Wayrilz

Overview

rilzabrutinib

kinase inhibitor

• CYP3A4 substrate
• CYP3A4 inhibitor, moderate
• BCRP inhibitor
• OATP1B1 inhibitor, weak
• OATP1B3 inhibitor, weak
• P-gp inhibitor, weak
• gastric pH sensitive
• immunomodulatory effects

Contraindicated

• adenovirus vaccine, live
Wayrilz (rilzabrutinib)

+

adenovirus vaccine, live

1 interaction

Contraindicated

rilzabrutinib + adenovirus vaccine, live

contraindicated; vaccinate at least 4wk before or 6mo after rilzabrutinib tx: combo may result in inadequate vaccine response, incr. risk of disseminated infection (immunosuppressive effects)

• BCG live intravesical
Wayrilz (rilzabrutinib)

+

BCG live intravesical

1 interaction

Contraindicated

rilzabrutinib + BCG live intravesical

contraindicated: combo may incr. risk of disseminated BCG infection; may decr. immune response (immunosuppressive effects)

• chikungunya vaccine, live
Wayrilz (rilzabrutinib)

+

chikungunya vaccine, live

1 interaction

Contraindicated

rilzabrutinib + chikungunya vaccine, live

contraindicated; vaccinate at least 4wk before or 6mo after rilzabrutinib tx: combo may result in inadequate vaccine response, incr. risk of disseminated infection (immunosuppressive effects)

• cholera vaccine, live
Wayrilz (rilzabrutinib)

+

cholera vaccine, live

1 interaction

Contraindicated

rilzabrutinib + cholera vaccine, live

contraindicated; vaccinate at least 4wk before or 6mo after rilzabrutinib tx: combo may result in inadequate vaccine response, incr. risk of disseminated infection (immunosuppressive effects)

• cisapride
Wayrilz (rilzabrutinib)

+

cisapride

1 interaction

Contraindicated

rilzabrutinib + cisapride

contraindicated: combo may incr. cisapride levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• colchicine
Wayrilz (rilzabrutinib)

+

colchicine

1 interaction

Contraindicated

rilzabrutinib + colchicine

CV RISK REDUCTION: avoid combo in pts w/ renal or hepatic impairment; otherwise, monitor CK, myopathy s/sx; GOUT or FMF: contraindicated in pts w/ renal or hepatic impairment; otherwise, use alternative or decr. colchicine dose based on indication during and x14 days after rilzabrutinib use as follows: GOUT PROPHYLAXIS: give colchicine 0.3-0.6 mg/day divided qd-bid; ACUTE GOUT TX: avoid combo if already receiving colchicine for gout prophylaxis; otherwise, give colchicine 1.2 mg x1 only; FMF: de: combo may incr. colchicine levels, risk of myopathy, rhabdomyolysis, other life-threatening toxicity (hepatic metab. inhibited, P-gp-mediated transport possibly inhibited)

• dengue vaccine, live
Wayrilz (rilzabrutinib)

+

dengue vaccine, live

1 interaction

Contraindicated

rilzabrutinib + dengue vaccine, live

contraindicated; vaccinate at least 4wk before or 6mo after rilzabrutinib tx: combo may result in inadequate vaccine response, incr. risk of disseminated infection (immunosuppressive effects)

• eliglustat
Wayrilz (rilzabrutinib)

+

eliglustat

1 interaction

Contraindicated

rilzabrutinib + eliglustat

CYP2D6 EM: contraindicated if also combined w/ moderate or strong CYP2D6 inhibitor; otherwise, monitor ECG; decr. eliglustat dose to 84 mg qd; CYP2D6 IM: contraindicated if also combined w/ moderate or strong CYP2D6 inhibitor; otherwise, avoid combo; CYP2D6 PM: avoid combo: combo may incr. eliglustat levels, risk of PR or QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• flibanserin
Wayrilz (rilzabrutinib)

+

flibanserin

1 interaction

Contraindicated

rilzabrutinib + flibanserin

contraindicated w/in 14 days prior to, during, and x2 days after flibanserin tx: combo may incr. levels of both drugs, risk of CNS depression, psychomotor impairment, severe hypotension (incl. syncope), other adverse effects (hepatic metab. inhibited)

• grazoprevir
Wayrilz (rilzabrutinib)

+

grazoprevir

1 interaction

Contraindicated

rilzabrutinib + grazoprevir

contraindicated: combo may incr. levels of both drugs, risk of adverse effects (hepatic metab. inhibited, hepatic transport possibly inhibited)

• influenza nasal vaccine, live
Wayrilz (rilzabrutinib)

+

influenza nasal vaccine, live

1 interaction

Contraindicated

rilzabrutinib + influenza nasal vaccine, live

contraindicated; vaccinate at least 4wk before or 6mo after rilzabrutinib tx: combo may result in inadequate vaccine response, incr. risk of disseminated infection (immunosuppressive effects)

• lomitapide
Wayrilz (rilzabrutinib)

+

lomitapide

1 interaction

Contraindicated

rilzabrutinib + lomitapide

contraindicated: combo may incr. levels of both drugs, risk of adverse effects (hepatic metab. inhibited)

• measles/mumps/rubella vaccine, live
Wayrilz (rilzabrutinib)

+

measles/ mumps/ rubella vaccine, live

1 interaction

Contraindicated

rilzabrutinib + measles/ mumps/ rubella vaccine, live

contraindicated; vaccinate at least 4wk before or 6mo after rilzabrutinib tx: combo may result in inadequate vaccine response, incr. risk of disseminated infection (immunosuppressive effects)

• rotavirus vaccine, live
Wayrilz (rilzabrutinib)

+

rotavirus vaccine, live

1 interaction

Contraindicated

rilzabrutinib + rotavirus vaccine, live

contraindicated; vaccinate at least 4wk before or 6mo after rilzabrutinib tx: combo may result in inadequate vaccine response, incr. risk of disseminated infection (immunosuppressive effects)

• smallpox vaccine, live
Wayrilz (rilzabrutinib)

+

smallpox vaccine, live

1 interaction

Contraindicated

rilzabrutinib + smallpox vaccine, live

contraindicated; vaccinate at least 4wk before or 6mo after rilzabrutinib tx: combo may result in inadequate vaccine response, incr. risk of disseminated infection (immunosuppressive effects)

• talimogene laherparepvec
Wayrilz (rilzabrutinib)

+

talimogene laherparepvec

1 interaction

Contraindicated

rilzabrutinib + talimogene laherparepvec

contraindicated: combo may incr. risk of disseminated herpetic infection; may decr. immune response (immunosuppressive effects)

• typhoid vaccine, live
Wayrilz (rilzabrutinib)

+

typhoid vaccine, live

1 interaction

Contraindicated

rilzabrutinib + typhoid vaccine, live

contraindicated; vaccinate at least 4wk before or 6mo after rilzabrutinib tx: combo may result in inadequate vaccine response, incr. risk of disseminated infection (immunosuppressive effects)

• varicella vaccine, live
Wayrilz (rilzabrutinib)

+

varicella vaccine, live

1 interaction

Contraindicated

rilzabrutinib + varicella vaccine, live

contraindicated; vaccinate at least 4wk before or 6mo after rilzabrutinib tx: combo may result in inadequate vaccine response, incr. risk of disseminated infection (immunosuppressive effects)

• yellow fever vaccine, live
Wayrilz (rilzabrutinib)

+

yellow fever vaccine, live

1 interaction

Contraindicated

rilzabrutinib + yellow fever vaccine, live

contraindicated; vaccinate at least 4wk before or 6mo after rilzabrutinib tx: combo may result in inadequate vaccine response, incr. risk of disseminated infection (immunosuppressive effects)

Avoid/Use Alternative

• adagrasib
Wayrilz (rilzabrutinib)

+

adagrasib

1 interaction

Avoid/Use Alternative

rilzabrutinib + adagrasib

avoid combo if adagrasib use greater than 7 days; use alternative or hold rilzabrutinib if adagrasib use less than 7 days: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• alfentanil
Wayrilz (rilzabrutinib)

+

alfentanil

1 interaction

Avoid/Use Alternative

rilzabrutinib + alfentanil

use alternative or monitor resp. rate; consider decr. alfentanil dose: combo may incr. alfentanil levels, risk of CNS and resp. depression, psychomotor impairment, delayed recovery from anesthesia, other adverse effects (hepatic metab. inhibited)

• alpelisib
Wayrilz (rilzabrutinib)

+

alpelisib

1 interaction

Avoid/Use Alternative

rilzabrutinib + alpelisib

use alternative: combo may incr. alpelisib levels, risk of adverse effects (BCRP-mediated transport possibly inhibited)

• alprazolam
Wayrilz (rilzabrutinib)

+

alprazolam

1 interaction

Avoid/Use Alternative

rilzabrutinib + alprazolam

use alternative or monitor resp. rate; consider decr. alprazolam dose: combo may incr. levels of both drugs, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• amiodarone
Wayrilz (rilzabrutinib)

+

amiodarone

1 interaction

Avoid/Use Alternative

rilzabrutinib + amiodarone

use alternative or monitor ECG: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• apalutamide
Wayrilz (rilzabrutinib)

+

apalutamide

1 interaction

Avoid/Use Alternative

rilzabrutinib + apalutamide

avoid combo: combo may decr. rilzabrutinib levels, efficacy (hepatic metab. induced)

• aprepitant
Wayrilz (rilzabrutinib)

+

aprepitant

1 interaction

Avoid/Use Alternative

rilzabrutinib + aprepitant

avoid combo w/ oral aprepitant; IV aprepitant use OK: combo may incr. levels of both drugs, risk of adverse effects (hepatic metab. inhibited)

• atazanavir
Wayrilz (rilzabrutinib)

+

atazanavir

1 interaction

Avoid/Use Alternative

rilzabrutinib + atazanavir

avoid combo if atazanavir use greater than 7 days; use alternative or hold rilzabrutinib if atazanavir use less than 7 days: combo may incr. rilzabrutinib levels, risk of adverse effects (hepatic metab. inhibited)

• atrasentan
Wayrilz (rilzabrutinib)

+

atrasentan

1 interaction

Avoid/Use Alternative

rilzabrutinib + atrasentan

avoid combo: combo may incr. atrasentan levels, risk of adverse effects (hepatic transport possibly inhibited)

• avacopan
Wayrilz (rilzabrutinib)

+

avacopan

1 interaction

Avoid/Use Alternative

rilzabrutinib + avacopan

avoid combo if avacopan use greater than 7 days; use alternative or hold rilzabrutinib if avacopan use less than 7 days: combo may incr. levels of both drugs, risk of serious infection, other adverse effects (hepatic metab. inhibited, additive effects)

• avapritinib
Wayrilz (rilzabrutinib)

+

avapritinib

1 interaction

Avoid/Use Alternative

rilzabrutinib + avapritinib

GIST: use alternative or monitor bleeding s/sx; decr. avapritinib start dose to 100 mg qd; ADVANCED SYSTEMIC MASTOCYTOSIS: use alternative or monitor bleeding s/sx; decr. avapritinib start dose to 50 mg qd; INDOLENT SYSTEMIC MASTOCYTOSIS: avoid combo: combo may incr. avapritinib levels, risk of bleeding (incl. life-threatening), other adverse effects (hepatic metab. inhibited)

• berotralstat
Wayrilz (rilzabrutinib)

+

berotralstat

1 interaction

Avoid/Use Alternative

rilzabrutinib + berotralstat

avoid combo if berotralstat use greater than 7 days; use alternative or hold rilzabrutinib if berotralstat use less than 7 days: combo may incr. rilzabrutinib levels, risk of adverse effects (hepatic metab. inhibited)

• bosentan
Wayrilz (rilzabrutinib)

+

bosentan

1 interaction

Avoid/Use Alternative

rilzabrutinib + bosentan

avoid combo: combo may incr. bosentan levels, risk of adverse effects; may decr. rilzabrutinib levels, efficacy (hepatic metab. inhibited, hepatic transport possibly inhibited; hepatic metab. induced)

• bosutinib
Wayrilz (rilzabrutinib)

+

bosutinib

1 interaction

Avoid/Use Alternative

rilzabrutinib + bosutinib

avoid combo: combo may incr. bosutinib levels, risk of myelosuppression, other adverse effects (hepatic metab. inhibited)

• brigatinib
Wayrilz (rilzabrutinib)

+

brigatinib

1 interaction

Avoid/Use Alternative

rilzabrutinib + brigatinib

use alternative or monitor BP, HR; decr. brigatinib dose by approx. 40% as follows: if taking 180 mg, decr. to 120 mg, if taking 120 mg, decr. to 90 mg; if taking 90 mg, decr. to 60 mg: combo may incr. brigatinib levels, risk of HTN, bradycardia, other adverse effects (hepatic metab. inhibited)

• brincidofovir
Wayrilz (rilzabrutinib)

+

brincidofovir

1 interaction

Avoid/Use Alternative

rilzabrutinib + brincidofovir

consider alternative or monitor LFTs, GI toxicity sx; give brincidofovir at least 3h before rilzabrutinib: combo may incr. brincidofovir levels, risk of hepatotoxicity, GI toxicity, other adverse effects (hepatic transport possibly inhibited)

• buspirone
Wayrilz (rilzabrutinib)

+

buspirone

1 interaction

Avoid/Use Alternative

rilzabrutinib + buspirone

consider alternative or restart buspirone dose at 2.5 mg bid: combo may incr. buspirone levels, risk of adverse effects (hepatic metab. inhibited)

• butalbital
Wayrilz (rilzabrutinib)

+

butalbital

1 interaction

Avoid/Use Alternative

rilzabrutinib + butalbital

avoid combo: combo may decr. rilzabrutinib levels, efficacy (hepatic metab. induced)

• carbamazepine
Wayrilz (rilzabrutinib)

+

carbamazepine

1 interaction

Avoid/Use Alternative

rilzabrutinib + carbamazepine

avoid combo: combo may incr. carbamazepine levels, risk of adverse effects; may decr. rilzabrutinib levels, efficacy (hepatic metab. inhibited; hepatic metab. induced)

• cenobamate
Wayrilz (rilzabrutinib)

+

cenobamate

1 interaction

Avoid/Use Alternative

rilzabrutinib + cenobamate

avoid combo: combo may decr. rilzabrutinib levels, efficacy (hepatic metab. induced)

• ceritinib
Wayrilz (rilzabrutinib)

+

ceritinib

1 interaction

Avoid/Use Alternative

rilzabrutinib + ceritinib

avoid combo if ceritinib use greater than 7 days; use alternative or hold rilzabrutinib if ceritinib use less than 7 days: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• chloramphenicol
Wayrilz (rilzabrutinib)

+

chloramphenicol

1 interaction

Avoid/Use Alternative

rilzabrutinib + chloramphenicol

avoid combo if chloramphenicol use greater than 7 days; use alternative or hold rilzabrutinib if chloramphenicol use less than 7 days: combo may incr. rilzabrutinib levels, risk of adverse effects (hepatic metab. inhibited)

• ciprofloxacin
Wayrilz (rilzabrutinib)

+

ciprofloxacin

1 interaction

Avoid/Use Alternative

rilzabrutinib + ciprofloxacin

avoid combo if ciprofloxacin use greater than 7 days; use alternative or hold rilzabrutinib if ciprofloxacin use less than 7 days: combo may incr. rilzabrutinib levels, risk of adverse effects (hepatic metab. inhibited)

• cladribine oral
Wayrilz (rilzabrutinib)

+

cladribine oral

1 interaction

Avoid/Use Alternative

rilzabrutinib + cladribine oral

use alternative or monitor CBC: combo may incr. cladribine levels, risk of serious infection, myelosuppression, other adverse effects (gut BCRP-mediated transport possibly inhibited, additive effects)

• clarithromycin
Wayrilz (rilzabrutinib)

+

clarithromycin

1 interaction

Avoid/Use Alternative

rilzabrutinib + clarithromycin

avoid combo if clarithromycin use greater than 7 days; use alternative or hold rilzabrutinib if clarithromycin use less than 7 days: combo may incr. rilzabrutinib levels, risk of adverse effects (hepatic metab. inhibited)

• clofazimine
Wayrilz (rilzabrutinib)

+

clofazimine

1 interaction

Avoid/Use Alternative

rilzabrutinib + clofazimine

avoid combo if clofazimine use greater than 7 days; use alternative or hold rilzabrutinib if clofazimine use less than 7 days: combo may incr. rilzabrutinib levels, risk of adverse effects (hepatic metab. inhibited)

• cobicistat
Wayrilz (rilzabrutinib)

+

cobicistat

1 interaction

Avoid/Use Alternative

rilzabrutinib + cobicistat

avoid combo if cobicistat use greater than 7 days; use alternative or hold rilzabrutinib if cobicistat use less than 7 days: combo may incr. rilzabrutinib levels, risk of adverse effects (hepatic metab. inhibited)

• cobimetinib
Wayrilz (rilzabrutinib)

+

cobimetinib

1 interaction

Avoid/Use Alternative

rilzabrutinib + cobimetinib

avoid combo or decr. cobimetinib dose to 20 mg/day and D/C rilzabrutinib w/in 14 days: combo may incr. cobimetinib levels, risk of adverse effects (hepatic metab. inhibited)

• codeine
Wayrilz (rilzabrutinib)

+

codeine

1 interaction

Avoid/Use Alternative

rilzabrutinib + codeine

use alternative or monitor resp. rate, consider decr. codeine dose: combo may incr. codeine and active metabolite morphine levels, incr. risk of, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited, may incr. production of active metabolite morphine)

• conivaptan
Wayrilz (rilzabrutinib)

+

conivaptan

1 interaction

Avoid/Use Alternative

rilzabrutinib + conivaptan

avoid combo if conivaptan use greater than 7 days; use alternative or hold rilzabrutinib during and x7 days after conivaptan tx if conivaptan use less than 7 days: combo may incr. levels of both drugs, risk of overly rapid serum sodium correction, neurologic sequelae, other adverse effects (hepatic metab. inhibited)

• crizotinib
Wayrilz (rilzabrutinib)

+

crizotinib

1 interaction

Avoid/Use Alternative

rilzabrutinib + crizotinib

avoid combo if crizotinib use greater than 7 days; use alternative or hold rilzabrutinib if crizotinib use less than 7 days: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, myelosuppression, other adverse effects (hepatic metab. inhibited)

• cyclosporine
Wayrilz (rilzabrutinib)

+

cyclosporine

1 interaction

Avoid/Use Alternative

rilzabrutinib + cyclosporine

avoid combo if cyclosporine use greater than 7 days; use alternative or hold rilzabrutinib if cyclosporine use less than 7 days: combo may incr. levels of both drugs, risk of serious infection, nephrotoxicity, other adverse effects (hepatic metab. inhibited, P-gp-mediated transport possibly inhibited, additive effects)

• dabigatran
Wayrilz (rilzabrutinib)

+

dabigatran

1 interaction

Avoid/Use Alternative

rilzabrutinib + dabigatran

ATRIAL FIBRILLATION: avoid combo if CrCl <30 mL/min; OTHER INDICATIONS: avoid combo if CrCl <50 mL/min; if dabigatran use for DVT/PE prophylaxis post-hip replacement and CrCl >50 mL/min, consider separating admin. at least 2h apart: combo may incr. dabigatran levels, risk of bleeding (incl. life-threatening), other adverse effects (P-gp-mediated transport possibly inhibited)

• dabrafenib
Wayrilz (rilzabrutinib)

+

dabrafenib

1 interaction

Avoid/Use Alternative

rilzabrutinib + dabrafenib

avoid combo: combo may decr. rilzabrutinib levels, efficacy (hepatic metab. induced)

• danazol
Wayrilz (rilzabrutinib)

+

danazol

1 interaction

Avoid/Use Alternative

rilzabrutinib + danazol

avoid combo if danazol use greater than 7 days; use alternative or hold rilzabrutinib if danazol use less than 7 days: combo may incr. rilzabrutinib levels, risk of adverse effects (hepatic metab. inhibited)

• darunavir
Wayrilz (rilzabrutinib)

+

darunavir

1 interaction

Avoid/Use Alternative

rilzabrutinib + darunavir

avoid combo if darunavir use greater than 7 days; use alternative or hold rilzabrutinib if darunavir use less than 7 days: combo may incr. rilzabrutinib levels, risk of adverse effects (hepatic metab. inhibited)

• defactinib
Wayrilz (rilzabrutinib)

+

defactinib

1 interaction

Avoid/Use Alternative

rilzabrutinib + defactinib

avoid combo: combo may incr. defactinib levels, risk of adverse effects (hepatic metab. inhibited)

• dexlansoprazole
Wayrilz (rilzabrutinib)

+

dexlansoprazole

1 interaction

Avoid/Use Alternative

rilzabrutinib + dexlansoprazole

avoid combo: combo may decr. rilzabrutinib levels, efficacy (absorption decreased at higher gastric pH)

• dihydrocodeine
Wayrilz (rilzabrutinib)

+

dihydrocodeine

1 interaction

Avoid/Use Alternative

rilzabrutinib + dihydrocodeine

use alternative or monitor resp. rate, consider decr. dihydrocodeine dose: combo may incr. dihydrocodeine and active metabolite dihydromorphine levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited, may incr. production of active metabolite dihydromorphine)

• dihydroergotamine
Wayrilz (rilzabrutinib)

+

dihydroergotamine

1 interaction

Avoid/Use Alternative

rilzabrutinib + dihydroergotamine

use alternative: combo may incr. dihydroergotamine levels, risk of ergot toxicity, severe vasospasm, ischemia, other adverse effects (hepatic metab. inhibited)

• diltiazem
Wayrilz (rilzabrutinib)

+

diltiazem

1 interaction

Avoid/Use Alternative

rilzabrutinib + diltiazem

avoid combo if diltiazem use greater than 7 days; use alternative or hold rilzabrutinib if diltiazem use less than 7 days: combo may incr. rilzabrutinib levels, risk of adverse effects (hepatic metab. inhibited)

• disopyramide
Wayrilz (rilzabrutinib)

+

disopyramide

1 interaction

Avoid/Use Alternative

rilzabrutinib + disopyramide

use alternative or monitor disopyramide levels, ECG: combo may incr. disopyramide levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• domperidone
Wayrilz (rilzabrutinib)

+

domperidone

1 interaction

Avoid/Use Alternative

rilzabrutinib + domperidone

avoid combo: combo may incr. domperidone levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• dordaviprone
Wayrilz (rilzabrutinib)

+

dordaviprone

1 interaction

Avoid/Use Alternative

rilzabrutinib + dordaviprone

use alternative or monitor ECG; for adult and pediatric pts weighing at least 52.5 kg, decr. dordaviprone dose to 500 mg once weekly; dose recommendation not established in pediatric pts weighing less than 52.5 kg: combo may incr. dordaviprone levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• doxorubicin
Wayrilz (rilzabrutinib)

+

doxorubicin

1 interaction

Avoid/Use Alternative

rilzabrutinib + doxorubicin

avoid combo: combo may incr. doxorubicin levels, risk serious infection, myelosuppression, cardiotoxicity, other adverse effects (hepatic metab. inhibited, additive effects)

• dronedarone
Wayrilz (rilzabrutinib)

+

dronedarone

1 interaction

Avoid/Use Alternative

rilzabrutinib + dronedarone

avoid combo if dronedarone use greater than 7 days; use alternative or hold rilzabrutinib if dronedarone use less than 7 days: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• duvelisib
Wayrilz (rilzabrutinib)

+

duvelisib

1 interaction

Avoid/Use Alternative

rilzabrutinib + duvelisib

avoid combo if duvelisib use greater than 7 days; use alternative or hold rilzabrutinib if duvelisib use less than 7 days: combo may incr. levels of both drugs, risk of adverse effects (hepatic metab. inhibited, additive effects)

• efavirenz
Wayrilz (rilzabrutinib)

+

efavirenz

1 interaction

Avoid/Use Alternative

rilzabrutinib + efavirenz

avoid combo: combo may decr. rilzabrutinib levels, efficacy (hepatic metab. induced)

• elacestrant
Wayrilz (rilzabrutinib)

+

elacestrant

1 interaction

Avoid/Use Alternative

rilzabrutinib + elacestrant

avoid combo: combo may incr. elacestrant levels, risk of adverse effects (hepatic metab. inhibited)

• elagolix
Wayrilz (rilzabrutinib)

+

elagolix

1 interaction

Avoid/Use Alternative

rilzabrutinib + elagolix

consider alternative: combo may incr. elagolix levels, risk of adverse effects (hepatic transport possibly inhibited)

• encorafenib
Wayrilz (rilzabrutinib)

+

encorafenib

1 interaction

Avoid/Use Alternative

rilzabrutinib + encorafenib

avoid combo: combo may incr. encorafenib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects; may decr. rilzabrutinib levels, efficacy (hepatic metab. inhibited; hepatic metab. induced)

• ensartinib
Wayrilz (rilzabrutinib)

+

ensartinib

1 interaction

Avoid/Use Alternative

rilzabrutinib + ensartinib

avoid combo: combo may incr. ensartinib levels, risk of bradycardia, hyperglycemia, other adverse effects (hepatic metab. possibly inhibited, P-gp-mediated transport possibly inhibited)

• entrectinib
Wayrilz (rilzabrutinib)

+

entrectinib

1 interaction

Avoid/Use Alternative

rilzabrutinib + entrectinib

PEDS PTS w/ ENTRECTINIB START DOSE <200 mg/day: avoid combo; ADULT AND PEDS PTS >2yo: use alternative or monitor ECG, CBC, limit coadmin. to 14 days or less and decr. entrectinib dose as follows: if entrectinib start dose 200 mg qd, decr. to 50 mg qd; if entrectinib start dose 300 mg qd, decr. to 100 mg qd; if entrectinib start dose 400 or 600 mg qd, decr. to 200 mg qd: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, myelosuppression, other adverse effects (hepatic metab. inhibited)

• enzalutamide
Wayrilz (rilzabrutinib)

+

enzalutamide

1 interaction

Avoid/Use Alternative

rilzabrutinib + enzalutamide

avoid combo: combo may decr. rilzabrutinib levels, efficacy (hepatic metab. induced)

• ergotamine
Wayrilz (rilzabrutinib)

+

ergotamine

1 interaction

Avoid/Use Alternative

rilzabrutinib + ergotamine

use alternative: combo may incr. ergotamine levels, risk of ergot toxicity, severe vasospasm, ischemia, other adverse effects (hepatic metab. inhibited)

• erythromycin
Wayrilz (rilzabrutinib)

+

erythromycin

1 interaction

Avoid/Use Alternative

rilzabrutinib + erythromycin

avoid combo if erythromycin use greater than 7 days; use alternative or hold rilzabrutinib if erythromycin use less than 7 days: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• esomeprazole
Wayrilz (rilzabrutinib)

+

esomeprazole

1 interaction

Avoid/Use Alternative

rilzabrutinib + esomeprazole

avoid combo: combo may decr. rilzabrutinib levels, efficacy (absorption decreased at higher gastric pH)

• etrasimod
Wayrilz (rilzabrutinib)

+

etrasimod

1 interaction

Avoid/Use Alternative

rilzabrutinib + etrasimod

if CYP2C9 poor metabolizer or if also combined w/ moderate or strong CYP2C9 inhibitor, avoid combo; otherwise, caution advised: combo may incr. etrasimod levels, risk of AV block, bradycardia, QT prolongation, cardiac arrhythmias, serious infection, other adverse effects (hepatic metab. inhibited, additive effects)

• etravirine
Wayrilz (rilzabrutinib)

+

etravirine

1 interaction

Avoid/Use Alternative

rilzabrutinib + etravirine

avoid combo: combo may decr. rilzabrutinib levels, efficacy (hepatic metab. induced)

• fedratinib
Wayrilz (rilzabrutinib)

+

fedratinib

1 interaction

Avoid/Use Alternative

rilzabrutinib + fedratinib

avoid combo if fedratinib use greater than 7 days; use alternative or hold rilzabrutinib if fedratinib use less than 7 days: combo may incr. levels of both drugs, risk myelosuppression, hepatotoxicity, other adverse effects (hepatic metab. inhibited)

• fentanyl
Wayrilz (rilzabrutinib)

+

fentanyl

1 interaction

Avoid/Use Alternative

rilzabrutinib + fentanyl

use alternative or monitor resp. rate, consider decr. fentanyl dose: combo may incr. fentanyl levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• fexinidazole
Wayrilz (rilzabrutinib)

+

fexinidazole

1 interaction

Avoid/Use Alternative

rilzabrutinib + fexinidazole

avoid combo: combo may decr. fexinidazole active metabolite levels, efficacy; may decr. rilzabrutinib levels, efficacy (hepatic metab. inhibited, decr. conversion to active metabolites; hepatic metab. induced)

• fluconazole
Wayrilz (rilzabrutinib)

+

fluconazole

1 interaction

Avoid/Use Alternative

rilzabrutinib + fluconazole

avoid combo if fluconazole use greater than 7 days; use alternative or hold rilzabrutinib if fluconazole use less than 7 days: combo may incr. rilzabrutinib levels, risk of adverse effects (hepatic metab. inhibited)

• fosamprenavir
Wayrilz (rilzabrutinib)

+

fosamprenavir

1 interaction

Avoid/Use Alternative

rilzabrutinib + fosamprenavir

avoid combo if fosamprenavir use greater than 7 days; use alternative or hold rilzabrutinib if fosamprenavir use less than 7 days: combo may incr. rilzabrutinib levels, risk of adverse effects (hepatic metab. inhibited)

• fosaprepitant
Wayrilz (rilzabrutinib)

+

fosaprepitant

1 interaction

Avoid/Use Alternative

rilzabrutinib + fosaprepitant

avoid combo: combo may incr. levels of both drugs, risk of adverse effects (hepatic metab. inhibited)

• fosphenytoin
Wayrilz (rilzabrutinib)

+

fosphenytoin

1 interaction

Avoid/Use Alternative

rilzabrutinib + fosphenytoin

avoid combo: combo may decr. rilzabrutinib levels, efficacy (hepatic metab. induced)

• futibatinib
Wayrilz (rilzabrutinib)

+

futibatinib

1 interaction

Avoid/Use Alternative

rilzabrutinib + futibatinib

avoid combo if also combined w/ strong CYP3A4 inhibitor; otherwise, monitor phosphate: combo may incr. futibatinib levels, risk of hyperphosphatemia, other adverse effects (hepatic metab. inhibited, P-gp-mediated transport possibly inhibited)

• grapefruit
Wayrilz (rilzabrutinib)

+

grapefruit

1 interaction

Avoid/Use Alternative

rilzabrutinib + grapefruit

avoid grapefruit juice: combo may incr. rilzabrutinib levels, risk of adverse effects (GI metab. inhibited)

• hydrocodone
Wayrilz (rilzabrutinib)

+

hydrocodone

1 interaction

Avoid/Use Alternative

rilzabrutinib + hydrocodone

use alternative or monitor resp. rate, ECG, consider decr. (benz)hydrocodone dose: combo may incr. hydrocodone levels, risk of CNS and resp. depression, psychomotor impairment, QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• idelalisib
Wayrilz (rilzabrutinib)

+

idelalisib

1 interaction

Avoid/Use Alternative

rilzabrutinib + idelalisib

avoid combo if idelalisib use greater than 7 days; use alternative or hold rilzabrutinib if idelalisib use less than 7 days: combo may incr. rilzabrutinib levels, risk of serious infection, other adverse effects (hepatic metab. inhibited, additive effects)

• imatinib
Wayrilz (rilzabrutinib)

+

imatinib

1 interaction

Avoid/Use Alternative

rilzabrutinib + imatinib

avoid combo if imatinib use greater than 7 days; use alternative or hold rilzabrutinib if imatinib use less than 7 days: combo may incr. levels of both drugs, risk of myelosuppression, other adverse effects (hepatic metab. inhibited, BCRP-mediated transport possibly inhibited)

• isavuconazonium
Wayrilz (rilzabrutinib)

+

isavuconazonium

1 interaction

Avoid/Use Alternative

rilzabrutinib + isavuconazonium

avoid combo if isavuconazole use greater than 7 days; use alternative or hold rilzabrutinib if isavuconazole use less than 7 days: combo may incr. levels of both drugs, risk of adverse effects (hepatic metab. inhibited)

• itraconazole
Wayrilz (rilzabrutinib)

+

itraconazole

1 interaction

Avoid/Use Alternative

rilzabrutinib + itraconazole

avoid combo if itraconazole use greater than 7 days; use alternative or hold rilzabrutinib during and x2wk after itraconazole tx if itraconazole use less than 7 days: combo may incr. levels of both drugs, risk of adverse effects (hepatic metab. inhibited)

• ivabradine
Wayrilz (rilzabrutinib)

+

ivabradine

1 interaction

Avoid/Use Alternative

rilzabrutinib + ivabradine

avoid combo: combo may incr. ivabradine levels, risk of bradycardia, QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• ivacaftor
Wayrilz (rilzabrutinib)

+

ivacaftor

1 interaction

Avoid/Use Alternative

rilzabrutinib + ivacaftor

pts <6 mo: avoid combo; pts >6 mo decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg qd; 6 mo-5 yo and 7-13.9 kg: give 50 mg qd; 6 mo-5 yo and >14 kg: give 75 mg qd; 6 yo and older: give 150 mg qd: combo may incr. levels of both drugs, risk of adverse effects (hepatic metab. inhibited)

• ivosidenib
Wayrilz (rilzabrutinib)

+

ivosidenib

1 interaction

Avoid/Use Alternative

rilzabrutinib + ivosidenib

avoid combo: combo may incr. ivosidenib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects; may decr. rilzabrutinib levels, efficacy (hepatic metab. inhibited; hepatic metab. induced)

• ixabepilone
Wayrilz (rilzabrutinib)

+

ixabepilone

1 interaction

Avoid/Use Alternative

rilzabrutinib + ixabepilone

consider alternatives or monitor CBC: combo may incr. ixabepilone levels, risk of serious infection, myelosuppression, other toxicity (hepatic metab. inhibited, additive effects)

• ketoconazole
Wayrilz (rilzabrutinib)

+

ketoconazole

1 interaction

Avoid/Use Alternative

rilzabrutinib + ketoconazole

avoid combo if ketoconazole use greater than 7 days; use alternative or hold rilzabrutinib during and up to 1wk after ketoconazole tx if ketoconazole use less than 7 days: combo may incr. rilzabrutinib levels, risk of adverse effects (hepatic metab. inhibited)

• lansoprazole
Wayrilz (rilzabrutinib)

+

lansoprazole

1 interaction

Avoid/Use Alternative

rilzabrutinib + lansoprazole

avoid combo: combo may decr. rilzabrutinib levels, efficacy (absorption decreased at higher gastric pH)

• lefamulin
Wayrilz (rilzabrutinib)

+

lefamulin

1 interaction

Avoid/Use Alternative

rilzabrutinib + lefamulin

avoid combo if oral lefamulin use greater than 7 days; use alternative or hold rilzabrutinib if oral lefamulin use less than 7 days; IV lefamulin use OK: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• lemborexant
Wayrilz (rilzabrutinib)

+

lemborexant

1 interaction

Avoid/Use Alternative

rilzabrutinib + lemborexant

avoid combo: combo may incr. lemborexant levels, risk of CNS depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• lenacapavir
Wayrilz (rilzabrutinib)

+

lenacapavir

1 interaction

Avoid/Use Alternative

rilzabrutinib + lenacapavir

avoid combo during and x9mo after lenacapavir tx: combo may incr. rilzabrutinib levels, risk of adverse effects (hepatic metab. inhibited)

• letermovir
Wayrilz (rilzabrutinib)

+

letermovir

1 interaction

Avoid/Use Alternative

rilzabrutinib + letermovir

avoid combo if letermovir use greater than 7 days; use alternative or hold rilzabrutinib if letermovir use less than 7 days: combo may incr. rilzabrutinib levels, risk of adverse effects (hepatic metab. inhibited)

• levoketoconazole
Wayrilz (rilzabrutinib)

+

levoketoconazole

1 interaction

Avoid/Use Alternative

rilzabrutinib + levoketoconazole

avoid combo if levoketoconazole use greater than 7 days; use alternative or hold rilzabrutinib x2wk before and during levoketoconazole tx if levoketoconazole use less than 7 days: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• lonafarnib
Wayrilz (rilzabrutinib)

+

lonafarnib

1 interaction

Avoid/Use Alternative

rilzabrutinib + lonafarnib

avoid combo if lonafarnib use greater than 7 days; use alternative or hold rilzabrutinib if lonafarnib use less than 7 days: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• lopinavir/ritonavir
Wayrilz (rilzabrutinib)

+

lopinavir/ ritonavir

1 interaction

Avoid/Use Alternative

rilzabrutinib + lopinavir/ ritonavir

avoid combo: combo may incr. or decr. rilzabrutinib levels, incr. risk of adverse effects or decr. efficacy (hepatic metab. altered)

• lorlatinib
Wayrilz (rilzabrutinib)

+

lorlatinib

1 interaction

Avoid/Use Alternative

rilzabrutinib + lorlatinib

avoid combo: combo may decr. rilzabrutinib levels, efficacy (hepatic metab. induced)

• lovastatin
Wayrilz (rilzabrutinib)

+

lovastatin

1 interaction

Avoid/Use Alternative

rilzabrutinib + lovastatin

use alternative or monitor CK, myopathy sx; adjust lovastatin max dose to 20 mg/day: combo may incr. levels of both drugs, risk of myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited, hepatic transport possibly inhibited)

• lumacaftor/ivacaftor
Wayrilz (rilzabrutinib)

+

lumacaftor/ ivacaftor

1 interaction

Avoid/Use Alternative

rilzabrutinib + lumacaftor/ ivacaftor

avoid combo: combo may incr. ivacaftor levels, risk of adverse effects; may decr. rilzabrutinib levels, efficacy (hepatic metab. inhibited; hepatic metab. induced)

• lurbinectedin
Wayrilz (rilzabrutinib)

+

lurbinectedin

1 interaction

Avoid/Use Alternative

rilzabrutinib + lurbinectedin

use alternative or monitor CBC; decr. lurbinectedin dose 50%: combo may incr. lurbinectedin levels, risk of myelosuppression, other adverse effects (hepatic metab. inhibited)

• macitentan
Wayrilz (rilzabrutinib)

+

macitentan

1 interaction

Avoid/Use Alternative

rilzabrutinib + macitentan

if also combined w/ strong-mod CYP2C9 inhibitor, avoid combo; otherwise, caution advised: combo may incr. macitentan levels, risk of adverse effects (hepatic metab. inhibited)

• mavacamten
Wayrilz (rilzabrutinib)

+

mavacamten

1 interaction

Avoid/Use Alternative

rilzabrutinib + mavacamten

avoid combo: combo may incr. mavacamten levels, risk of heart failure, other adverse effects; may decr. rilzabrutinib levels, efficacy (hepatic metab. inhibited; hepatic metab. induced)

• meperidine
Wayrilz (rilzabrutinib)

+

meperidine

1 interaction

Avoid/Use Alternative

rilzabrutinib + meperidine

use alternative or monitor resp. rate, ECG; consider decr. meperidine dose: combo may incr. meperidine levels, risk of CNS and respiratory depression, psychomotor impairment, QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• methadone
Wayrilz (rilzabrutinib)

+

methadone

1 interaction

Avoid/Use Alternative

rilzabrutinib + methadone

use alternative or monitor resp. rate, ECG, consider decr. methadone dose: combo may incr. methadone levels, risk of CNS and resp. depression, psychomotor impairment, QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• methylergonovine
Wayrilz (rilzabrutinib)

+

methylergonovine

1 interaction

Avoid/Use Alternative

rilzabrutinib + methylergonovine

avoid combo: combo may incr. methylergonovine levels, risk of ergot toxicity, severe vasospasm, ischemia, other adverse effects (hepatic metab. inhibited)

• midazolam
Wayrilz (rilzabrutinib)

+

midazolam

1 interaction

Avoid/Use Alternative

rilzabrutinib + midazolam

avoid combo if midazolam nasal use; otherwise, monitor resp. rate, consider decr. midazolam dose: combo may incr. midazolam and active metabolite levels, risk of profound CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• mifepristone
Wayrilz (rilzabrutinib)

+

mifepristone

1 interaction

Avoid/Use Alternative

rilzabrutinib + mifepristone

avoid combo if mifepristone use greater than 7 days; use alternative or hold rilzabrutinib during and x14 days after daily mifepristone use if mifepristone use less than 7 days; caution advised if pregnancy termination use: combo may incr. levels of both drugs, risk of adverse effects (hepatic metab. inhibited)

• mitapivat
Wayrilz (rilzabrutinib)

+

mitapivat

1 interaction

Avoid/Use Alternative

rilzabrutinib + mitapivat

avoid combo: combo may incr. mitapivat levels, risk of adverse effects; may decr. rilzabrutinib levels, efficacy (hepatic metab. inhibited; hepatic metab. induced)

• mitotane
Wayrilz (rilzabrutinib)

+

mitotane

1 interaction

Avoid/Use Alternative

rilzabrutinib + mitotane

avoid combo: combo may decr. rilzabrutinib levels, efficacy (hepatic metab. induced)

• mobocertinib
Wayrilz (rilzabrutinib)

+

mobocertinib

1 interaction

Avoid/Use Alternative

rilzabrutinib + mobocertinib

use alternative or monitor ECG; decr. mobocertinib dose as follows: if taking 160 mg, decr. dose to 80 mg; if taking 120 mg, decr. dose to 40 mg, if taking 80 mg, decr. dose to 40 mg: combo may incr. mobocertinib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• modafinil
Wayrilz (rilzabrutinib)

+

modafinil

1 interaction

Avoid/Use Alternative

rilzabrutinib + modafinil

avoid combo: combo may decr. rilzabrutinib levels, efficacy (hepatic metab. induced)

• nafcillin
Wayrilz (rilzabrutinib)

+

nafcillin

1 interaction

Avoid/Use Alternative

rilzabrutinib + nafcillin

avoid combo: combo may decr. rilzabrutinib levels, efficacy (hepatic metab. induced)

• naloxegol
Wayrilz (rilzabrutinib)

+

naloxegol

1 interaction

Avoid/Use Alternative

rilzabrutinib + naloxegol

use alternative or decr. naloxegol dose to 12.5 mg/day: combo may incr. naloxegol levels, risk of adverse effects (hepatic metab. inhibited)

• natalizumab
Wayrilz (rilzabrutinib)

+

natalizumab

1 interaction

Avoid/Use Alternative

rilzabrutinib + natalizumab

avoid combo: combo may incr. risk of serious infection (additive effects)

• nefazodone
Wayrilz (rilzabrutinib)

+

nefazodone

1 interaction

Avoid/Use Alternative

rilzabrutinib + nefazodone

avoid combo if nefazodone use greater than 7 days; use alternative or hold rilzabrutinib if nefazodone use less than 7 days: combo may incr. rilzabrutinib levels, risk of adverse effects (hepatic metab. inhibited)

• nelfinavir
Wayrilz (rilzabrutinib)

+

nelfinavir

1 interaction

Avoid/Use Alternative

rilzabrutinib + nelfinavir

avoid combo if nelfinavir use greater than 7 days; use alternative or hold rilzabrutinib if nelfinavir use less than 7 days: combo may incr. rilzabrutinib levels, risk of adverse effects (hepatic metab. inhibited)

• neratinib
Wayrilz (rilzabrutinib)

+

neratinib

1 interaction

Avoid/Use Alternative

rilzabrutinib + neratinib

avoid combo: combo may incr. neratinib levels, risk of adverse effects (hepatic metab. inhibited, P-gp-mediated transport possibly inhibited)

• netupitant
Wayrilz (rilzabrutinib)

+

netupitant

1 interaction

Avoid/Use Alternative

rilzabrutinib + netupitant

avoid combo if (fos)netupitant use greater than 7 days; use alternative or hold rilzabrutinib during and x1wk after (fos)netupitant tx if (fos)netupitant use less than 7 days: combo may incr. rilzabrutinib levels, risk of adverse effects (hepatic metab. inhibited)

• nilotinib
Wayrilz (rilzabrutinib)

+

nilotinib

1 interaction

Avoid/Use Alternative

rilzabrutinib + nilotinib

avoid combo if nilotinib use greater than 7 days; use alternative or hold rilzabrutinib if nilotinib use less than 7 days: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, myelosuppression, other adverse effects (hepatic metab. inhibited)

• nirogacestat
Wayrilz (rilzabrutinib)

+

nirogacestat

1 interaction

Avoid/Use Alternative

rilzabrutinib + nirogacestat

avoid combo: combo may incr. levels of both drugs, risk of hypophosphatemia, other adverse effects (hepatic metab. inhibited)

• nisoldipine
Wayrilz (rilzabrutinib)

+

nisoldipine

1 interaction

Avoid/Use Alternative

rilzabrutinib + nisoldipine

consider alternative or monitor BP: combo may incr. nisoldipine levels, risk of hypotension, other adverse effects (hepatic metab. inhibited)

• olaparib
Wayrilz (rilzabrutinib)

+

olaparib

1 interaction

Avoid/Use Alternative

rilzabrutinib + olaparib

use alternative or monitor CBC; decr. olaparib dose to 150 mg bid: combo may incr. olaparib levels, risk of myelosuppression, other adverse effects (hepatic metab. inhibited)

• oliceridine
Wayrilz (rilzabrutinib)

+

oliceridine

1 interaction

Avoid/Use Alternative

rilzabrutinib + oliceridine

use alternative or monitor resp. rate, ECG; consider decr. oliceridine frequency: combo may incr. oliceridine levels, risk of CNS and resp. depression, psychomotor impairment, QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• omaveloxolone
Wayrilz (rilzabrutinib)

+

omaveloxolone

1 interaction

Avoid/Use Alternative

rilzabrutinib + omaveloxolone

use alternative or decr. omaveloxolone dose to 100 mg/day: combo may incr. omaveloxolone levels, risk of adverse effects (hepatic metab. inhibited)

• omeprazole
Wayrilz (rilzabrutinib)

+

omeprazole

1 interaction

Avoid/Use Alternative

rilzabrutinib + omeprazole

avoid combo: combo may decr. rilzabrutinib levels, efficacy (absorption decreased at higher gastric pH)

• oxycodone
Wayrilz (rilzabrutinib)

+

oxycodone

1 interaction

Avoid/Use Alternative

rilzabrutinib + oxycodone

use alternative or monitor resp. rate; consider decr. oxycodone dose: combo may incr. oxycodone levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• pacritinib
Wayrilz (rilzabrutinib)

+

pacritinib

1 interaction

Avoid/Use Alternative

rilzabrutinib + pacritinib

avoid combo: combo may incr. pacritinib levels, risk of QT prolongation, cardiac arrhythmias, myelosuppression, bleeding (incl. life-threatening), other adverse effects; may decr. rilzabrutinib levels, efficacy (hepatic metab. inhibited; hepatic metab. induced)

• palovarotene
Wayrilz (rilzabrutinib)

+

palovarotene

1 interaction

Avoid/Use Alternative

rilzabrutinib + palovarotene

use alternative or decr. palovarotene dose as follows: wt 10-19.9 kg maint. dose 1 mg daily, flare dose 5 mg daily wk 1-4, then 2.5 mg daily wk 5-12; wt 20-39.9 kg maint. dose 1.5 mg daily, flare dose 6 mg daily wk 1-4, then 3 mg daily wk 5-12; wt 40-59.9 kg maint. dose 2 mg daily, flare dose 7.5 mg daily wk 1-4, then 4 mg daily wk 5-12; wt 60 kg and greater or 14 yo and older maint. dose 2.5 mg daily, flare dose 10 mg daily wk 1-4, then 5 mg daily wk 5-12: combo may incr. palovarotene levels, risk of adverse effects (hepatic metab. inhibited)

• pantoprazole
Wayrilz (rilzabrutinib)

+

pantoprazole

1 interaction

Avoid/Use Alternative

rilzabrutinib + pantoprazole

avoid combo: combo may decr. rilzabrutinib levels, efficacy (absorption decreased at higher gastric pH)

• pazopanib
Wayrilz (rilzabrutinib)

+

pazopanib

1 interaction

Avoid/Use Alternative

rilzabrutinib + pazopanib

avoid combo: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited, BCRP-mediated transport possibly inhibited)

• pemigatinib
Wayrilz (rilzabrutinib)

+

pemigatinib

1 interaction

Avoid/Use Alternative

rilzabrutinib + pemigatinib

use alternative or monitor phosphate and decr. pemigatinib dose as follows: if on pemigatinib 13.5 mg qd, decr. to 9 mg qd; if on pemigatinib 9 mg qd, decr. to 4.5 mg qd: combo may incr. pemigatinib levels, risk of hyperphosphatemia, other adverse effects (hepatic metab. inhibited)

• pentobarbital
Wayrilz (rilzabrutinib)

+

pentobarbital

1 interaction

Avoid/Use Alternative

rilzabrutinib + pentobarbital

avoid combo: combo may decr. rilzabrutinib levels, efficacy (hepatic metab. induced)

• pexidartinib
Wayrilz (rilzabrutinib)

+

pexidartinib

1 interaction

Avoid/Use Alternative

rilzabrutinib + pexidartinib

avoid combo: combo may incr. pexidartinib levels, risk of hepatotoxicity, other adverse effects; may decr. rilzabrutinib levels, efficacy (hepatic metab. inhibited; hepatic metab. induced)

• phenobarbital
Wayrilz (rilzabrutinib)

+

phenobarbital

1 interaction

Avoid/Use Alternative

rilzabrutinib + phenobarbital

avoid combo: combo may decr. rilzabrutinib levels, efficacy (hepatic metab. induced)

• phenytoin
Wayrilz (rilzabrutinib)

+

phenytoin

1 interaction

Avoid/Use Alternative

rilzabrutinib + phenytoin

avoid combo: combo may decr. rilzabrutinib levels, efficacy (hepatic metab. induced)

• pimecrolimus topical
Wayrilz (rilzabrutinib)

+

pimecrolimus topical

1 interaction

Avoid/Use Alternative

rilzabrutinib + pimecrolimus topical

avoid combo: combo may incr. risk of serious infection (additive effects)

• pimozide
Wayrilz (rilzabrutinib)

+

pimozide

1 interaction

Avoid/Use Alternative

rilzabrutinib + pimozide

avoid combo: combo may incr. pimozide levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• posaconazole
Wayrilz (rilzabrutinib)

+

posaconazole

1 interaction

Avoid/Use Alternative

rilzabrutinib + posaconazole

avoid combo if posaconazole use greater than 7 days; use alternative or hold rilzabrutinib if posaconazole use less than 7 days: combo may incr. rilzabrutinib levels, risk of adverse effects (hepatic metab. inhibited)

• pralsetinib
Wayrilz (rilzabrutinib)

+

pralsetinib

1 interaction

Avoid/Use Alternative

rilzabrutinib + pralsetinib

use alternative or consider monitoring ECG, electrolytes and decr. pralsetinib dose as follows: if on pralsetinib 400 mg qd, decr. to 300 mg qd; if on pralsetinib 300 mg qd, decr. to 200 mg qd; if on pralsetinib 200 mg qd, decr. to 100 mg qd: combo may incr. pralsetinib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited, P-gp-mediated transport possibly inhibited)

• primidone
Wayrilz (rilzabrutinib)

+

primidone

1 interaction

Avoid/Use Alternative

rilzabrutinib + primidone

avoid combo: combo may decr. rilzabrutinib levels, efficacy (hepatic metab. induced)

• propafenone
Wayrilz (rilzabrutinib)

+

propafenone

1 interaction

Avoid/Use Alternative

rilzabrutinib + propafenone

if CYP2D6 poor metabolizer or if also combined w/ CYP2D6 inhibitor, avoid combo; otherwise, monitor ECG, BP: combo may incr. propafenone levels, risk of QT prolongation, cardiac arrhythmias, hypotension, other adverse effects (hepatic metab. inhibited)

• rabeprazole
Wayrilz (rilzabrutinib)

+

rabeprazole

1 interaction

Avoid/Use Alternative

rilzabrutinib + rabeprazole

avoid combo: combo may decr. rilzabrutinib levels, efficacy (absorption decreased at higher gastric pH)

• rabies vaccine
Wayrilz (rilzabrutinib)

+

rabies vaccine

1 interaction

Avoid/Use Alternative

rilzabrutinib + rabies vaccine

if possible, avoid immunosuppressive tx or vaccinate at least 2wk before starting rilzabrutinib tx; otherwise, consider post-immunization titer check or revaccination after immunocompetence restored: combo may result in inadequate vaccine response (immunosuppressive effects)

• relugolix
Wayrilz (rilzabrutinib)

+

relugolix

1 interaction

Avoid/Use Alternative

rilzabrutinib + relugolix

PROSTATE CANCER: may hold relugolix if rilzabrutinib tx up to 2wk; otherwise, use alternative or monitor ECG, electrolytes and admin. relugolix at least 6h before rilzabrutinib; FIBROID-ASSOC. BLEEDING: use alternative or admin. relugolix at least 6h before rilzabrutinib: combo may incr. relugolix levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (gut P-gp-mediated transport possibly inhibited)

• repotrectinib
Wayrilz (rilzabrutinib)

+

repotrectinib

1 interaction

Avoid/Use Alternative

rilzabrutinib + repotrectinib

avoid combo; D/C rilzabrutinib 3-5 half-lives prior to repotrectinib tx: combo may incr. repotrectinib levels, risk of adverse effects; may decr. rilzabrutinib levels, efficacy (hepatic metab. inhibited, P-gp-mediated transport possibly inhibited; hepatic metab. induced)

• resmetirom
Wayrilz (rilzabrutinib)

+

resmetirom

1 interaction

Avoid/Use Alternative

rilzabrutinib + resmetirom

avoid combo: combo may incr. resmetirom levels, risk of adverse effects (hepatic transport possibly inhibited)

• ribociclib
Wayrilz (rilzabrutinib)

+

ribociclib

1 interaction

Avoid/Use Alternative

rilzabrutinib + ribociclib

avoid combo if ribociclib use greater than 7 days; use alternative or hold rilzabrutinib if ribociclib use less than 7 days: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, myelosuppression, other adverse effects (hepatic metab. inhibited)

• rifabutin
Wayrilz (rilzabrutinib)

+

rifabutin

1 interaction

Avoid/Use Alternative

rilzabrutinib + rifabutin

avoid combo: combo may incr. rifabutin levels, risk of myelosuppression, uveitis, other adverse effects; may decr. rilzabrutinib levels, efficacy (hepatic metab. inhibited; hepatic metab. induced)

• rifampin
Wayrilz (rilzabrutinib)

+

rifampin

1 interaction

Avoid/Use Alternative

rilzabrutinib + rifampin

avoid combo: combo may incr. rifampin levels, risk of adverse effects; may decr. rilzabrutinib levels, efficacy (hepatic transport possibly inhibited; hepatic metab. induced)

• rifapentine
Wayrilz (rilzabrutinib)

+

rifapentine

1 interaction

Avoid/Use Alternative

rilzabrutinib + rifapentine

avoid combo: combo may decr. rilzabrutinib levels, efficacy (hepatic metab. induced)

• ritonavir
Wayrilz (rilzabrutinib)

+

ritonavir

1 interaction

Avoid/Use Alternative

rilzabrutinib + ritonavir

avoid combo if ritonavir use greater than 7 days; use alternative or hold rilzabrutinib if ritonavir use less than 7 days: combo may incr. rilzabrutinib levels, risk of adverse effects (hepatic metab. inhibited)

• rivaroxaban
Wayrilz (rilzabrutinib)

+

rivaroxaban

1 interaction

Avoid/Use Alternative

rilzabrutinib + rivaroxaban

use alternative if CrCl <80; otherwise, monitor bleeding s/sx: combo may incr. rivaroxaban levels, risk of bleeding, other adverse effects (hepatic metab. inhibited, P-gp-mediated transport possibly inhibited, BCRP-mediated transport possibly inhibited)

• selpercatinib
Wayrilz (rilzabrutinib)

+

selpercatinib

1 interaction

Avoid/Use Alternative

rilzabrutinib + selpercatinib

use alternative or monitor ECG, electrolytes; decr. selpercatinib dose as follows: if on selpercatinib 40 mg tid, decr. to 40 mg qd; if on selpercatinib 80 mg bid, decr. to 40 mg bid; if on selpercatinib 120 mg bid, decr. to 80 mg bid; if on selpercatinib 160 mg bid, decr. to 120 mg bid: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• selumetinib
Wayrilz (rilzabrutinib)

+

selumetinib

1 interaction

Avoid/Use Alternative

rilzabrutinib + selumetinib

use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• simvastatin
Wayrilz (rilzabrutinib)

+

simvastatin

1 interaction

Avoid/Use Alternative

rilzabrutinib + simvastatin

use alternative or monitor CK, myopathy sx; adjust max simvastatin dose to 10 mg/day: combo may incr. simvastatin levels, risk of myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited, BCRP-mediated transport possibly inhibited, hepatic transport possibly inhibited)

• siponimod
Wayrilz (rilzabrutinib)

+

siponimod

1 interaction

Avoid/Use Alternative

rilzabrutinib + siponimod

if also combined w/ moderate or strong CYP2C9 inhibitor, avoid combo; otherwise, caution advised: combo may incr. siponimod levels, risk of serious infection, other adverse effects (hepatic metab. inhibited, additive effects)

• sirolimus albumin-bound
Wayrilz (rilzabrutinib)

+

sirolimus albumin-bound

1 interaction

Avoid/Use Alternative

rilzabrutinib + sirolimus albumin-bound

avoid combo: combo may incr. sirolimus albumin-bound levels, risk of serious infection, myelosuppression, bleeding (incl. life-threatening), other adverse effects (hepatic metab. inhibited, P-gp-mediated transport possibly inhibited, additive effects)

• sonidegib
Wayrilz (rilzabrutinib)

+

sonidegib

1 interaction

Avoid/Use Alternative

rilzabrutinib + sonidegib

avoid combo or monitor closely: combo may incr. sonidegib levels, risk of adverse effects (hepatic metab. inhibited)

• sotorasib
Wayrilz (rilzabrutinib)

+

sotorasib

1 interaction

Avoid/Use Alternative

rilzabrutinib + sotorasib

avoid combo: combo may decr. rilzabrutinib levels, efficacy (hepatic metab. induced)

• St. John's wort
Wayrilz (rilzabrutinib)

+

St. John's wort

1 interaction

Avoid/Use Alternative

rilzabrutinib + St. John's wort

avoid combo: combo may decr. rilzabrutinib levels, efficacy (hepatic metab. induced)

• sufentanil
Wayrilz (rilzabrutinib)

+

sufentanil

1 interaction

Avoid/Use Alternative

rilzabrutinib + sufentanil

consider alternative or monitor resp. rate, consider decr. sufentanil dose or frequency: combo may incr. sufentanil levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• tazemetostat
Wayrilz (rilzabrutinib)

+

tazemetostat

1 interaction

Avoid/Use Alternative

rilzabrutinib + tazemetostat

use alternative or monitor ECG, CBC; decr. tazemetostat dose as follows: if taking 800 mg bid, decr. tazemetostat dose to 400 mg bid; if taking 600 mg bid, decr. tazemetostat dose to 400 mg qam plus 200 mg qpm; if taking 400 mg bid, decr. tazemetostat dose to 200 mg bid: combo may incr. tazemetostat levels, risk of QT prolongation, cardiac arrhythmias, myelosuppression, other adverse effects (hepatic metab. inhibited)

• tipranavir
Wayrilz (rilzabrutinib)

+

tipranavir

1 interaction

Avoid/Use Alternative

rilzabrutinib + tipranavir

avoid combo if tipranavir use greater than 7 days; use alternative or hold rilzabrutinib if tipranavir use less than 7 days: combo may incr. rilzabrutinib levels, risk of adverse effects (hepatic metab. inhibited)

• tolvaptan
Wayrilz (rilzabrutinib)

+

tolvaptan

1 interaction

Avoid/Use Alternative

rilzabrutinib + tolvaptan

HYPONATREMIA USE: avoid combo; AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DZ USE: decr. tolvaptan total daily dose by 50% as follows: if taking 60 mg/day, decr. to 15 mg qam and 15 mg qpm; if taking 90 mg/day, decr. to 30 mg qam and 15 mg qpm; if taking 120 mg/day, decr. to 45 mg qam and 15 mg qpm: combo may incr. levels of both drugs, risk of adverse effects (hepatic metab. inhibited)

• topotecan
Wayrilz (rilzabrutinib)

+

topotecan

1 interaction

Avoid/Use Alternative

rilzabrutinib + topotecan

avoid combo w/ oral topotecan; caution advised w/ IV topotecan: combo may incr. topotecan levels, risk of serious infection, myelosuppression, other adverse effects (gut P-gp-mediated transport possibly inhibited, gut BCRP-mediated transport possibly inhibited, additive effects)

• tramadol
Wayrilz (rilzabrutinib)

+

tramadol

1 interaction

Avoid/Use Alternative

rilzabrutinib + tramadol

use alternative or monitor resp. rate, ECG, consider decr. tramadol dose: combo may incr. tramadol and active metabolite levels, risk of CNS and resp. depression, psychomotor impairment, seizures, serotonin syndrome, QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited, may incr. production of active metabolite)

• tucatinib
Wayrilz (rilzabrutinib)

+

tucatinib

1 interaction

Avoid/Use Alternative

rilzabrutinib + tucatinib

avoid combo if tucatinib use greater than 7 days; use alternative or hold rilzabrutinib if tucatinib use less than 7 days: combo may incr. rilzabrutinib levels, risk of adverse effects (hepatic metab. inhibited)

• vardenafil
Wayrilz (rilzabrutinib)

+

vardenafil

1 interaction

Avoid/Use Alternative

rilzabrutinib + vardenafil

max vardenafil dose 5 mg/24h; avoid combo w/ ODT form: combo may incr. vardenafil levels, risk of QT prolongation, cardiac arrhythmias, hypotension, priapism, other adverse effects (hepatic metab. inhibited)

• venetoclax
Wayrilz (rilzabrutinib)

+

venetoclax

1 interaction

Avoid/Use Alternative

rilzabrutinib + venetoclax

ALL INDICATIONS: monitor CBC, tumor lysis syndrome s/sx; CLL/SLL: consider alternative or decr. venetoclax dose by at least 50%; AML: decr. venetoclax dose by at least 50%: combo may incr. venetoclax levels, risk of serious infection, myelosuppression, tumor lysis syndrome, other adverse effects (hepatic metab. inhibited, P-gp-mediated transport possibly inhibited, additive effects)

• verapamil
Wayrilz (rilzabrutinib)

+

verapamil

1 interaction

Avoid/Use Alternative

rilzabrutinib + verapamil

avoid combo if verapamil use greater than 7 days; use alternative or hold rilzabrutinib if verapamil use less than 7 days: combo may incr. levels of both drugs, risk of hypotension, bradycardia, AV block, other adverse effects (hepatic metab. inhibited)

• vonoprazan
Wayrilz (rilzabrutinib)

+

vonoprazan

1 interaction

Avoid/Use Alternative

rilzabrutinib + vonoprazan

avoid combo: combo may incr. rilzabrutinib levels, risk of adverse effects; may decr. rilzabrutinib levels, efficacy (hepatic metab. inhibited; absorption decreased at higher gastric pH)

• voriconazole
Wayrilz (rilzabrutinib)

+

voriconazole

1 interaction

Avoid/Use Alternative

rilzabrutinib + voriconazole

avoid combo if voriconazole use greater than 7 days; use alternative or hold rilzabrutinib if voriconazole use less than 7 days: combo may incr. rilzabrutinib levels, risk of adverse effects (hepatic metab. inhibited)

• zavegepant
Wayrilz (rilzabrutinib)

+

zavegepant

1 interaction

Avoid/Use Alternative

rilzabrutinib + zavegepant

avoid combo: combo may incr. zavegepant levels, risk of adverse effects (hepatic transport possibly inhibited)

Monitor/Modify Tx

• abemaciclib
Wayrilz (rilzabrutinib)

+

abemaciclib

1 interaction

Monitor/Modify Tx

rilzabrutinib + abemaciclib

consider decr. abemaciclib 200 mg bid dose to 150 mg bid, abemaciclib 150 mg bid dose to 100 mg bid, abemaciclib 100 mg bid dose to 50 mg bid; monitor CBC: combo may incr. abemaciclib levels, risk of serious infection, other adverse effects (hepatic metab. inhibited, additive effects)

• acalabrutinib
Wayrilz (rilzabrutinib)

+

acalabrutinib

1 interaction

Monitor/Modify Tx

rilzabrutinib + acalabrutinib

decr. acalabrutinib dose to 100 mg qd; monitor CBC: combo may incr. acalabrutinib levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metab. inhibited, additive effects)

• afatinib
Wayrilz (rilzabrutinib)

+

afatinib

1 interaction

Monitor/Modify Tx

rilzabrutinib + afatinib

decr. afatinib dose by 10 mg/day if not tolerated: combo may incr. afatinib levels, risk of adverse effects (P-gp-mediated transport possibly inhibited)

• alfuzosin
Wayrilz (rilzabrutinib)

+

alfuzosin

1 interaction

Monitor/Modify Tx

rilzabrutinib + alfuzosin

monitor BP, ECG: combo may incr. alfuzosin levels, risk of QT prolongation, cardiac arrhythmias, hypotension (incl. orthostasis, syncope), other adverse effects (hepatic metab. inhibited)

• aluminum hydroxide
Wayrilz (rilzabrutinib)

+

aluminum hydroxide

1 interaction

Monitor/Modify Tx

rilzabrutinib + aluminum hydroxide

give rilzabrutinib at least 2h before aluminum hydroxide: combo may decr. rilzabrutinib levels, efficacy (absorption decreased at higher gastric pH)

• anthrax vaccine
Wayrilz (rilzabrutinib)

+

anthrax vaccine

1 interaction

Monitor/Modify Tx

rilzabrutinib + anthrax vaccine

if possible, vaccinate at least 2wk before starting rilzabrutinib tx; otherwise, consider post-immunization titer check or revaccination after immunocompetence restored: combo may result in inadequate vaccine response (immunosuppressive effects)

• apixaban
Wayrilz (rilzabrutinib)

+

apixaban

1 interaction

Monitor/Modify Tx

rilzabrutinib + apixaban

monitor bleeding s/sx: combo may incr. apixaban levels, risk of bleeding, other adverse effects (hepatic metab. inhibited, P-gp-mediated transport possibly inhibited)

• aripiprazole oral
Wayrilz (rilzabrutinib)

+

aripiprazole oral

1 interaction

Monitor/Modify Tx

rilzabrutinib + aripiprazole oral

consider decr. PO aripiprazole dose; if also CYP2D6 PM or if also combined w/ strong CYP2D6 inhibitor, consider decr. PO aripiprazole dose up to 75%; no dose adjustment if depression adjunct tx use: combo may incr. aripiprazole levels, risk of adverse effects (hepatic metab. inhibited)

• artemether/lumefantrine
Wayrilz (rilzabrutinib)

+

artemether/ lumefantrine

1 interaction

Monitor/Modify Tx

rilzabrutinib + artemether/ lumefantrine

monitor ECG: combo may incr. artemether/lumefantrine levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• atogepant
Wayrilz (rilzabrutinib)

+

atogepant

1 interaction

Monitor/Modify Tx

rilzabrutinib + atogepant

CHRONIC MIGRAINE: decr. atogepant dose to 30 mg/day; EPISODIC MIGRAINE: decr. atogepant dose to 10 or 30 mg/day: combo may incr. atogepant levels, risk of adverse effects (hepatic transport possibly inhibited)

• atorvastatin
Wayrilz (rilzabrutinib)

+

atorvastatin

1 interaction

Monitor/Modify Tx

rilzabrutinib + atorvastatin

monitor CK, myopathy sx: combo may incr. levels of both drugs, risk of myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited, P-gp-mediated transport possibly inhibited, BCRP-mediated transport possibly inhibited, hepatic transport possibly inhibited)

• avanafil
Wayrilz (rilzabrutinib)

+

avanafil

1 interaction

Monitor/Modify Tx

rilzabrutinib + avanafil

monitor BP; adjust max avanafil dose to 50 mg/24h: combo may incr. avanafil levels, risk of hypotension, priapism, other adverse effects (hepatic metab. inhibited)

• avatrombopag
Wayrilz (rilzabrutinib)

+

avatrombopag

1 interaction

Monitor/Modify Tx

rilzabrutinib + avatrombopag

CHRONIC IMMUNE THROMBOCYTOPENIA: monitor platelets, thrombosis s/sx; if avatrombopag tablet also combined w/ a moderate or strong CYP2C9 inhibitor, decr. start dose to 20 mg 3x/wk; if avatrombopag sprinkle also combined w/ a moderate or strong CYP2C9 inhibitor, decr. start dose to 10 mg 3x/wk; CHRONIC LIVER DZ: monitor platelets, thrombosis s/sx: combo may incr. avatrombopag levels, risk of thromboembolism, other adverse effects (hepatic metab. inhibited)

• axitinib
Wayrilz (rilzabrutinib)

+

axitinib

1 interaction

Monitor/Modify Tx

rilzabrutinib + axitinib

consider decr. axitinib dose: combo may incr. axitinib levels, risk of adverse effects (hepatic metab. inhibited)

• brexpiprazole
Wayrilz (rilzabrutinib)

+

brexpiprazole

1 interaction

Monitor/Modify Tx

rilzabrutinib + brexpiprazole

if CYP2D6 poor metabolizer or if also combined w/ moderate or strong CYP2D6 inhibitor, decr. brexpiprazole dose 75%: combo may incr. brexpiprazole levels, risk of adverse effects (hepatic metab. inhibited)

• bromocriptine
Wayrilz (rilzabrutinib)

+

bromocriptine

1 interaction

Monitor/Modify Tx

rilzabrutinib + bromocriptine

limit bromocriptine max dose to 1.6 mg/day if diabetes tx; otherwise, caution advised: combo may incr. bromocriptine levels, risk of adverse effects (hepatic metab. inhibited)

• budesonide
Wayrilz (rilzabrutinib)

+

budesonide

1 interaction

Monitor/Modify Tx

rilzabrutinib + budesonide

monitor hypercorticism s/sx: combo may incr. budesonide levels, risk of systemic corticosteroid effects, incl. Cushing syndrome, adrenal suppression, serious infection, other adverse effects (hepatic metab. inhibited, additive effects)

• butorphanol
Wayrilz (rilzabrutinib)

+

butorphanol

1 interaction

Monitor/Modify Tx

rilzabrutinib + butorphanol

monitor resp. rate, consider decr. butorphanol dose: combo may incr. butorphanol levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• cabozantinib
Wayrilz (rilzabrutinib)

+

cabozantinib

1 interaction

Monitor/Modify Tx

rilzabrutinib + cabozantinib

monitor ECG, BP, bleeding s/sx: combo may incr. cabozantinib levels, risk of QT prolongation, cardiac arrhythmias, HTN, GI or other bleeding (incl. life-threatening), other adverse effects (hepatic metab. inhibited)

• calcium carbonate
Wayrilz (rilzabrutinib)

+

calcium carbonate

1 interaction

Monitor/Modify Tx

rilzabrutinib + calcium carbonate

give rilzabrutinib at least 2h before calcium carbonate: combo may decr. rilzabrutinib levels, efficacy (absorption decreased at higher gastric pH)

• capivasertib
Wayrilz (rilzabrutinib)

+

capivasertib

1 interaction

Monitor/Modify Tx

rilzabrutinib + capivasertib

monitor glucose; decr. capivasertib dose to 320 mg bid x4 days followed by 3 days off: combo may incr. levels of both drugs, risk of severe hyperglycemia, other adverse effects (hepatic metab. inhibited)

• carfilzomib
Wayrilz (rilzabrutinib)

+

carfilzomib

1 interaction

Monitor/Modify Tx

rilzabrutinib + carfilzomib

consider antiviral prophylaxis: combo may incr. risk of serious infection (additive effects)

• cariprazine
Wayrilz (rilzabrutinib)

+

cariprazine

1 interaction

Monitor/Modify Tx

rilzabrutinib + cariprazine

if starting cariprazine tx, adjust dose as follows: SCHIZOPHRENIA/BIPOLAR MANIA: start cariprazine 1.5 mg qod, then may incr. to 1.5 mg qd; BIPOLAR DEPRESSION/DEPRESSION ADJUNCT: start cariprazine 1.5 mg qod; if on stable cariprazine tx and starting rilzabrutinib, adjust cariprazine dose as follows: ALL INDICATIONS: if on cariprazine 1.5 mg or 3 mg qd, decr. dose to 1.5 mg qod; if on cariprazine 4.5 mg or 6 mg qd, decr. dose to 1.5 mg qd: combo may incr. cariprazine and active metabolite levels, risk of adverse effects (hepatic metab. inhibited)

• chikungunya vaccine
Wayrilz (rilzabrutinib)

+

chikungunya vaccine

1 interaction

Monitor/Modify Tx

rilzabrutinib + chikungunya vaccine

if possible, vaccinate at least 2wk before starting rilzabrutinib tx; otherwise, consider post-immunization titer check or revaccination after immunocompetence restored: combo may result in inadequate vaccine response (immunosuppressive effects)

• cilostazol
Wayrilz (rilzabrutinib)

+

cilostazol

1 interaction

Monitor/Modify Tx

rilzabrutinib + cilostazol

decr. cilostazol dose to 50 mg bid: combo may incr. levels of both drugs, risk of adverse effects (hepatic metab. inhibited)

• cimetidine
Wayrilz (rilzabrutinib)

+

cimetidine

1 interaction

Monitor/Modify Tx

rilzabrutinib + cimetidine

give rilzabrutinib at least 2h before cimetidine: combo may incr. rilzabrutinib levels, risk of adverse effects; may decr. rilzabrutinib levels, efficacy (hepatic metab. inhibited; absorption decreased at higher gastric pH)

• clonazepam
Wayrilz (rilzabrutinib)

+

clonazepam

1 interaction

Monitor/Modify Tx

rilzabrutinib + clonazepam

monitor resp. rate: combo may incr. clonazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• clozapine
Wayrilz (rilzabrutinib)

+

clozapine

1 interaction

Monitor/Modify Tx

rilzabrutinib + clozapine

monitor ECG, BP, HR; consider decr. clozapine dose: combo may incr. clozapine levels, risk of QT prolongation, cardiac arrhythmias, hypotension, bradycardia, other adverse effects (hepatic metab. inhibited)

• copanlisib
Wayrilz (rilzabrutinib)

+

copanlisib

1 interaction

Monitor/Modify Tx

rilzabrutinib + copanlisib

monitor CBC: combo may incr. copanlisib levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metab. inhibited, additive effects)

• COVID-19 vaccine
Wayrilz (rilzabrutinib)

+

COVID-19 vaccine

1 interaction

Monitor/Modify Tx

rilzabrutinib + COVID-19 vaccine

if possible, vaccinate at least 4wk before starting rilzabrutinib tx; otherwise, consider post-immunization titer check or revaccination after immunocompetence restored: combo may result in inadequate vaccine response (immunosuppressive effects)

• daridorexant
Wayrilz (rilzabrutinib)

+

daridorexant

1 interaction

Monitor/Modify Tx

rilzabrutinib + daridorexant

adjust max daridorexant dose to 25 mg/day: combo may incr. levels of both drugs, risk of CNS depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• dasatinib
Wayrilz (rilzabrutinib)

+

dasatinib

1 interaction

Monitor/Modify Tx

rilzabrutinib + dasatinib

monitor ECG, CBC: combo may incr. dasatinib levels, risk of QT prolongation, cardiac arrhythmias, myelosuppression, other adverse effects (hepatic metab. inhibited)

• deflazacort
Wayrilz (rilzabrutinib)

+

deflazacort

1 interaction

Monitor/Modify Tx

rilzabrutinib + deflazacort

decr. deflazacort to 1/3 usual dose: combo may incr. deflazacort active metabolite levels, risk of systemic corticosteroid effects incl. Cushing syndrome, adrenal suppression, serious infection (hepatic metab. inhibited, additive effects)

• digoxin
Wayrilz (rilzabrutinib)

+

digoxin

1 interaction

Monitor/Modify Tx

rilzabrutinib + digoxin

monitor digoxin levels, HR; decr. digoxin frequency or dose by 15-30%; EFFECT: combo may incr. digoxin levels, risk of bradycardia, AV block, other adverse effects: combo may incr. digoxin levels, risk of bradycardia, AV block, other adverse effects (P-gp-mediated transport possibly inhibited)

• diphtheria/tetanus vaccine
Wayrilz (rilzabrutinib)

+

diphtheria/ tetanus vaccine

1 interaction

Monitor/Modify Tx

rilzabrutinib + diphtheria/ tetanus vaccine

if possible, vaccinate at least 2wk before starting rilzabrutinib tx; otherwise, consider post-immunization titer check or revaccination after immunocompetence restored: combo may result in inadequate vaccine response (immunosuppressive effects)

• diphtheria/tetanus/pertussis vaccine
Wayrilz (rilzabrutinib)

+

diphtheria/ tetanus/ pertussis vaccine

1 interaction

Monitor/Modify Tx

rilzabrutinib + diphtheria/ tetanus/ pertussis vaccine

if possible, vaccinate at least 2wk before starting rilzabrutinib tx; otherwise, consider post-immunization titer check or revaccination after immunocompetence restored: combo may result in inadequate vaccine response (immunosuppressive effects)

• docetaxel
Wayrilz (rilzabrutinib)

+

docetaxel

1 interaction

Monitor/Modify Tx

rilzabrutinib + docetaxel

monitor CBC; consider decr. docetaxel dose: combo may incr. docetaxel levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metab. inhibited)

• dofetilide
Wayrilz (rilzabrutinib)

+

dofetilide

1 interaction

Monitor/Modify Tx

rilzabrutinib + dofetilide

monitor ECG: combo may incr. dofetilide levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• ebola vaccine, live
Wayrilz (rilzabrutinib)

+

ebola vaccine, live

1 interaction

Monitor/Modify Tx

rilzabrutinib + ebola vaccine, live

consider vaccinating at least 4wk before or 6mo after rilzabrutinib tx: combo may result in inadequate vaccine response; may incr. risk of mild vesicular stomatitis virus infection (immunosuppressive effects, recombinant vaccine w/ vesicular stomatitis virus vector)

• edoxaban
Wayrilz (rilzabrutinib)

+

edoxaban

1 interaction

Monitor/Modify Tx

rilzabrutinib + edoxaban

monitor bleeding s/sx: combo may incr. edoxaban levels, risk of bleeding, other adverse effects (P-gp-mediated transport possibly inhibited)

• elexacaftor/tezacaftor/ivacaftor
Wayrilz (rilzabrutinib)

+

elexacaftor/ tezacaftor/ ivacaftor

1 interaction

Monitor/Modify Tx

rilzabrutinib + elexacaftor/ tezacaftor/ ivacaftor

2-5 YO: decr. dose by alternating one elexacaftor/tezacaftor/ivacaftor packet or one ivacaftor packet at each morning dose, no evening doses; 6 YO AND OLDER: decr. dose by alternating two elexacaftor/tezacaftor/ivacaftor tabs or one ivacaftor tab at each morning dose, no evening doses: combo may incr. elexacaftor/tezacaftor/ivacaftor levels, risk of adverse effects (hepatic metab. inhibited)

• eluxadoline
Wayrilz (rilzabrutinib)

+

eluxadoline

1 interaction

Monitor/Modify Tx

rilzabrutinib + eluxadoline

decr. eluxadoline dose to 75 mg bid: combo may incr. eluxadoline levels, risk of adverse effects (hepatic transport possibly inhibited)

• enfortumab vedotin
Wayrilz (rilzabrutinib)

+

enfortumab vedotin

1 interaction

Monitor/Modify Tx

rilzabrutinib + enfortumab vedotin

if also combined w/ strong CYP3A4 inhibitor, monitor CBC, glucose: combo may incr. enfortumab vedotin levels, risk of myelosuppression, neuropathy, hyperglycemia, other adverse effects (P-gp-mediated transport possibly inhibited)

• eplerenone
Wayrilz (rilzabrutinib)

+

eplerenone

1 interaction

Monitor/Modify Tx

rilzabrutinib + eplerenone

monitor potassium, Cr in 3-7 days after tx start; in post-MI CHF pts, max eplerenone dose 25 mg/day; in HTN pts, start eplerenone 25 mg qd, max dose 50 mg/day: combo may incr. eplerenone levels, risk of hyperkalemia, other adverse effects (hepatic metab. inhibited)

• erdafitinib
Wayrilz (rilzabrutinib)

+

erdafitinib

1 interaction

Monitor/Modify Tx

rilzabrutinib + erdafitinib

monitor phosphate: combo may incr. erdafitinib levels, risk of hyperphosphatemia, other adverse effects (hepatic metab. inhibited)

• estazolam
Wayrilz (rilzabrutinib)

+

estazolam

1 interaction

Monitor/Modify Tx

rilzabrutinib + estazolam

monitor resp. rate; consider decr. estazolam dose: combo may incr. estazolam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• estradiol (contraceptive)
Wayrilz (rilzabrutinib)

+

estradiol (contraceptive)

1 interaction

Monitor/Modify Tx

rilzabrutinib + estradiol (contraceptive)

monitor thrombosis s/sx: combo may incr. estradiol levels, risk of thromboembolism, other adverse effects (hepatic metab. inhibited)

• ethinyl estradiol (contraceptive)
Wayrilz (rilzabrutinib)

+

ethinyl estradiol (contraceptive)

1 interaction

Monitor/Modify Tx

rilzabrutinib + ethinyl estradiol (contraceptive)

monitor thrombosis s/sx, especially if oral ethinyl estradiol dose >35 mcg/day: combo may incr. levels of both drugs, risk of thromboembolism, other adverse effects (hepatic metab. inhibited)

• everolimus
Wayrilz (rilzabrutinib)

+

everolimus

1 interaction

Monitor/Modify Tx

rilzabrutinib + everolimus

admin. PCP prophylaxis; BREAST CA, PNET, RENAL CELL CA, or RENAL ANGIOMYOLIPOMA w/ TSC: decr. everolimus dose to 2.5 mg/day, may then incr. to 5 mg/day if tolerated, monitor CBC; TSC-ASSOC. SEGA or TSC-ASSOC. PARTIAL-ONSET SEIZURES: monitor everolimus levels, CBC and decr. everolimus dose 50%; give every other day if already on lowest available dose; TRANSPLANT: monitor everolimus levels, CBC: combo may incr. levels of both drugs, risk of serious infection, myelosuppression, other adverse effects (hepatic metab. inhibited, P-gp-mediated transport possibly inhibited, additive effects)

• famotidine
Wayrilz (rilzabrutinib)

+

famotidine

1 interaction

Monitor/Modify Tx

rilzabrutinib + famotidine

give rilzabrutinib at least 2h before famotidine: combo may decr. rilzabrutinib levels, efficacy (absorption decreased at higher gastric pH)

• felodipine
Wayrilz (rilzabrutinib)

+

felodipine

1 interaction

Monitor/Modify Tx

rilzabrutinib + felodipine

monitor BP, HR: combo may incr. felodipine levels, risk of hypotension, reflex tachycardia, other adverse effects (hepatic metab. inhibited)

• finerenone
Wayrilz (rilzabrutinib)

+

finerenone

1 interaction

Monitor/Modify Tx

rilzabrutinib + finerenone

monitor potassium: combo may incr. levels of both drugs, risk of hyperkalemia, other adverse effects (hepatic metab. inhibited)

• fluvastatin
Wayrilz (rilzabrutinib)

+

fluvastatin

1 interaction

Monitor/Modify Tx

rilzabrutinib + fluvastatin

monitor CK, myopathy sx: combo may incr. fluvastatin levels, risk of myopathy, rhabdomyolysis, other adverse effects (BCRP-mediated transport possibly inhibited, hepatic transport possibly inhibited)

• gepirone
Wayrilz (rilzabrutinib)

+

gepirone

1 interaction

Monitor/Modify Tx

rilzabrutinib + gepirone

monitor ECG, electrolytes; decr. gepirone dose 50%: combo may incr. gepirone levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• gilteritinib
Wayrilz (rilzabrutinib)

+

gilteritinib

1 interaction

Monitor/Modify Tx

rilzabrutinib + gilteritinib

monitor ECG: combo may incr. gilteritinib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• glasdegib
Wayrilz (rilzabrutinib)

+

glasdegib

1 interaction

Monitor/Modify Tx

rilzabrutinib + glasdegib

monitor CBC, ECG: combo may incr. glasdegib levels, risk of QT prolongation, cardiac arrhythmias, myelosuppression, other adverse effects (hepatic metab. inhibited)

• guanfacine
Wayrilz (rilzabrutinib)

+

guanfacine

1 interaction

Monitor/Modify Tx

rilzabrutinib + guanfacine

decr. guanfacine ER dose 50%, consider decr. dose for immed.-release form: combo may incr. guanfacine levels, risk of adverse effects (hepatic metab. inhibited)

• Haemophilus b vaccine
Wayrilz (rilzabrutinib)

+

Haemophilus b vaccine

1 interaction

Monitor/Modify Tx

rilzabrutinib + Haemophilus b vaccine

if possible, vaccinate at least 2wk before starting rilzabrutinib tx; otherwise, consider post-immunization titer check or revaccination after immunocompetence restored: combo may result in inadequate vaccine response (immunosuppressive effects)

• hepatitis A vaccine
Wayrilz (rilzabrutinib)

+

hepatitis A vaccine

1 interaction

Monitor/Modify Tx

rilzabrutinib + hepatitis A vaccine

if possible, vaccinate at least 2wk before starting rilzabrutinib tx; otherwise, consider post-immunization titer check or revaccination after immunocompetence restored: combo may result in inadequate vaccine response (immunosuppressive effects)

• hepatitis B vaccine
Wayrilz (rilzabrutinib)

+

hepatitis B vaccine

1 interaction

Monitor/Modify Tx

rilzabrutinib + hepatitis B vaccine

if possible, vaccinate at least 2wk before starting rilzabrutinib tx; otherwise, consider post-immunization titer check or revaccination after immunocompetence restored: combo may result in inadequate vaccine response (immunosuppressive effects)

• human papillomavirus vaccine
Wayrilz (rilzabrutinib)

+

human papillomavirus vaccine

1 interaction

Monitor/Modify Tx

rilzabrutinib + human papillomavirus vaccine

if possible, vaccinate at least 2wk before starting rilzabrutinib tx; otherwise, consider post-immunization titer check or revaccination after immunocompetence restored: combo may result in inadequate vaccine response (immunosuppressive effects)

• hydrocortisone
Wayrilz (rilzabrutinib)

+

hydrocortisone

1 interaction

Monitor/Modify Tx

rilzabrutinib + hydrocortisone

consider decr. hydrocortisone dose: combo may incr. hydrocortisone levels, risk of systemic corticosteroid effects, incl. Cushing syndrome and adrenal suppression, serious infection, other adverse effects (hepatic metab. inhibited, additive effects)

• ibrutinib
Wayrilz (rilzabrutinib)

+

ibrutinib

1 interaction

Monitor/Modify Tx

rilzabrutinib + ibrutinib

B-CELL MALIGNANCIES: decr. ibrutinib dose to 280 mg qd; CHRONIC GVHD: consider decr. ibrutinib dose: combo may incr. ibrutinib levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metab. inhibited, additive effects)

• iloperidone
Wayrilz (rilzabrutinib)

+

iloperidone

1 interaction

Monitor/Modify Tx

rilzabrutinib + iloperidone

monitor ECG: combo may incr. iloperidone levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• influenza H5N1 vaccine
Wayrilz (rilzabrutinib)

+

influenza H5N1 vaccine

1 interaction

Monitor/Modify Tx

rilzabrutinib + influenza H5N1 vaccine

if possible, vaccinate at least 2wk before starting rilzabrutinib tx; otherwise, consider post-immunization titer check or revaccination after immunocompetence restored: combo may result in inadequate vaccine response (immunosuppressive effects)

• influenza vaccine
Wayrilz (rilzabrutinib)

+

influenza vaccine

1 interaction

Monitor/Modify Tx

rilzabrutinib + influenza vaccine

if possible, vaccinate at least 2wk before starting rilzabrutinib tx; otherwise, consider vaccination after immunocompetence restored: combo may result in inadequate vaccine response (immunosuppressive effects)

• irinotecan
Wayrilz (rilzabrutinib)

+

irinotecan

1 interaction

Monitor/Modify Tx

rilzabrutinib + irinotecan

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited, BCRP-mediated transport possibly inhibited, additive effects)

• Japanese encephalitis vaccine
Wayrilz (rilzabrutinib)

+

Japanese encephalitis vaccine

1 interaction

Monitor/Modify Tx

rilzabrutinib + Japanese encephalitis vaccine

if possible, vaccinate at least 2wk before starting rilzabrutinib tx; otherwise, consider post-immunization titer check or revaccination after immunocompetence restored: combo may result in inadequate vaccine response (immunosuppressive effects)

• lapatinib
Wayrilz (rilzabrutinib)

+

lapatinib

1 interaction

Monitor/Modify Tx

rilzabrutinib + lapatinib

monitor ECG; consider decr. lapatinib dose: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited, BCRP-mediated transport possibly inhibited)

• lidocaine
Wayrilz (rilzabrutinib)

+

lidocaine

1 interaction

Monitor/Modify Tx

rilzabrutinib + lidocaine

monitor lidocaine levels if lidocaine antiarrhythmic use; otherwise, monitor BP, HR: combo may incr. lidocaine levels, risk of hypotension, bradycardia, other adverse effects; risk may be higher w/ continuous infusion or higher doses for local anesthesia (hepatic metab. inhibited)

• lumateperone
Wayrilz (rilzabrutinib)

+

lumateperone

1 interaction

Monitor/Modify Tx

rilzabrutinib + lumateperone

monitor ECG; decr. lumateperone dose to 21 mg qd: combo may incr. lumateperone levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• lurasidone
Wayrilz (rilzabrutinib)

+

lurasidone

1 interaction

Monitor/Modify Tx

rilzabrutinib + lurasidone

monitor ECG; decr. lurasidone start dose to 20 mg or decr. usual lurasidone dose 50%, max 80 mg/day: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• magnesium carbonate
Wayrilz (rilzabrutinib)

+

magnesium carbonate

1 interaction

Monitor/Modify Tx

rilzabrutinib + magnesium carbonate

give rilzabrutinib at least 2h before magnesium carbonate: combo may decr. rilzabrutinib levels, efficacy (absorption decreased at higher gastric pH)

• magnesium hydroxide
Wayrilz (rilzabrutinib)

+

magnesium hydroxide

1 interaction

Monitor/Modify Tx

rilzabrutinib + magnesium hydroxide

give rilzabrutinib at least 2h before magnesium hydroxide: combo may decr. rilzabrutinib levels, efficacy (absorption decreased at higher gastric pH)

• magnesium oxide
Wayrilz (rilzabrutinib)

+

magnesium oxide

1 interaction

Monitor/Modify Tx

rilzabrutinib + magnesium oxide

give rilzabrutinib at least 2h before magnesium oxide: combo may decr. rilzabrutinib levels, efficacy (absorption decreased at higher gastric pH)

• mavorixafor
Wayrilz (rilzabrutinib)

+

mavorixafor

1 interaction

Monitor/Modify Tx

rilzabrutinib + mavorixafor

monitor ECG: combo may incr. mavorixafor levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited, P-gp-mediated transport possibly inhibited)

• mefloquine
Wayrilz (rilzabrutinib)

+

mefloquine

1 interaction

Monitor/Modify Tx

rilzabrutinib + mefloquine

monitor ECG: combo may incr. mefloquine levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• meningococcal vaccine
Wayrilz (rilzabrutinib)

+

meningococcal vaccine

1 interaction

Monitor/Modify Tx

rilzabrutinib + meningococcal vaccine

if possible, vaccinate at least 2wk before starting rilzabrutinib tx; otherwise, consider post-immunization titer check or revaccination after immunocompetence restored: combo may result in inadequate vaccine response (immunosuppressive effects)

• methotrexate
Wayrilz (rilzabrutinib)

+

methotrexate

1 interaction

Monitor/Modify Tx

rilzabrutinib + methotrexate

monitor CBC, renal fxn: combo may incr. methotrexate levels, risk of serious infection, myelosuppression, nephrotoxicity, other adverse effects (BCRP-mediated transport possibly inhibited, additive effects)

• midostaurin
Wayrilz (rilzabrutinib)

+

midostaurin

1 interaction

Monitor/Modify Tx

rilzabrutinib + midostaurin

monitor ECG, CBC: combo may incr. midostaurin levels, risk of QT prolongation, cardiac arrhythmias, myelosuppression, other adverse effects (hepatic metab. inhibited)

• mitoxantrone
Wayrilz (rilzabrutinib)

+

mitoxantrone

1 interaction

Monitor/Modify Tx

rilzabrutinib + mitoxantrone

monitor CBC, cardiac fxn, incl. LVEF: combo may incr. mitoxantrone levels, risk of serious infection, myelosuppression, cardiotoxicity, other adverse effects (BCRP-mediated transport possibly inhibited, additive effects)

• momelotinib
Wayrilz (rilzabrutinib)

+

momelotinib

1 interaction

Monitor/Modify Tx

rilzabrutinib + momelotinib

monitor CBC, bleeding s/sx: combo may incr. momelotinib levels, risk of serious infection, myelosuppression, other adverse effects (hepatic transport possibly inhibited, additive effects)

• morphine
Wayrilz (rilzabrutinib)

+

morphine

1 interaction

Monitor/Modify Tx

rilzabrutinib + morphine

monitor resp. rate, consider decr. dose of one or both drugs: combo may incr. morphine levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (P-gp-mediated transport possibly inhibited)

• nateglinide
Wayrilz (rilzabrutinib)

+

nateglinide

1 interaction

Monitor/Modify Tx

rilzabrutinib + nateglinide

monitor glucose: combo may incr. nateglinide levels, risk of hypoglycemia, other adverse effects (hepatic transport possibly inhibited)

• nifedipine
Wayrilz (rilzabrutinib)

+

nifedipine

1 interaction

Monitor/Modify Tx

rilzabrutinib + nifedipine

monitor BP, consider lowest nifedipine start dose: combo may incr. nifedipine levels, risk of hypotension, other adverse effects (hepatic metab. inhibited)

• nimodipine
Wayrilz (rilzabrutinib)

+

nimodipine

1 interaction

Monitor/Modify Tx

rilzabrutinib + nimodipine

monitor BP: combo may incr. nimodipine levels, risk of hypotension, other adverse effects (hepatic metab. inhibited)

• nizatidine
Wayrilz (rilzabrutinib)

+

nizatidine

1 interaction

Monitor/Modify Tx

rilzabrutinib + nizatidine

give rilzabrutinib at least 2h before nizatidine: combo may decr. rilzabrutinib levels, efficacy (absorption decreased at higher gastric pH)

• nortriptyline
Wayrilz (rilzabrutinib)

+

nortriptyline

1 interaction

Monitor/Modify Tx

rilzabrutinib + nortriptyline

monitor nortriptyline levels: combo may incr. nortriptyline levels, risk of adverse effects (hepatic metab. inhibited)

• osilodrostat
Wayrilz (rilzabrutinib)

+

osilodrostat

1 interaction

Monitor/Modify Tx

rilzabrutinib + osilodrostat

monitor ECG: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• palbociclib
Wayrilz (rilzabrutinib)

+

palbociclib

1 interaction

Monitor/Modify Tx

rilzabrutinib + palbociclib

monitor CBC: combo may incr. levels of both drugs, risk of myelosuppression, other adverse effects (hepatic metab. inhibited)

• panobinostat
Wayrilz (rilzabrutinib)

+

panobinostat

1 interaction

Monitor/Modify Tx

rilzabrutinib + panobinostat

monitor ECG, CBC: combo may incr. panobinostat levels, risk of QT prolongation, cardiac arrhythmias, serious infection, myelosuppression, other adverse effects (hepatic metab. inhibited, additive effects)

• pimavanserin
Wayrilz (rilzabrutinib)

+

pimavanserin

1 interaction

Monitor/Modify Tx

rilzabrutinib + pimavanserin

consider monitoring ECG: combo may incr. pimavanserin levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• pirtobrutinib
Wayrilz (rilzabrutinib)

+

pirtobrutinib

1 interaction

Monitor/Modify Tx

rilzabrutinib + pirtobrutinib

monitor CBC: combo may incr. levels of both drugs, risk of serious infection, myelosuppression, other adverse effects (hepatic metab. inhibited, additive effects)

• pitavastatin
Wayrilz (rilzabrutinib)

+

pitavastatin

1 interaction

Monitor/Modify Tx

rilzabrutinib + pitavastatin

monitor CK, myopathy sx: combo may incr. pitavastatin levels, risk of myopathy, rhabdomyolysis, other adverse effects (BCRP-mediated transport possibly inhibited, hepatic transport possibly inhibited)

• pneumococcal vaccine
Wayrilz (rilzabrutinib)

+

pneumococcal vaccine

1 interaction

Monitor/Modify Tx

rilzabrutinib + pneumococcal vaccine

if possible, vaccinate at least 2wk before starting rilzabrutinib tx; otherwise, consider post-immunization titer check or revaccination after immunocompetence restored: combo may result in inadequate vaccine response (immunosuppressive effects)

• poliovirus vaccine
Wayrilz (rilzabrutinib)

+

poliovirus vaccine

1 interaction

Monitor/Modify Tx

rilzabrutinib + poliovirus vaccine

if possible, vaccinate at least 2wk before starting rilzabrutinib tx; otherwise, consider post-immunization titer check or revaccination after immunocompetence restored: combo may result in inadequate vaccine response (immunosuppressive effects)

• ponatinib
Wayrilz (rilzabrutinib)

+

ponatinib

1 interaction

Monitor/Modify Tx

rilzabrutinib + ponatinib

monitor CBC: combo may incr. ponatinib levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metab. inhibited, additive effects)

• pravastatin
Wayrilz (rilzabrutinib)

+

pravastatin

1 interaction

Monitor/Modify Tx

rilzabrutinib + pravastatin

monitor CK, myopathy sx: combo may incr. pravastatin levels, risk of myopathy, rhabdomyolysis, other adverse effects (BCRP-mediated transport possibly inhibited, hepatic transport possibly inhibited)

• quetiapine
Wayrilz (rilzabrutinib)

+

quetiapine

1 interaction

Monitor/Modify Tx

rilzabrutinib + quetiapine

monitor ECG; consider decr. quetiapine dose: combo may incr. quetiapine levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• quinidine (antiarrhythmic)
Wayrilz (rilzabrutinib)

+

quinidine (antiarrhythmic)

1 interaction

Monitor/Modify Tx

rilzabrutinib + quinidine (antiarrhythmic)

monitor quinidine levels, ECG: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited, P-gp-mediated transport possibly inhibited)

• quinidine (CYP2D6 inhibitor)
Wayrilz (rilzabrutinib)

+

quinidine (CYP2D6 inhibitor)

1 interaction

Monitor/Modify Tx

rilzabrutinib + quinidine (CYP2D6 inhibitor)

monitor ECG: combo may incr. quinidine levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• quinine
Wayrilz (rilzabrutinib)

+

quinine

1 interaction

Monitor/Modify Tx

rilzabrutinib + quinine

monitor ECG: combo may incr. quinine levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• quizartinib
Wayrilz (rilzabrutinib)

+

quizartinib

1 interaction

Monitor/Modify Tx

rilzabrutinib + quizartinib

monitor ECG, electrolytes: combo may incr. quizartinib levels, risk of QT prolongation, cardiac arrhythmias, serious infection, other adverse effects (hepatic metab. inhibited, additive effects)

• ranolazine
Wayrilz (rilzabrutinib)

+

ranolazine

1 interaction

Monitor/Modify Tx

rilzabrutinib + ranolazine

monitor ECG; adjust ranolazine max dose to 1000 mg/day: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited, P-gp-mediated transport possibly inhibited)

• red yeast rice
Wayrilz (rilzabrutinib)

+

red yeast rice

1 interaction

Monitor/Modify Tx

rilzabrutinib + red yeast rice

monitor CK, myopathy sx w/ large amounts of red yeast rice: combo may incr. lovastatin levels, risk of myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited, hepatic transport possibly inhibited, red yeast rice contains varying amounts of lovastatin)

• repaglinide
Wayrilz (rilzabrutinib)

+

repaglinide

1 interaction

Monitor/Modify Tx

rilzabrutinib + repaglinide

monitor glucose: combo may incr. repaglinide levels, risk of hypoglycemia, other adverse effects (hepatic metab. inhibited, hepatic transport possibly inhibited)

• respiratory syncytial virus vaccine
Wayrilz (rilzabrutinib)

+

respiratory syncytial virus vaccine

1 interaction

Monitor/Modify Tx

rilzabrutinib + respiratory syncytial virus vaccine

if possible, vaccinate at least 2wk before starting rilzabrutinib tx; otherwise, consider post-immunization titer check or revaccination after immunocompetence restored: combo may result in inadequate vaccine response (immunosuppressive effects)

• rimegepant
Wayrilz (rilzabrutinib)

+

rimegepant

1 interaction

Monitor/Modify Tx

rilzabrutinib + rimegepant

separate rimegepant doses by at least 48h: combo may incr. rimegepant levels, risk of adverse effects (hepatic metab. inhibited)

• riociguat
Wayrilz (rilzabrutinib)

+

riociguat

1 interaction

Monitor/Modify Tx

rilzabrutinib + riociguat

consider decr. riociguat start dose to 0.5 mg PO tid; monitor BP: combo may incr. riociguat levels, risk of severe hypotension, other adverse effects (hepatic metab. inhibited, BCRP-mediated transport possibly inhibited)

• rosuvastatin
Wayrilz (rilzabrutinib)

+

rosuvastatin

1 interaction

Monitor/Modify Tx

rilzabrutinib + rosuvastatin

monitor CK, myopathy sx: combo may incr. rosuvastatin levels, risk of myopathy, rhabdomyolysis, other adverse effects (BCRP-mediated transport possibly inhibited, hepatic transport possibly inhibited)

• ruxolitinib
Wayrilz (rilzabrutinib)

+

ruxolitinib

1 interaction

Monitor/Modify Tx

rilzabrutinib + ruxolitinib

monitor CBC: combo may incr. ruxolitinib levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metab. inhibited, additive effects)

• ruxolitinib topical
Wayrilz (rilzabrutinib)

+

ruxolitinib topical

1 interaction

Monitor/Modify Tx

rilzabrutinib + ruxolitinib topical

monitor CBC: combo may incr. ruxolitinib levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metab. inhibited, additive effects)

• sebetralstat
Wayrilz (rilzabrutinib)

+

sebetralstat

1 interaction

Monitor/Modify Tx

rilzabrutinib + sebetralstat

consider monitoring ECG; decr. sebetralstat dose to 300 mg, may give second 300 mg dose at least 3h after first dose if needed: combo may incr. sebetralstat levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• sertraline
Wayrilz (rilzabrutinib)

+

sertraline

1 interaction

Monitor/Modify Tx

rilzabrutinib + sertraline

monitor ECG: combo may incr. sertraline levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• sipuleucel-T
Wayrilz (rilzabrutinib)

+

sipuleucel-T

1 interaction

Monitor/Modify Tx

rilzabrutinib + sipuleucel-T

consider decr. rilzabrutinib dose or D/C during leukapheresis and sipuleucel-T admin.: combo may decr. efficacy of sipuleucel-T; may incr. risk of adverse effects (antagonistic effects; additive effects)

• sirolimus
Wayrilz (rilzabrutinib)

+

sirolimus

1 interaction

Monitor/Modify Tx

rilzabrutinib + sirolimus

monitor sirolimus levels: combo may incr. sirolimus levels, risk of serious infection, other adverse effects (hepatic metab. inhibited, P-gp-mediated transport possibly inhibited, additive effects)

• smallpox/mpox vaccine, live
Wayrilz (rilzabrutinib)

+

smallpox/ mpox vaccine, live

1 interaction

Monitor/Modify Tx

rilzabrutinib + smallpox/ mpox vaccine, live

consider vaccinating at least 4wk before or 6mo after rilzabrutinib tx: combo may result in inadequate vaccine response (immunosuppressive effects)

• sodium bicarbonate
Wayrilz (rilzabrutinib)

+

sodium bicarbonate

1 interaction

Monitor/Modify Tx

rilzabrutinib + sodium bicarbonate

give rilzabrutinib at least 2h before oral sodium bicarbonate: combo may decr. rilzabrutinib levels, efficacy (absorption decreased at higher gastric pH)

• sodium citrate
Wayrilz (rilzabrutinib)

+

sodium citrate

1 interaction

Monitor/Modify Tx

rilzabrutinib + sodium citrate

give rilzabrutinib at least 2h before sodium citrate: combo may decr. rilzabrutinib levels, efficacy (absorption decreased at higher gastric pH)

• sparsentan
Wayrilz (rilzabrutinib)

+

sparsentan

1 interaction

Monitor/Modify Tx

rilzabrutinib + sparsentan

monitor BP, potassium, renal fxn: combo may incr. sparsentan levels, risk of hypotension (incl. orthostasis, syncope), hyperkalemia, edema, nephrotoxicity, other adverse effects (hepatic metab. inhibited)

• sunitinib
Wayrilz (rilzabrutinib)

+

sunitinib

1 interaction

Monitor/Modify Tx

rilzabrutinib + sunitinib

consider monitoring ECG, electrolytes: combo may incr. sunitinib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• suvorexant
Wayrilz (rilzabrutinib)

+

suvorexant

1 interaction

Monitor/Modify Tx

rilzabrutinib + suvorexant

decr. suvorexant dose to 5 mg, max 10 mg/day: combo may incr. suvorexant levels, risk of CNS depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• suzetrigine
Wayrilz (rilzabrutinib)

+

suzetrigine

1 interaction

Monitor/Modify Tx

rilzabrutinib + suzetrigine

start suzetrigine 100 mg x1 at least 1h before or 2h after food, after 12h give 50 mg q12h x3 doses, then after 12h give 50mg q24h: combo may incr. suzetrigine and active metabolite levels, risk of adverse effects (hepatic metab. inhibited)

• tacrolimus
Wayrilz (rilzabrutinib)

+

tacrolimus

1 interaction

Monitor/Modify Tx

rilzabrutinib + tacrolimus

monitor tacrolimus levels, ECG, renal fxn: combo may incr. tacrolimus levels, risk of QT prolongation, cardiac arrhythmias, nephrotoxicity, serious infection, other adverse effects (hepatic metab. inhibited, P-gp-mediated transport possibly inhibited, additive effects)

• tadalafil
Wayrilz (rilzabrutinib)

+

tadalafil

1 interaction

Monitor/Modify Tx

rilzabrutinib + tadalafil

monitor BP: combo may incr. tadalafil levels, risk of hypotension, priapism, other adverse effects (hepatic metab. inhibited)

• talazoparib
Wayrilz (rilzabrutinib)

+

talazoparib

1 interaction

Monitor/Modify Tx

rilzabrutinib + talazoparib

monitor CBC: combo may incr. talazoparib levels, risk of myelosuppression, other adverse effects (P-gp-mediated transport possibly inhibited, BCRP-mediated transport possibly inhibited)

• tamsulosin
Wayrilz (rilzabrutinib)

+

tamsulosin

1 interaction

Monitor/Modify Tx

rilzabrutinib + tamsulosin

monitor BP, especially w/ tamsulosin dose >0.4 mg: combo may incr. tamsulosin levels, risk of hypotension (incl. orthostasis, syncope), other adverse effects (hepatic metab. inhibited)

• temsirolimus
Wayrilz (rilzabrutinib)

+

temsirolimus

1 interaction

Monitor/Modify Tx

rilzabrutinib + temsirolimus

monitor CBC; consider decr. temsirolimus dose; consider admin. PCP prophylaxis: combo may incr. temsirolimus and active metabolite sirolimus levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metab. inhibited, additive effects)

• tenofovir alafenamide
Wayrilz (rilzabrutinib)

+

tenofovir alafenamide

1 interaction

Monitor/Modify Tx

rilzabrutinib + tenofovir alafenamide

if tenofovir alafenamide not admin. w/ cobicistat, monitor renal fxn: combo may incr. tenofovir levels, risk of nephrotoxicity, other adverse effects (gut P-gp-mediated transport possibly inhibited, gut BCRP-mediated transport possibly inhibited)

• tenofovir disoproxil
Wayrilz (rilzabrutinib)

+

tenofovir disoproxil

1 interaction

Monitor/Modify Tx

rilzabrutinib + tenofovir disoproxil

monitor renal fxn: combo may incr. tenofovir levels, risk of nephrotoxicity, other adverse effects (gut P-gp-mediated transport possibly inhibited, gut BCRP-mediated transport possibly inhibited)

• tezacaftor/ivacaftor
Wayrilz (rilzabrutinib)

+

tezacaftor/ ivacaftor

1 interaction

Monitor/Modify Tx

rilzabrutinib + tezacaftor/ ivacaftor

decr. dose by alternating tezacaftor/ivacaftor tab and ivacaftor tab at morning dose, no evening doses: combo may incr. tezacaftor/ivacaftor levels, risk of adverse effects (hepatic metab. inhibited)

• tick-borne encephalitis vaccine
Wayrilz (rilzabrutinib)

+

tick-borne encephalitis vaccine

1 interaction

Monitor/Modify Tx

rilzabrutinib + tick-borne encephalitis vaccine

if possible, vaccinate at least 2wk before starting rilzabrutinib tx; otherwise, consider post-immunization titer check or revaccination after immunocompetence restored: combo may result in inadequate vaccine response (immunosuppressive effects)

• tofacitinib
Wayrilz (rilzabrutinib)

+

tofacitinib

1 interaction

Monitor/Modify Tx

rilzabrutinib + tofacitinib

ALL INDICATIONS: monitor CBC; if also combined w/ strong CYP2C19 inhibitor, adjust tofacitinib dose as follows: RHEUMATOID or PSORIATIC ARTHRITIS: decr. tofacitinib dose to 5 mg qd; ULCERATIVE COLITIS: decr. tofacitinib 22 mg qd dose to 11 mg qd; decr. tofacitinib 11 mg qd dose to 5 mg qd; decr. tofacitinib 10 mg bid dose to 5 mg bid; decr. tofacitinib 5 mg bid dose to 5 mg qd; JUVENILE IDIOPATHIC ARTHRITIS: decr. usual tofacitinib bid dose to qd: combo may incr. tofacitinib levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metab. inhibited, additive effects)

• toremifene
Wayrilz (rilzabrutinib)

+

toremifene

1 interaction

Monitor/Modify Tx

rilzabrutinib + toremifene

monitor ECG: combo may incr. toremifene levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• trabectedin
Wayrilz (rilzabrutinib)

+

trabectedin

1 interaction

Monitor/Modify Tx

rilzabrutinib + trabectedin

monitor CBC, cardiac fxn, LFTs: combo may incr. trabectedin levels, risk of myelosuppression, cardiotoxicity, hepatotoxicity, other adverse effects (hepatic metab. inhibited)

• trazodone
Wayrilz (rilzabrutinib)

+

trazodone

1 interaction

Monitor/Modify Tx

rilzabrutinib + trazodone

monitor ECG, BP: combo may incr. trazodone levels, risk of QT prolongation, cardiac arrhythmias, hypotension (incl. orthostasis, syncope), other adverse effects (hepatic metab. inhibited)

• triazolam
Wayrilz (rilzabrutinib)

+

triazolam

1 interaction

Monitor/Modify Tx

rilzabrutinib + triazolam

monitor resp. rate; consider decr. triazolam dose: combo may incr. triazolam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• typhoid vaccine
Wayrilz (rilzabrutinib)

+

typhoid vaccine

1 interaction

Monitor/Modify Tx

rilzabrutinib + typhoid vaccine

if possible, vaccinate at least 2wk before starting rilzabrutinib tx; otherwise, consider post-immunization titer check or revaccination after immunocompetence restored: combo may result in inadequate vaccine response (immunosuppressive effects)

• ubrogepant
Wayrilz (rilzabrutinib)

+

ubrogepant

1 interaction

Monitor/Modify Tx

rilzabrutinib + ubrogepant

limit ubrogepant dose to 50 mg, may give second 50 mg dose after 2h if needed: combo may incr. ubrogepant levels, risk of adverse effects (hepatic metab. inhibited, P-gp-mediated transport possibly inhibited, BCRP-mediated transport possibly inhibited)

• vanzacaftor/tezacaftor/deutivacaftor
Wayrilz (rilzabrutinib)

+

vanzacaftor/ tezacaftor/ deutivacaftor

1 interaction

Monitor/Modify Tx

rilzabrutinib + vanzacaftor/ tezacaftor/ deutivacaftor

6-11 YO AND WT <40 KG: decr. vanzacaftor/tezacaftor/deutivacaftor dose to two tablets (4 mg/20 mg/50 mg each) qod; 6-11 YO AND WT 40 KG AND ABOVE: decr. vanzacaftor/tezacaftor/deutivacaftor dose to one tablet (10 mg/50 mg/125 mg) qod; 12 YO AND OLDER: decr. vanzacaftor/tezacaftor/deutivacaftor dose to one tablet (10 mg/50 mg/125 mg) qod: combo may incr. vanzacaftor/tezacaftor/deutivacaftor levels, risk of adverse effects (hepatic metab. inhibited)

• vemurafenib
Wayrilz (rilzabrutinib)

+

vemurafenib

1 interaction

Monitor/Modify Tx

rilzabrutinib + vemurafenib

monitor ECG: combo may incr. vemurafenib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. inhibited)

• vinblastine
Wayrilz (rilzabrutinib)

+

vinblastine

1 interaction

Monitor/Modify Tx

rilzabrutinib + vinblastine

monitor CBC: combo may incr. vinblastine levels, risk of serious infection, myelosuppression, autonomic neuropathy, other adverse effects (hepatic metab. inhibited, additive effects)

• vincristine
Wayrilz (rilzabrutinib)

+

vincristine

1 interaction

Monitor/Modify Tx

rilzabrutinib + vincristine

monitor CBC: combo may incr. vincristine levels, risk of serious infection, myelosuppression, autonomic neuropathy, other adverse effects (hepatic metab. inhibited, additive effects)

• vinorelbine
Wayrilz (rilzabrutinib)

+

vinorelbine

1 interaction

Monitor/Modify Tx

rilzabrutinib + vinorelbine

monitor CBC: combo may incr. vinorelbine levels, risk of serious infection, myelosuppression, autonomic neuropathy, other adverse effects (hepatic metab. inhibited, additive effects)

• voclosporin
Wayrilz (rilzabrutinib)

+

voclosporin

1 interaction

Monitor/Modify Tx

rilzabrutinib + voclosporin

monitor ECG, renal fxn; decr. voclosporin morning dose to 15.8 mg and evening dose to 7.9 mg: combo may incr. voclosporin levels, risk of QT prolongation, cardiac arrhythmias, serious infection, nephrotoxicity, other adverse effects (hepatic metab. inhibited, additive effects)

• warfarin
Wayrilz (rilzabrutinib)

+

warfarin

1 interaction

Monitor/Modify Tx

rilzabrutinib + warfarin

monitor INR, bleeding s/sx, especially during initiation/titration: combo may incr. warfarin levels, risk of bleeding (incl. life-threatening), other adverse effects (hepatic metab. inhibited)

• zanubrutinib
Wayrilz (rilzabrutinib)

+

zanubrutinib

1 interaction

Monitor/Modify Tx

rilzabrutinib + zanubrutinib

monitor CBC; decr. zanubrutinib dose to 80 mg bid: combo may incr. zanubrutinib levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metab. inhibited, additive effects)

• zoster vaccine, recombinant
Wayrilz (rilzabrutinib)

+

zoster vaccine, recombinant

1 interaction

Monitor/Modify Tx

rilzabrutinib + zoster vaccine, recombinant

if possible, vaccinate at least 4wk before and after rilzabrutinib tx: combo may result in inadequate vaccine response (immunosuppressive effects)