Ibrutinib does not have clinically relevant interactions with oral contraceptives or substrates of CYP3A and CYP2B6. 2020

Jan de Jong, and Anna Mitselos, and Wojciech Jurczak, and Raul Cordoba, and Carlos Panizo, and Tomasz Wrobel, and Monika Dlugosz-Danecka, and James Jiao, and Juthamas Sukbuntherng, and Daniele Ouellet, and Peter Hellemans
Clinical Pharmacology, Janssen Research & Development LLC, San Diego, CA, USA.

Ibrutinib may inhibit intestinal CYP3A4 and induce CYP2B6 and/or CYP3A. Secondary to potential induction, ibrutinib may reduce the exposure and effectiveness of oral contraceptives (OCs). This phase I study evaluated the effect of ibrutinib on the pharmacokinetics of the CYP2B6 substrate bupropion, CYP3A substrate midazolam, and OCs ethinylestradiol (EE) and levonorgestrel (LN). Female patients (N = 22) with B-cell malignancies received single doses of EE/LN (30/150 μg) and bupropion/midazolam (75/2 mg) during a pretreatment phase on days 1 and 3, respectively (before starting ibrutinib on day 8), and again after ibrutinib 560 mg/day for ≥ 2 weeks. Intestinal CYP3A inhibition was assessed on day 8 (single-dose ibrutinib plus single-dose midazolam). Systemic induction was assessed at steady-state on days 22 (EE/LN plus ibrutinib) and 24 (bupropion/midazolam plus ibrutinib). The geometric mean ratios (GMRs; test/reference) for maximum plasma concentration (Cmax ) and area under the plasma concentration-time curve (AUC) were derived using linear mixed-effects models (90% confidence interval within 80%-125% indicated no interaction). On day 8, the GMR for midazolam exposure with ibrutinib coadministration was ≤ 20% lower than the reference, indicating lack of intestinal CYP3A4 inhibition. At ibrutinib steady-state, the Cmax and AUC of EE were 33% higher than the reference, which was not considered clinically relevant. No substantial changes were noted for LN, midazolam, or bupropion. No unexpected safety findings were observed. A single dose of ibrutinib did not inhibit intestinal CYP3A4, and repeated administration did not induce CYP3A4/2B6, as assessed using EE, LN, midazolam, and bupropion.

UI MeSH Term Description Entries
D008258 Waldenstrom Macroglobulinemia A lymphoproliferative disorder characterized by pleomorphic B-LYMPHOCYTES including PLASMA CELLS, with increased levels of monoclonal serum IMMUNOGLOBULIN M. There is lymphoplasmacytic cells infiltration into bone marrow and often other tissues, also known as lymphoplasmacytic lymphoma. Clinical features include ANEMIA; HEMORRHAGES; and hyperviscosity. Lymphoma, Lymphoplasmacytoid,Macroglobulinemia,Familial Waldenstrom's Macroglobulinaemia,Lymphoma, Lymphocytic, Plasmacytoid,Primary Macroglobulinemia,Waldenstrom's Macroglobulinaemia,Waldenstrom's Macroglobulinemia,Familial Waldenstrom Macroglobulinaemia,Familial Waldenstroms Macroglobulinaemia,Lymphomas, Lymphoplasmacytoid,Lymphoplasmacytoid Lymphoma,Lymphoplasmacytoid Lymphomas,Macroglobulinaemia, Familial Waldenstrom's,Macroglobulinaemia, Waldenstrom's,Macroglobulinemia, Primary,Macroglobulinemia, Waldenstrom,Macroglobulinemia, Waldenstrom's,Waldenstrom Macroglobulinaemia,Waldenstrom's Macroglobulinaemia, Familial,Waldenstroms Macroglobulinaemia,Waldenstroms Macroglobulinemia
D008657 Metabolic Clearance Rate Volume of biological fluid completely cleared of drug metabolites as measured in unit time. Elimination occurs as a result of metabolic processes in the kidney, liver, saliva, sweat, intestine, heart, brain, or other site. Total Body Clearance Rate,Clearance Rate, Metabolic,Clearance Rates, Metabolic,Metabolic Clearance Rates,Rate, Metabolic Clearance,Rates, Metabolic Clearance
D008874 Midazolam A short-acting hypnotic-sedative drug with anxiolytic and amnestic properties. It is used in dentistry, cardiac surgery, endoscopic procedures, as preanesthetic medication, and as an adjunct to local anesthesia. The short duration and cardiorespiratory stability makes it useful in poor-risk, elderly, and cardiac patients. It is water-soluble at pH less than 4 and lipid-soluble at physiological pH. Dormicum,Midazolam Hydrochloride,Midazolam Maleate,Ro 21-3981,Versed,Hydrochloride, Midazolam,Maleate, Midazolam,Ro 21 3981,Ro 213981
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010880 Piperidines A family of hexahydropyridines.
D003276 Contraceptives, Oral Compounds, usually hormonal, taken orally in order to block ovulation and prevent the occurrence of pregnancy. The hormones are generally estrogen or progesterone or both. Low-Dose Oral Contraceptive,Oral Contraceptive,Oral Contraceptives,Oral Contraceptives, Low-Dose,Oral Contraceptives, Phasic,Contraceptive, Low-Dose Oral,Contraceptive, Oral,Contraceptives, Low-Dose Oral,Contraceptives, Phasic Oral,Low Dose Oral Contraceptive,Low-Dose Oral Contraceptives,Oral Contraceptive, Low-Dose,Oral Contraceptives, Low Dose,Phasic Oral Contraceptives
D004347 Drug Interactions The action of a drug that may affect the activity, metabolism, or toxicity of another drug. Drug Interaction,Interaction, Drug,Interactions, Drug
D004997 Ethinyl Estradiol A semisynthetic alkylated ESTRADIOL with a 17-alpha-ethinyl substitution. It has high estrogenic potency when administered orally, and is often used as the estrogenic component in ORAL CONTRACEPTIVES. 19-Norpregna-1,3,5(10)-trien-20-yne-3,17-diol, (17alpha)-,Ethynyl Estradiol,Estinyl,Ethinyl Estradiol Hemihydrate,Ethinyl Estradiol, (8 alpha)-Isomer,Ethinyl Estradiol, (8 alpha,17 alpha)-Isomer,Ethinyl Estradiol, (8 alpha,9 beta,13 alpha,14 beta)-Isomer,Ethinyl Estradiol, (9 beta,17 alpha)-Isomer,Ethinyl-Oestradiol Effik,Ethinylestradiol Jenapharm,Ethinyloestradiol,Lynoral,Microfollin,Microfollin Forte,Progynon C,Estradiol, Ethinyl,Estradiol, Ethynyl,Ethinyl Oestradiol Effik,Hemihydrate, Ethinyl Estradiol,Jenapharm, Ethinylestradiol
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

Related Publications

Jan de Jong, and Anna Mitselos, and Wojciech Jurczak, and Raul Cordoba, and Carlos Panizo, and Tomasz Wrobel, and Monika Dlugosz-Danecka, and James Jiao, and Juthamas Sukbuntherng, and Daniele Ouellet, and Peter Hellemans
May 2024, Cancer chemotherapy and pharmacology,
Jan de Jong, and Anna Mitselos, and Wojciech Jurczak, and Raul Cordoba, and Carlos Panizo, and Tomasz Wrobel, and Monika Dlugosz-Danecka, and James Jiao, and Juthamas Sukbuntherng, and Daniele Ouellet, and Peter Hellemans
November 2011, Journal of molecular modeling,
Jan de Jong, and Anna Mitselos, and Wojciech Jurczak, and Raul Cordoba, and Carlos Panizo, and Tomasz Wrobel, and Monika Dlugosz-Danecka, and James Jiao, and Juthamas Sukbuntherng, and Daniele Ouellet, and Peter Hellemans
March 2024, Cancer chemotherapy and pharmacology,
Jan de Jong, and Anna Mitselos, and Wojciech Jurczak, and Raul Cordoba, and Carlos Panizo, and Tomasz Wrobel, and Monika Dlugosz-Danecka, and James Jiao, and Juthamas Sukbuntherng, and Daniele Ouellet, and Peter Hellemans
November 1994, Environmental health perspectives,
Jan de Jong, and Anna Mitselos, and Wojciech Jurczak, and Raul Cordoba, and Carlos Panizo, and Tomasz Wrobel, and Monika Dlugosz-Danecka, and James Jiao, and Juthamas Sukbuntherng, and Daniele Ouellet, and Peter Hellemans
October 2020, Clinical pharmacokinetics,
Jan de Jong, and Anna Mitselos, and Wojciech Jurczak, and Raul Cordoba, and Carlos Panizo, and Tomasz Wrobel, and Monika Dlugosz-Danecka, and James Jiao, and Juthamas Sukbuntherng, and Daniele Ouellet, and Peter Hellemans
May 2018, Clinical and translational science,
Jan de Jong, and Anna Mitselos, and Wojciech Jurczak, and Raul Cordoba, and Carlos Panizo, and Tomasz Wrobel, and Monika Dlugosz-Danecka, and James Jiao, and Juthamas Sukbuntherng, and Daniele Ouellet, and Peter Hellemans
August 2019, Scientific reports,
Jan de Jong, and Anna Mitselos, and Wojciech Jurczak, and Raul Cordoba, and Carlos Panizo, and Tomasz Wrobel, and Monika Dlugosz-Danecka, and James Jiao, and Juthamas Sukbuntherng, and Daniele Ouellet, and Peter Hellemans
December 1990, American journal of obstetrics and gynecology,
Jan de Jong, and Anna Mitselos, and Wojciech Jurczak, and Raul Cordoba, and Carlos Panizo, and Tomasz Wrobel, and Monika Dlugosz-Danecka, and James Jiao, and Juthamas Sukbuntherng, and Daniele Ouellet, and Peter Hellemans
February 2012, Current cardiology reports,
Jan de Jong, and Anna Mitselos, and Wojciech Jurczak, and Raul Cordoba, and Carlos Panizo, and Tomasz Wrobel, and Monika Dlugosz-Danecka, and James Jiao, and Juthamas Sukbuntherng, and Daniele Ouellet, and Peter Hellemans
February 2009, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association,
Copied contents to your clipboard!