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Zegfrovy
sunvozertinib
Adult Dosing .
Dosage forms: TAB: 150 mg, 200 mg
Special Note
- [uses, dosing may vary]
- Info: refer to institution protocols and pkg insert prior to prescribing for uses, concomitant meds, and dosing incl. toxicity-related dose adjustments
non-small cell lung CA, locally advanced or metastatic
- [200 mg PO qd]
- Info: for pts w/ EGFR exon 20 insertion mutations w/ dz progression on or after platinum-containing chemo; give w/ food; do not cut/crush/chew tab
renal dosing
- [see below]
- CrCl >30: no adjustment; CrCl <30: not defined
- HD/PD: not defined
hepatic dosing
- [see below]
- bilirubin 1.1-3x ULN or AST >ULN: no adjustment; bilirubin >3x ULN: not defined
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- avoid: breastfeeding during tx and x2wk after D/C
- caution: pts of childbearing potential
- caution: male pts of reproductive potential
- caution: pts 65 yo and older
Drug Interactions .
Overview
sunvozertinib
kinase inhibitor
- CYP3A4 substrate
- BCRP inhibitor
- P-gp inhibitor, weak
- CYP3A4 inducer, weak
- immunosuppressive effects
- skin irritant/drying agent
Contraindicated
- colchicine
- ranolazine
Avoid/Use Alternative
- adagrasib
- adapalene topical
- adenovirus vaccine, live
- alitretinoin topical
- alpelisib
- apalutamide
- apixaban
- atazanavir
- atogepant
- benzoyl peroxide topical
- bexarotene topical
- bosentan
- butalbital
- carbamazepine
- cenobamate
- ceritinib
- chikungunya vaccine, live
- chloramphenicol
- cholera vaccine, live
- cladribine oral
- clarithromycin
- cobicistat
- codeine
- dabigatran
- dabrafenib
- dengue vaccine, live
- desogestrel (contraceptive)
- dienogest (contraceptive)
- dolutegravir
- drospirenone (contraceptive)
- efavirenz
- encorafenib
- ensartinib
- enzalutamide
- estradiol (contraceptive)
- ethinyl estradiol (contraceptive)
- ethynodiol (contraceptive)
- etonogestrel (contraceptive)
- etravirine
- fentanyl
- fexinidazole
- fosamprenavir
- fosphenytoin
- futibatinib
- idelalisib
- influenza nasal vaccine, live
- itraconazole
- ivosidenib
- ketoconazole
- levoketoconazole
- levonorgestrel (contraceptive)
- levonorgestrel (post-coital contraceptive)
- lonafarnib
- lopinavir/ritonavir
- lorlatinib
- lumacaftor/ivacaftor
- lumateperone
- mavacamten
- measles/mumps/rubella vaccine, live
- medroxyprogesterone (contraceptive)
- meperidine
- mifepristone
- mitapivat
- mitotane
- modafinil
- nafcillin
- nefazodone
- nelfinavir
- neratinib
- norelgestromin (contraceptive)
- norethindrone (contraceptive)
- norgestimate (contraceptive)
- norgestrel (contraceptive)
- oliceridine
- oxycodone
- pacritinib
- pazopanib
- pentobarbital
- pexidartinib
- phenobarbital
- phenytoin
- posaconazole
- pralsetinib
- primidone
- rabies vaccine
- relugolix
- repotrectinib
- ribociclib
- rifabutin
- rifampin
- rifapentine
- ritonavir
- rivaroxaban
- rotavirus vaccine, live
- segesterone (contraceptive)
- sirolimus albumin-bound
- smallpox vaccine, live
- sotorasib
- St. John's wort
- tazarotene topical
- tipranavir
- topotecan
- tramadol
- tretinoin topical
- trifarotene topical
- tucatinib
- typhoid vaccine, live
- ubrogepant
- ulipristal (post-coital contraceptive)
- varicella vaccine, live
- venetoclax
- voriconazole
- yellow fever vaccine, live
- zuranolone
Monitor/Modify Tx
- afatinib
- amlodipine
- anthrax vaccine
- atorvastatin
- buprenorphine
- chikungunya vaccine
- COVID-19 vaccine
- cyclophosphamide
- cyclosporine
- digoxin
- diltiazem
- diphtheria/tetanus vaccine
- diphtheria/tetanus/pertussis vaccine
- disopyramide
- ebola vaccine, live
- edoxaban
- enfortumab vedotin
- everolimus
- fluvastatin
- Haemophilus b vaccine
- hepatitis A vaccine
- hepatitis B vaccine
- human papillomavirus vaccine
- ifosfamide
- imatinib
- influenza H5N1 vaccine
- influenza vaccine
- irinotecan
- isradipine
- Japanese encephalitis vaccine
- lapatinib
- mavorixafor
- meningococcal vaccine
- methotrexate
- mitoxantrone
- morphine
- nicardipine
- nimodipine
- nisoldipine
- pitavastatin
- pneumococcal vaccine
- poliovirus vaccine
- pravastatin
- quinidine (antiarrhythmic)
- respiratory syncytial virus vaccine
- riociguat
- rosuvastatin
- simvastatin
- sirolimus
- smallpox/mpox vaccine, live
- tacrolimus
- talazoparib
- tenofovir alafenamide
- tenofovir disoproxil
- tiagabine
- tick-borne encephalitis vaccine
- typhoid vaccine
- warfarin
Caution Advised
- abemaciclib
- acalabrutinib
- alfentanil
- alprazolam
- amiodarone
- aprepitant
- artemether/lumefantrine
- avacopan
- avapritinib
- axitinib
- bictegravir
- bosutinib
- brigatinib
- budesonide
- buspirone
- cabozantinib
- capivasertib
- capmatinib
- cobimetinib
- crizotinib
- daridorexant
- darolutamide
- darunavir
- dasatinib
- defactinib
- deflazacort
- doravirine
- dronedarone
- drospirenone (hormone replacement)
- elacestrant
- elbasvir
- elexacaftor/tezacaftor/ivacaftor
- eliglustat
- elvitegravir
- entrectinib
- erdafitinib
- erlotinib
- fedratinib
- felodipine
- finerenone
- fosaprepitant
- fostamatinib
- fruquintinib
- ganaxolone
- gepirone
- gilteritinib
- glasdegib
- glecaprevir
- grazoprevir
- guanfacine
- haloperidol
- hydrocortisone
- ibrutinib
- isavuconazonium
- istradefylline
- ivacaftor
- larotrectinib
- lazertinib
- lefamulin
- lenacapavir
- leniolisib
- letermovir
- levonorgestrel intrauterine device (contraceptive)
- lurasidone
- macitentan
- maraviroc
- methadone
- midazolam
- midostaurin
- mobocertinib
- naldemedine
- naloxegol
- netupitant
- nevirapine
- nifedipine
- nilotinib
- nirmatrelvir
- nirogacestat
- olaparib
- olutasidenib
- palbociclib
- pemigatinib
- perampanel
- pibrentasvir
- pimavanserin
- pirtobrutinib
- ponatinib
- praziquantel
- pretomanid
- quetiapine
- quinine
- quizartinib
- rilpivirine
- ripretinib
- roflumilast
- rolapitant
- samidorphan
- sebetralstat
- seladelpar
- selpercatinib
- selumetinib
- sildenafil
- sonidegib
- sulfasalazine
- suzetrigine
- tadalafil
- tamoxifen
- tasimelteon
- tazemetostat
- temsirolimus
- tezacaftor/ivacaftor
- ticagrelor
- tofacitinib
- tolvaptan
- toremifene
- vanzacaftor/tezacaftor/deutivacaftor
- velpatasvir
- verapamil
- voclosporin
- vonoprazan
- voxelotor
- voxilaprevir
- zanubrutinib
Adverse Reactions .
Serious Reactions
- interstitial lung dz
- pneumonitis
- diarrhea, severe
- nausea, severe
- vomiting, severe
- rash, severe
- ocular toxicity
- pancreatitis
- pneumonia
- arrhythmia
Common Reactions
- diarrhea
- rash
- appetite decr.
- fatigue
- stomatitis
- vomiting
- nausea
- paronychia
- constipation
- weight decr.
- pruritus
- musculoskeletal pain
- pneumonia
- UTI
- xeroderma
- abdominal pain
- ocular toxicity
- abdominal distension
- peripheral neuropathy
- arrhythmia
- edema
- malaise
- Cr incr.
- Hgb decr.
- CK incr.
- lymphocytes decr.
- lipase incr.
- ALT or AST incr.
- neutrophils decr.
- proteinuria
- amylase incr.
- sodium decr.
- albumin decr.
- potassium decr.
- magnesium incr.
- alk phos incr.
Safety/Monitoring .
Monitoring Parameters
pregnancy test before tx start; s/sx interstitial lung dz
Pregnancy/Lactation .
Pregnancy
Clinical Summary
weigh risk/benefit during pregnancy; no human data available; risk of fetal harm, incl. teratogenicity, based on animal data at 0.02-0.6x systemic exposure and drug's mechanism of action
Individuals of Reproductive Potential
obtain pregnancy test before tx start; avoid pregnancy by using effective non-hormonal contraception during tx and x2wk after D/C in pts of childbearing potential and using effective contraception during tx and x2wk after D/C in male pts
Lactation
Clinical Summary
avoid breastfeeding during tx and x2wk after D/C; no human data available to assess risk of infant harm or effects on milk production
Pharmacology .
Metabolism: liver primarily; CYP450: 3A substrate; Info: active metabolite
Excretion: feces 79% (7.3% unchanged), urine 10% (5.6% unchanged); Half-life: 50h
Subclass: EGFR Antagonists ; Kinase Inhibitors, EGFR Inhibitors
Mechanism of Action
binds to epidermal growth factor receptor (EGFR), inhibiting kinase activity and cancer cell signal transduction
Formulary .
No Formulary Selected
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