
Brigatinib and Phenytoin: major interaction.
Last updated Sources: UK SmPC
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
Phenytoin induces CYP3A4 and can reduce brigatinib concentrations substantially. Reduced exposure may compromise control of ALK-positive lung cancer.
What this interaction means in plain words
Brigatinib and Phenytoin 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.
Brigatinib belongs to Oncology; Phenytoin belongs to Central Nervous System.
Why it happens
Phenytoin induces CYP3A4, accelerating brigatinib metabolism.
What to do
Avoid concomitant use and choose a non-inducing antiepileptic. If a strong inducer is unavoidable, the brigatinib dose may need to be increased per labeling, with monitoring of tumor response.
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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References
Other interactions of Phenytoin
- Artemether / lumefantrine + Phenytoin Contraindicated
- Bictegravir + Phenytoin Contraindicated
- Cabotegravir + Phenytoin Contraindicated
- Doravirine + Phenytoin Contraindicated
- Elbasvir / grazoprevir + Phenytoin Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Phenytoin Contraindicated
Other interactions of Brigatinib
Frequently asked questions
Can I take Brigatinib with Phenytoin?
MediHelp rates the interaction as major. Brigatinib and Phenytoin 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. Phenytoin induces CYP3A4 and can reduce brigatinib concentrations substantially. Reduced exposure may compromise control of ALK-positive lung cancer.
How serious is the interaction between Brigatinib and Phenytoin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid concomitant use and choose a non-inducing antiepileptic. If a strong inducer is unavoidable, the brigatinib dose may need to be increased per labeling, with monitoring of tumor response.
What other medicines interact with Phenytoin?
MediHelp also lists interactions of Phenytoin with, for example, Artemether / lumefantrine, Bictegravir, Cabotegravir. The full list is on the Phenytoin page.
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