Tagrisso

Overview

osimertinib

kinase inhibitor

• CYP3A4 substrate
• BCRP inhibitor
• P-gp inhibitor, weak
• cardiotoxic effects
• prolongs QT interval (known)

Contraindicated

• cisapride
Tagrisso (osimertinib)

+

cisapride

1 interaction

Contraindicated

osimertinib + cisapride

contraindicated: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• colchicine
Tagrisso (osimertinib)

+

colchicine

1 interaction

Contraindicated

osimertinib + colchicine

CV RISK REDUCTION: consider monitoring CK, myopathy s/sx; GOUT OR FMF: contraindicated in pts w/ renal or hepatic impairment; otherwise, consider decr. colchicine dose during and x14 days after osimertinib use: combo may incr. colchicine levels, risk of myopathy, rhabdomyolysis, other life-threatening toxicity (P-gp-mediated transport inhibited)

• domperidone
Tagrisso (osimertinib)

+

domperidone

1 interaction

Contraindicated

osimertinib + domperidone

contraindicated: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• dronedarone
Tagrisso (osimertinib)

+

dronedarone

1 interaction

Contraindicated

osimertinib + dronedarone

contraindicated: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• levoketoconazole
Tagrisso (osimertinib)

+

levoketoconazole

1 interaction

Contraindicated

osimertinib + levoketoconazole

contraindicated: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• pimozide
Tagrisso (osimertinib)

+

pimozide

1 interaction

Contraindicated

osimertinib + pimozide

contraindicated: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• thioridazine
Tagrisso (osimertinib)

+

thioridazine

1 interaction

Contraindicated

osimertinib + thioridazine

contraindicated: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

Avoid/Use Alternative

• adagrasib
Tagrisso (osimertinib)

+

adagrasib

1 interaction

Avoid/Use Alternative

osimertinib + adagrasib

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• alpelisib
Tagrisso (osimertinib)

+

alpelisib

1 interaction

Avoid/Use Alternative

osimertinib + alpelisib

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

• amiodarone
Tagrisso (osimertinib)

+

amiodarone

1 interaction

Avoid/Use Alternative

osimertinib + amiodarone

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• anagrelide
Tagrisso (osimertinib)

+

anagrelide

1 interaction

Avoid/Use Alternative

osimertinib + anagrelide

use alternative or monitor cardiac fxn, ECG, electrolytes: combo may incr. risk of cardiotoxicity, QT prolongation, cardiac arrhythmias (additive effects)

• apalutamide
Tagrisso (osimertinib)

+

apalutamide

1 interaction

Avoid/Use Alternative

osimertinib + apalutamide

use alternative or incr. osimertinib dose to 160 mg qd, then resume usual dose 3wk after apalutamide D/C; monitor ECG, electrolytes: combo may decr. osimertinib levels, efficacy; may incr. risk of QT prolongation, cardiac arrhythmias (hepatic metabolism induced; additive effects)

• apixaban
Tagrisso (osimertinib)

+

apixaban

1 interaction

Avoid/Use Alternative

osimertinib + apixaban

ADULT PTS: monitor bleeding s/sx; if also combined w/ strong CYP3A4 inhibitor, decr. apixaban 5mg bid or 10 mg bid dose by 50% or avoid combo if already on 2.5 mg bid; PEDS PTS: monitor bleeding s/sx; if also combined w/ strong CYP3A4 inhibitor, consider decr. apixaban dose: combo may incr. apixaban levels, risk of bleeding, other adverse effects (P-gp-mediated transport inhibited)

• apomorphine
Tagrisso (osimertinib)

+

apomorphine

1 interaction

Avoid/Use Alternative

osimertinib + apomorphine

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• arsenic trioxide
Tagrisso (osimertinib)

+

arsenic trioxide

1 interaction

Avoid/Use Alternative

osimertinib + arsenic trioxide

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• artemether/lumefantrine
Tagrisso (osimertinib)

+

artemether/ lumefantrine

1 interaction

Avoid/Use Alternative

osimertinib + artemether/ lumefantrine

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• asenapine
Tagrisso (osimertinib)

+

asenapine

1 interaction

Avoid/Use Alternative

osimertinib + asenapine

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• azithromycin
Tagrisso (osimertinib)

+

azithromycin

1 interaction

Avoid/Use Alternative

osimertinib + azithromycin

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• bedaquiline
Tagrisso (osimertinib)

+

bedaquiline

1 interaction

Avoid/Use Alternative

osimertinib + bedaquiline

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• butalbital
Tagrisso (osimertinib)

+

butalbital

1 interaction

Avoid/Use Alternative

osimertinib + butalbital

use alternative or incr. osimertinib dose to 160 mg qd, then resume usual dose 3wk after butalbital D/C: combo may decr. osimertinib levels, efficacy (hepatic metabolism induced)

• cabozantinib
Tagrisso (osimertinib)

+

cabozantinib

1 interaction

Avoid/Use Alternative

osimertinib + cabozantinib

use alternative monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• carbamazepine
Tagrisso (osimertinib)

+

carbamazepine

1 interaction

Avoid/Use Alternative

osimertinib + carbamazepine

use alternative or incr. osimertinib dose to 160 mg qd, then resume usual dose 3wk after carbamazepine D/C: combo may decr. osimertinib levels, efficacy (hepatic metabolism induced)

• ceritinib
Tagrisso (osimertinib)

+

ceritinib

1 interaction

Avoid/Use Alternative

osimertinib + ceritinib

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• chloroquine
Tagrisso (osimertinib)

+

chloroquine

1 interaction

Avoid/Use Alternative

osimertinib + chloroquine

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• citalopram
Tagrisso (osimertinib)

+

citalopram

1 interaction

Avoid/Use Alternative

osimertinib + citalopram

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• cladribine oral
Tagrisso (osimertinib)

+

cladribine oral

1 interaction

Avoid/Use Alternative

osimertinib + cladribine oral

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

• clarithromycin
Tagrisso (osimertinib)

+

clarithromycin

1 interaction

Avoid/Use Alternative

osimertinib + clarithromycin

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• clofazimine
Tagrisso (osimertinib)

+

clofazimine

1 interaction

Avoid/Use Alternative

osimertinib + clofazimine

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• crizotinib
Tagrisso (osimertinib)

+

crizotinib

1 interaction

Avoid/Use Alternative

osimertinib + crizotinib

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• dabigatran
Tagrisso (osimertinib)

+

dabigatran

1 interaction

Avoid/Use Alternative

osimertinib + 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 (including life-threatening), other adverse effects (P-gp-mediated transport inhibited)

• degarelix
Tagrisso (osimertinib)

+

degarelix

1 interaction

Avoid/Use Alternative

osimertinib + degarelix

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects, androgen deprivation may prolong QT)

• desflurane
Tagrisso (osimertinib)

+

desflurane

1 interaction

Avoid/Use Alternative

osimertinib + desflurane

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• desipramine
Tagrisso (osimertinib)

+

desipramine

1 interaction

Avoid/Use Alternative

osimertinib + desipramine

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• dexmedetomidine
Tagrisso (osimertinib)

+

dexmedetomidine

1 interaction

Avoid/Use Alternative

osimertinib + dexmedetomidine

avoid combo: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• dexmedetomidine injection
Tagrisso (osimertinib)

+

dexmedetomidine injection

1 interaction

Avoid/Use Alternative

osimertinib + dexmedetomidine injection

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• dexrazoxane
Tagrisso (osimertinib)

+

dexrazoxane

1 interaction

Avoid/Use Alternative

osimertinib + dexrazoxane

monitor CBC if anthracycline extravasation or doxorubicin cardioprotective use, otherwise avoid combo: combo may incr. risk of myelosuppression; may decr. efficacy of cancer chemo (additive effects; mechanism unknown)

• disopyramide
Tagrisso (osimertinib)

+

disopyramide

1 interaction

Avoid/Use Alternative

osimertinib + disopyramide

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• dofetilide
Tagrisso (osimertinib)

+

dofetilide

1 interaction

Avoid/Use Alternative

osimertinib + dofetilide

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• donepezil
Tagrisso (osimertinib)

+

donepezil

1 interaction

Avoid/Use Alternative

osimertinib + donepezil

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• dordaviprone
Tagrisso (osimertinib)

+

dordaviprone

1 interaction

Avoid/Use Alternative

osimertinib + dordaviprone

use alternative or monitor ECG, electrolytes; separate admin.: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• droperidol
Tagrisso (osimertinib)

+

droperidol

1 interaction

Avoid/Use Alternative

osimertinib + droperidol

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• efavirenz
Tagrisso (osimertinib)

+

efavirenz

1 interaction

Avoid/Use Alternative

osimertinib + efavirenz

consider alternative or monitor ECG, electrolytes: combo may decr. osimertinib levels, efficacy; may incr. risk of QT prolongation, cardiac arrhythmias (hepatic metabolism induced; additive effects)

• encorafenib
Tagrisso (osimertinib)

+

encorafenib

1 interaction

Avoid/Use Alternative

osimertinib + encorafenib

use alternative or incr. osimertinib dose to 160 mg qd, then resume usual dose 3wk after encorafenib D/C; monitor ECG, electrolytes, cardiac fxn (incl. LVEF) if encorafenib used in combo w/ binimetinib: combo may incr. risk of QT prolongation, cardiac arrhythmias, cardiotoxicity; may decr. osimertinib levels, efficacy (additive effects; hepatic metabolism induced)

• ensartinib
Tagrisso (osimertinib)

+

ensartinib

1 interaction

Avoid/Use Alternative

osimertinib + ensartinib

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

• entrectinib
Tagrisso (osimertinib)

+

entrectinib

1 interaction

Avoid/Use Alternative

osimertinib + entrectinib

avoid combo: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• enzalutamide
Tagrisso (osimertinib)

+

enzalutamide

1 interaction

Avoid/Use Alternative

osimertinib + enzalutamide

use alternative or incr. osimertinib dose to 160 mg qd, then resume usual dose 3wk after enzalutamide D/C: combo may decr. osimertinib levels, efficacy (hepatic metabolism induced)

• ephedra
Tagrisso (osimertinib)

+

ephedra

1 interaction

Avoid/Use Alternative

osimertinib + ephedra

avoid combo: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• epirubicin
Tagrisso (osimertinib)

+

epirubicin

1 interaction

Avoid/Use Alternative

osimertinib + epirubicin

use alternative or monitor electrolytes, cardiac fxn, incl. ECG, LVEF: combo may incr. risk of QT prolongation, cardiac arrhythmias, cardiotoxicity (additive effects)

• eribulin
Tagrisso (osimertinib)

+

eribulin

1 interaction

Avoid/Use Alternative

osimertinib + eribulin

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• erythromycin
Tagrisso (osimertinib)

+

erythromycin

1 interaction

Avoid/Use Alternative

osimertinib + erythromycin

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• etrasimod
Tagrisso (osimertinib)

+

etrasimod

1 interaction

Avoid/Use Alternative

osimertinib + etrasimod

consider alternative or monitor HR, ECG, electrolytes: combo may incr. risk of bradycardia, AV block, QT prolongation, cardiac arrhythmias (additive effects)

• fexinidazole
Tagrisso (osimertinib)

+

fexinidazole

1 interaction

Avoid/Use Alternative

osimertinib + fexinidazole

if possible, do not initiate fexinidazole until 5 half-lives after osimertinib D/C; use alternative or monitor ECG, electrolytes during and x7 days after fexinidazole tx: combo may decr. osimertinib levels, efficacy; may incr. risk of QT prolongation, cardiac arrhythmias (hepatic metabolism induced; additive effects)

• flecainide
Tagrisso (osimertinib)

+

flecainide

1 interaction

Avoid/Use Alternative

osimertinib + flecainide

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• fluorouracil
Tagrisso (osimertinib)

+

fluorouracil

1 interaction

Avoid/Use Alternative

osimertinib + fluorouracil

use alternative or monitor cardiac function (including ECG), electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias, cardiotoxicity (additive effects)

• fluoxetine
Tagrisso (osimertinib)

+

fluoxetine

1 interaction

Avoid/Use Alternative

osimertinib + fluoxetine

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• foscarnet
Tagrisso (osimertinib)

+

foscarnet

1 interaction

Avoid/Use Alternative

osimertinib + foscarnet

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• fosfomycin injection
Tagrisso (osimertinib)

+

fosfomycin injection

1 interaction

Avoid/Use Alternative

osimertinib + fosfomycin injection

avoid combo: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• fosphenytoin
Tagrisso (osimertinib)

+

fosphenytoin

1 interaction

Avoid/Use Alternative

osimertinib + fosphenytoin

use alternative or incr. osimertinib dose to 160 mg qd, then resume usual dose 3wk after fosphenytoin D/C: combo may decr. osimertinib levels, efficacy (hepatic metabolism induced)

• gepotidacin
Tagrisso (osimertinib)

+

gepotidacin

1 interaction

Avoid/Use Alternative

osimertinib + gepotidacin

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• gilteritinib
Tagrisso (osimertinib)

+

gilteritinib

1 interaction

Avoid/Use Alternative

osimertinib + gilteritinib

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• givinostat
Tagrisso (osimertinib)

+

givinostat

1 interaction

Avoid/Use Alternative

osimertinib + givinostat

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• glasdegib
Tagrisso (osimertinib)

+

glasdegib

1 interaction

Avoid/Use Alternative

osimertinib + glasdegib

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• goserelin
Tagrisso (osimertinib)

+

goserelin

1 interaction

Avoid/Use Alternative

osimertinib + goserelin

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects, androgen deprivation may prolong QT)

• grapefruit
Tagrisso (osimertinib)

+

grapefruit

1 interaction

Avoid/Use Alternative

osimertinib + grapefruit

use alternative or monitor ECG, electrolytes w/ large amounts of grapefruit (>1L juice): combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• haloperidol
Tagrisso (osimertinib)

+

haloperidol

1 interaction

Avoid/Use Alternative

osimertinib + haloperidol

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• histrelin
Tagrisso (osimertinib)

+

histrelin

1 interaction

Avoid/Use Alternative

osimertinib + histrelin

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects, androgen deprivation may prolong QT)

• hydroxychloroquine
Tagrisso (osimertinib)

+

hydroxychloroquine

1 interaction

Avoid/Use Alternative

osimertinib + hydroxychloroquine

use alternative or monitor electrolytes, cardiac fxn, incl. ECG: combo may incr. risk of QT prolongation, cardiac arrhythmias, cardiotoxicity (additive effects)

• hydroxyzine
Tagrisso (osimertinib)

+

hydroxyzine

1 interaction

Avoid/Use Alternative

osimertinib + hydroxyzine

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• ibutilide
Tagrisso (osimertinib)

+

ibutilide

1 interaction

Avoid/Use Alternative

osimertinib + ibutilide

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• idarubicin
Tagrisso (osimertinib)

+

idarubicin

1 interaction

Avoid/Use Alternative

osimertinib + idarubicin

use alternative at least 5 half-lives after osimertinib D/C; otherwise, monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• iloperidone
Tagrisso (osimertinib)

+

iloperidone

1 interaction

Avoid/Use Alternative

osimertinib + iloperidone

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• inotuzumab ozogamicin
Tagrisso (osimertinib)

+

inotuzumab ozogamicin

1 interaction

Avoid/Use Alternative

osimertinib + inotuzumab ozogamicin

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• isoflurane
Tagrisso (osimertinib)

+

isoflurane

1 interaction

Avoid/Use Alternative

osimertinib + isoflurane

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• ivabradine
Tagrisso (osimertinib)

+

ivabradine

1 interaction

Avoid/Use Alternative

osimertinib + ivabradine

consider alternative or monitor HR, ECG, electrolytes: combo may incr. risk of bradycardia, AV block, QT prolongation, cardiac arrhythmias (additive effects)

• ivosidenib
Tagrisso (osimertinib)

+

ivosidenib

1 interaction

Avoid/Use Alternative

osimertinib + ivosidenib

use alternative or monitor ECG, electrolytes; incr. osimertinib dose to 160 mg qd, then resume usual dose 3wk after ivosidenib D/C: combo may decr. osimertinib levels, efficacy; may incr. risk of QT prolongation, cardiac arrhythmias (hepatic metabolism induced; additive effects)

• lefamulin
Tagrisso (osimertinib)

+

lefamulin

1 interaction

Avoid/Use Alternative

osimertinib + lefamulin

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• leuprolide
Tagrisso (osimertinib)

+

leuprolide

1 interaction

Avoid/Use Alternative

osimertinib + leuprolide

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects, androgen deprivation may prolong QT)

• levofloxacin
Tagrisso (osimertinib)

+

levofloxacin

1 interaction

Avoid/Use Alternative

osimertinib + levofloxacin

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• lofexidine
Tagrisso (osimertinib)

+

lofexidine

1 interaction

Avoid/Use Alternative

osimertinib + lofexidine

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• lonafarnib
Tagrisso (osimertinib)

+

lonafarnib

1 interaction

Avoid/Use Alternative

osimertinib + lonafarnib

use alternative or monitor HR, ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• loperamide
Tagrisso (osimertinib)

+

loperamide

1 interaction

Avoid/Use Alternative

osimertinib + loperamide

use alternative or monitor ECG, electrolytes, esp. if loperamide dose >16mg/day: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• lopinavir/ritonavir
Tagrisso (osimertinib)

+

lopinavir/ ritonavir

1 interaction

Avoid/Use Alternative

osimertinib + lopinavir/ ritonavir

use alternative or monitor ECG, electrolytes: combo may decr. osimertinib levels, efficacy; may incr. risk of QT prolongation, cardiac arrhythmias (hepatic metabolism induced; additive effects)

• lumacaftor/ivacaftor
Tagrisso (osimertinib)

+

lumacaftor/ ivacaftor

1 interaction

Avoid/Use Alternative

osimertinib + lumacaftor/ ivacaftor

use alternative or incr. osimertinib dose to 160 mg qd, then resume usual dose 3wk after lumacaftor D/C: combo may decr. osimertinib levels, efficacy (hepatic metabolism induced)

• macimorelin
Tagrisso (osimertinib)

+

macimorelin

1 interaction

Avoid/Use Alternative

osimertinib + macimorelin

avoid combo, allowing sufficient washout time before diagnostic test: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• methadone
Tagrisso (osimertinib)

+

methadone

1 interaction

Avoid/Use Alternative

osimertinib + methadone

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• mifepristone
Tagrisso (osimertinib)

+

mifepristone

1 interaction

Avoid/Use Alternative

osimertinib + mifepristone

use alternative or monitor ECG, electrolytes if daily mifepristone use: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• milsaperidone
Tagrisso (osimertinib)

+

milsaperidone

1 interaction

Avoid/Use Alternative

osimertinib + milsaperidone

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• mitotane
Tagrisso (osimertinib)

+

mitotane

1 interaction

Avoid/Use Alternative

osimertinib + mitotane

use alternative or incr. osimertinib dose to 160 mg qd, then resume usual dose 3wk after mitotane D/C: combo may decr. osimertinib levels, efficacy (hepatic metabolism induced)

• mobocertinib
Tagrisso (osimertinib)

+

mobocertinib

1 interaction

Avoid/Use Alternative

osimertinib + mobocertinib

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• moxifloxacin
Tagrisso (osimertinib)

+

moxifloxacin

1 interaction

Avoid/Use Alternative

osimertinib + moxifloxacin

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• neratinib
Tagrisso (osimertinib)

+

neratinib

1 interaction

Avoid/Use Alternative

osimertinib + neratinib

avoid combo if also combined w/ strong-mod CYP3A4 inhibitor; otherwise, caution advised: combo may incr. neratinib levels, risk of adverse effects (P-gp-mediated transport inhibited)

• nilotinib
Tagrisso (osimertinib)

+

nilotinib

1 interaction

Avoid/Use Alternative

osimertinib + nilotinib

avoid combo: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• oliceridine
Tagrisso (osimertinib)

+

oliceridine

1 interaction

Avoid/Use Alternative

osimertinib + oliceridine

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• ondansetron
Tagrisso (osimertinib)

+

ondansetron

1 interaction

Avoid/Use Alternative

osimertinib + ondansetron

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• oxaliplatin
Tagrisso (osimertinib)

+

oxaliplatin

1 interaction

Avoid/Use Alternative

osimertinib + oxaliplatin

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• ozanimod
Tagrisso (osimertinib)

+

ozanimod

1 interaction

Avoid/Use Alternative

osimertinib + ozanimod

consider alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• pacritinib
Tagrisso (osimertinib)

+

pacritinib

1 interaction

Avoid/Use Alternative

osimertinib + pacritinib

avoid combo: combo may decr. osimertinib levels, efficacy; may incr. risk of QT prolongation, cardiac arrhythmias (hepatic metabolism induced; additive effects)

• palifermin
Tagrisso (osimertinib)

+

palifermin

1 interaction

Avoid/Use Alternative

osimertinib + palifermin

avoid palifermin admin. w/in 24h before, during tx, or w/in 24h after myelotoxic chemo; otherwise, caution advised: combo may incr. severity and duration of oral mucositis (antagonistic effects)

• paliperidone
Tagrisso (osimertinib)

+

paliperidone

1 interaction

Avoid/Use Alternative

osimertinib + paliperidone

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• palonosetron
Tagrisso (osimertinib)

+

palonosetron

1 interaction

Avoid/Use Alternative

osimertinib + palonosetron

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• pasireotide
Tagrisso (osimertinib)

+

pasireotide

1 interaction

Avoid/Use Alternative

osimertinib + pasireotide

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• pazopanib
Tagrisso (osimertinib)

+

pazopanib

1 interaction

Avoid/Use Alternative

osimertinib + pazopanib

avoid combo: combo may incr. pazopanib levels, risk of QT prolongation, cardiac arrhythmias, cardiotoxicity, other adverse effects (BCRP-mediated transport inhibited, additive effects)

• pentamidine
Tagrisso (osimertinib)

+

pentamidine

1 interaction

Avoid/Use Alternative

osimertinib + pentamidine

use alternative or monitor ECG, electrolytes; risk may be lower w/ nebulized pentamidine: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• pentobarbital
Tagrisso (osimertinib)

+

pentobarbital

1 interaction

Avoid/Use Alternative

osimertinib + pentobarbital

use alternative or incr. osimertinib dose to 160 mg qd, then resume usual dose 3wk after pentobarbital D/C: combo may decr. osimertinib levels, efficacy (hepatic metabolism induced)

• phenobarbital
Tagrisso (osimertinib)

+

phenobarbital

1 interaction

Avoid/Use Alternative

osimertinib + phenobarbital

avoid combo if neonatal seizure use; otherwise, use alternative or monitor ECG, electrolytes; incr. osimertinib dose to 160 mg qd, then resume usual dose 3wk after phenobarbital D/C: combo may decr. osimertinib levels, efficacy; may incr. risk of QT prolongation, cardiac arrhythmias (hepatic metabolism induced; additive effects)

• phenytoin
Tagrisso (osimertinib)

+

phenytoin

1 interaction

Avoid/Use Alternative

osimertinib + phenytoin

use alternative or incr. osimertinib dose to 160 mg qd, then resume usual dose 3wk after phenytoin D/C: combo may decr. osimertinib levels, efficacy (hepatic metabolism induced)

• pimavanserin
Tagrisso (osimertinib)

+

pimavanserin

1 interaction

Avoid/Use Alternative

osimertinib + pimavanserin

avoid combo: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• pitolisant
Tagrisso (osimertinib)

+

pitolisant

1 interaction

Avoid/Use Alternative

osimertinib + pitolisant

avoid combo: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• ponesimod
Tagrisso (osimertinib)

+

ponesimod

1 interaction

Avoid/Use Alternative

osimertinib + ponesimod

use alternative or monitor HR, ECG, electrolytes: combo may incr. risk of bradycardia, AV block, QT prolongation, cardiac arrhythmias (additive effects)

• pralsetinib
Tagrisso (osimertinib)

+

pralsetinib

1 interaction

Avoid/Use Alternative

osimertinib + pralsetinib

use alternative or monitor ECG, electrolytes and decr. pralsetinib dose as follows: if on pralsetinib 400 mg qd, decr. to 300 mg qd; if on pralsetinib 400 mg qd and also combined w/ strong CYP3A4 inhibitor: decr. to 200 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 (P-gp-mediated transport inhibited, additive effects)

• primidone
Tagrisso (osimertinib)

+

primidone

1 interaction

Avoid/Use Alternative

osimertinib + primidone

use alternative or incr. osimertinib dose to 160 mg qd, then resume usual dose 3wk after primidone D/C: combo may decr. osimertinib levels, efficacy (hepatic metabolism induced)

• procainamide
Tagrisso (osimertinib)

+

procainamide

1 interaction

Avoid/Use Alternative

osimertinib + procainamide

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• propafenone
Tagrisso (osimertinib)

+

propafenone

1 interaction

Avoid/Use Alternative

osimertinib + propafenone

use alternative or monitor electrolytes, cardiac fxn, incl. ECG: combo may incr. risk of QT prolongation, cardiac arrhythmias, cardiotoxicity (additive effects)

• quetiapine
Tagrisso (osimertinib)

+

quetiapine

1 interaction

Avoid/Use Alternative

osimertinib + quetiapine

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• quinidine (antiarrhythmic)
Tagrisso (osimertinib)

+

quinidine (antiarrhythmic)

1 interaction

Avoid/Use Alternative

osimertinib + quinidine (antiarrhythmic)

use alternative or monitor quinidine levels, ECG, electrolytes: combo may incr. quinidine levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (P-gp-mediated transport inhibited, additive effects)

• quinidine (CYP2D6 inhibitor)
Tagrisso (osimertinib)

+

quinidine (CYP2D6 inhibitor)

1 interaction

Avoid/Use Alternative

osimertinib + quinidine (CYP2D6 inhibitor)

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• quinine
Tagrisso (osimertinib)

+

quinine

1 interaction

Avoid/Use Alternative

osimertinib + quinine

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• quizartinib
Tagrisso (osimertinib)

+

quizartinib

1 interaction

Avoid/Use Alternative

osimertinib + quizartinib

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• radium Ra 223 dichloride
Tagrisso (osimertinib)

+

radium Ra 223 dichloride

1 interaction

Avoid/Use Alternative

osimertinib + radium Ra 223 dichloride

use alternative or monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• relugolix
Tagrisso (osimertinib)

+

relugolix

1 interaction

Avoid/Use Alternative

osimertinib + relugolix

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

• repotrectinib
Tagrisso (osimertinib)

+

repotrectinib

1 interaction

Avoid/Use Alternative

osimertinib + repotrectinib

avoid combo: combo may incr. repotrectinib levels, risk of adverse effects; may decr. osimertinib levels, efficacy (P-gp-mediated transport inhibited; hepatic metabolism induced)

• revumenib
Tagrisso (osimertinib)

+

revumenib

1 interaction

Avoid/Use Alternative

osimertinib + revumenib

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• ribociclib
Tagrisso (osimertinib)

+

ribociclib

1 interaction

Avoid/Use Alternative

osimertinib + ribociclib

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• rifabutin
Tagrisso (osimertinib)

+

rifabutin

1 interaction

Avoid/Use Alternative

osimertinib + rifabutin

use alternative or incr. osimertinib dose to 160 mg qd, then resume usual dose 3wk after rifabutin D/C: combo may decr. osimertinib levels, efficacy (hepatic metabolism induced)

• rifampin
Tagrisso (osimertinib)

+

rifampin

1 interaction

Avoid/Use Alternative

osimertinib + rifampin

use alternative or incr. osimertinib dose to 160 mg qd, then resume usual dose 3wk after rifampin D/C: combo may decr. osimertinib levels, efficacy (hepatic metabolism induced)

• rilpivirine
Tagrisso (osimertinib)

+

rilpivirine

1 interaction

Avoid/Use Alternative

osimertinib + rilpivirine

consider alternative or monitor ECG, electrolytes; risk may be lower w/ IM rilpivirine: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• rivaroxaban
Tagrisso (osimertinib)

+

rivaroxaban

1 interaction

Avoid/Use Alternative

osimertinib + rivaroxaban

avoid combo if also combined w/ strong CYP3A4 inhibitor; use alternative if CrCl <80 and combined w/ moderate CYP3A4 inhibitor; otherwise, monitor bleeding s/sx: combo may incr. rivaroxaban levels, risk of bleeding, other adverse effects (BCRP-mediated transport inhibited, P-gp-mediated transport inhibited)

• romidepsin
Tagrisso (osimertinib)

+

romidepsin

1 interaction

Avoid/Use Alternative

osimertinib + romidepsin

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• rucaparib
Tagrisso (osimertinib)

+

rucaparib

1 interaction

Avoid/Use Alternative

osimertinib + rucaparib

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• selpercatinib
Tagrisso (osimertinib)

+

selpercatinib

1 interaction

Avoid/Use Alternative

osimertinib + selpercatinib

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• sertraline
Tagrisso (osimertinib)

+

sertraline

1 interaction

Avoid/Use Alternative

osimertinib + sertraline

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• sevoflurane
Tagrisso (osimertinib)

+

sevoflurane

1 interaction

Avoid/Use Alternative

osimertinib + sevoflurane

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• siponimod
Tagrisso (osimertinib)

+

siponimod

1 interaction

Avoid/Use Alternative

osimertinib + siponimod

consider alternative or monitor HR, ECG, electrolytes: combo may incr. risk of bradycardia, AV block, QT prolongation, cardiac arrhythmias (additive effects)

• sirolimus albumin-bound
Tagrisso (osimertinib)

+

sirolimus albumin-bound

1 interaction

Avoid/Use Alternative

osimertinib + sirolimus albumin-bound

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

• solifenacin
Tagrisso (osimertinib)

+

solifenacin

1 interaction

Avoid/Use Alternative

osimertinib + solifenacin

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• sorafenib
Tagrisso (osimertinib)

+

sorafenib

1 interaction

Avoid/Use Alternative

osimertinib + sorafenib

use alternative or monitor ECG, electrolytes, cardiac fxn: combo may incr. risk of cardiotoxicity, QT prolongation, cardiac arrhythmias (additive effects)

• sotalol
Tagrisso (osimertinib)

+

sotalol

1 interaction

Avoid/Use Alternative

osimertinib + sotalol

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• St. John's wort
Tagrisso (osimertinib)

+

St. John's wort

1 interaction

Avoid/Use Alternative

osimertinib + St. John's wort

avoid combo: combo may decr. osimertinib levels, efficacy (hepatic metabolism induced)

• taletrectinib
Tagrisso (osimertinib)

+

taletrectinib

1 interaction

Avoid/Use Alternative

osimertinib + taletrectinib

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• telavancin
Tagrisso (osimertinib)

+

telavancin

1 interaction

Avoid/Use Alternative

osimertinib + telavancin

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• tetrabenazine
Tagrisso (osimertinib)

+

tetrabenazine

1 interaction

Avoid/Use Alternative

osimertinib + tetrabenazine

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• topotecan
Tagrisso (osimertinib)

+

topotecan

1 interaction

Avoid/Use Alternative

osimertinib + topotecan

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

• toremifene
Tagrisso (osimertinib)

+

toremifene

1 interaction

Avoid/Use Alternative

osimertinib + toremifene

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• tramadol
Tagrisso (osimertinib)

+

tramadol

1 interaction

Avoid/Use Alternative

osimertinib + tramadol

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• trazodone
Tagrisso (osimertinib)

+

trazodone

1 interaction

Avoid/Use Alternative

osimertinib + trazodone

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• triclabendazole
Tagrisso (osimertinib)

+

triclabendazole

1 interaction

Avoid/Use Alternative

osimertinib + triclabendazole

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• trifluridine
Tagrisso (osimertinib)

+

trifluridine

1 interaction

Avoid/Use Alternative

osimertinib + trifluridine

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• triptorelin
Tagrisso (osimertinib)

+

triptorelin

1 interaction

Avoid/Use Alternative

osimertinib + triptorelin

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects, androgen deprivation may prolong QT)

• vandetanib
Tagrisso (osimertinib)

+

vandetanib

1 interaction

Avoid/Use Alternative

osimertinib + vandetanib

use alternative or monitor cardiac fxn, ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias, cardiotoxicity (additive effects)

• vemurafenib
Tagrisso (osimertinib)

+

vemurafenib

1 interaction

Avoid/Use Alternative

osimertinib + vemurafenib

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• venetoclax
Tagrisso (osimertinib)

+

venetoclax

1 interaction

Avoid/Use Alternative

osimertinib + venetoclax

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 (P-gp-mediated transport inhibited)

• ziftomenib
Tagrisso (osimertinib)

+

ziftomenib

1 interaction

Avoid/Use Alternative

osimertinib + ziftomenib

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• ziprasidone
Tagrisso (osimertinib)

+

ziprasidone

1 interaction

Avoid/Use Alternative

osimertinib + ziprasidone

use alternative or monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

Monitor/Modify Tx

• adalimumab
Tagrisso (osimertinib)

+

adalimumab

1 interaction

Monitor/Modify Tx

osimertinib + adalimumab

monitor cardiac fxn: combo may incr. risk of cardiotoxicity (additive effects)

• ado-trastuzumab emtansine
Tagrisso (osimertinib)

+

ado-trastuzumab emtansine

1 interaction

Monitor/Modify Tx

osimertinib + ado-trastuzumab emtansine

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• afatinib
Tagrisso (osimertinib)

+

afatinib

1 interaction

Monitor/Modify Tx

osimertinib + afatinib

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

• aficamten
Tagrisso (osimertinib)

+

aficamten

1 interaction

Monitor/Modify Tx

osimertinib + aficamten

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• albuterol
Tagrisso (osimertinib)

+

albuterol

1 interaction

Monitor/Modify Tx

osimertinib + albuterol

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• albuterol inhaled
Tagrisso (osimertinib)

+

albuterol inhaled

1 interaction

Monitor/Modify Tx

osimertinib + albuterol inhaled

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• aldesleukin
Tagrisso (osimertinib)

+

aldesleukin

1 interaction

Monitor/Modify Tx

osimertinib + aldesleukin

monitor cardiac fxn: combo may incr. risk of cardiotoxicity (additive effects)

• alemtuzumab
Tagrisso (osimertinib)

+

alemtuzumab

1 interaction

Monitor/Modify Tx

osimertinib + alemtuzumab

monitor CBC; myelosuppression risk may be lower w/ alemtuzumab doses used for MS: combo may incr. risk of myelosuppression (additive effects)

• alfuzosin
Tagrisso (osimertinib)

+

alfuzosin

1 interaction

Monitor/Modify Tx

osimertinib + alfuzosin

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• amisulpride
Tagrisso (osimertinib)

+

amisulpride

1 interaction

Monitor/Modify Tx

osimertinib + amisulpride

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• amitriptyline
Tagrisso (osimertinib)

+

amitriptyline

1 interaction

Monitor/Modify Tx

osimertinib + amitriptyline

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• arformoterol inhaled
Tagrisso (osimertinib)

+

arformoterol inhaled

1 interaction

Monitor/Modify Tx

osimertinib + arformoterol inhaled

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• asciminib
Tagrisso (osimertinib)

+

asciminib

1 interaction

Monitor/Modify Tx

osimertinib + asciminib

monitor electrolytes, cardiac fxn, incl. ECG: combo may incr. risk of QT prolongation, cardiac arrhythmias, cardiotoxicity (additive effects)

• atorvastatin
Tagrisso (osimertinib)

+

atorvastatin

1 interaction

Monitor/Modify Tx

osimertinib + atorvastatin

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

• avelumab
Tagrisso (osimertinib)

+

avelumab

1 interaction

Monitor/Modify Tx

osimertinib + avelumab

monitor cardiac fxn: combo may incr. risk of cardiotoxicity (additive effects)

• axitinib
Tagrisso (osimertinib)

+

axitinib

1 interaction

Monitor/Modify Tx

osimertinib + axitinib

monitor cardiac fxn: combo may incr. risk of cardiotoxicity (additive effects)

• balsalazide
Tagrisso (osimertinib)

+

balsalazide

1 interaction

Monitor/Modify Tx

osimertinib + balsalazide

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• berotralstat
Tagrisso (osimertinib)

+

berotralstat

1 interaction

Monitor/Modify Tx

osimertinib + berotralstat

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• bevacizumab
Tagrisso (osimertinib)

+

bevacizumab

1 interaction

Monitor/Modify Tx

osimertinib + bevacizumab

monitor cardiac fxn: combo may incr. risk of cardiotoxicity (additive effects)

• bezlotoxumab
Tagrisso (osimertinib)

+

bezlotoxumab

1 interaction

Monitor/Modify Tx

osimertinib + bezlotoxumab

monitor cardiac fxn: combo may incr. risk of cardiotoxicity (additive effects)

• binimetinib
Tagrisso (osimertinib)

+

binimetinib

1 interaction

Monitor/Modify Tx

osimertinib + binimetinib

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• bortezomib
Tagrisso (osimertinib)

+

bortezomib

1 interaction

Monitor/Modify Tx

osimertinib + bortezomib

monitor cardiac fxn: combo may incr. risk of cardiotoxicity (additive effects)

• buprenorphine
Tagrisso (osimertinib)

+

buprenorphine

1 interaction

Monitor/Modify Tx

osimertinib + buprenorphine

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• capecitabine
Tagrisso (osimertinib)

+

capecitabine

1 interaction

Monitor/Modify Tx

osimertinib + capecitabine

monitor cardiac fxn: combo may incr. risk of cardiotoxicity (additive effects)

• carfilzomib
Tagrisso (osimertinib)

+

carfilzomib

1 interaction

Monitor/Modify Tx

osimertinib + carfilzomib

monitor cardiac fxn: combo may incr. risk of cardiotoxicity (additive effects)

• certolizumab pegol
Tagrisso (osimertinib)

+

certolizumab pegol

1 interaction

Monitor/Modify Tx

osimertinib + certolizumab pegol

monitor cardiac fxn: combo may incr. risk of cardiotoxicity (additive effects)

• chlorpromazine
Tagrisso (osimertinib)

+

chlorpromazine

1 interaction

Monitor/Modify Tx

osimertinib + chlorpromazine

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• ciprofloxacin
Tagrisso (osimertinib)

+

ciprofloxacin

1 interaction

Monitor/Modify Tx

osimertinib + ciprofloxacin

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• clomipramine
Tagrisso (osimertinib)

+

clomipramine

1 interaction

Monitor/Modify Tx

osimertinib + clomipramine

monitor ECG, electrolytes: combo may incr. risk of QT interval prolongation, cardiac arrhythmias (additive effects)

• clozapine
Tagrisso (osimertinib)

+

clozapine

1 interaction

Monitor/Modify Tx

osimertinib + clozapine

monitor ECG, electrolytes, CBC: combo may incr. risk of QT prolongation, cardiac arrhythmias, myelosuppression (additive effects)

• cyclophosphamide
Tagrisso (osimertinib)

+

cyclophosphamide

1 interaction

Monitor/Modify Tx

osimertinib + cyclophosphamide

monitor cardiac fxn: combo may incr. risk of cardiotoxicity (additive effects)

• cyclosporine
Tagrisso (osimertinib)

+

cyclosporine

1 interaction

Monitor/Modify Tx

osimertinib + cyclosporine

monitor cyclosporine levels, renal fxn: combo may incr. cyclosporine levels, risk of serious infection, nephrotoxicity, other adverse effects (P-gp-mediated transport inhibited)

• dabrafenib
Tagrisso (osimertinib)

+

dabrafenib

1 interaction

Monitor/Modify Tx

osimertinib + dabrafenib

monitor cardiac fxn, incl. LVEF: combo may decr. osimertinib levels, efficacy; may incr. risk of cardiotoxicity (hepatic metabolism induced; additive effects)

• dasatinib
Tagrisso (osimertinib)

+

dasatinib

1 interaction

Monitor/Modify Tx

osimertinib + dasatinib

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• daunorubicin
Tagrisso (osimertinib)

+

daunorubicin

1 interaction

Monitor/Modify Tx

osimertinib + daunorubicin

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• deferasirox
Tagrisso (osimertinib)

+

deferasirox

1 interaction

Monitor/Modify Tx

osimertinib + deferasirox

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• deutetrabenazine
Tagrisso (osimertinib)

+

deutetrabenazine

1 interaction

Monitor/Modify Tx

osimertinib + deutetrabenazine

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• digoxin
Tagrisso (osimertinib)

+

digoxin

1 interaction

Monitor/Modify Tx

osimertinib + digoxin

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

• doxorubicin
Tagrisso (osimertinib)

+

doxorubicin

1 interaction

Monitor/Modify Tx

osimertinib + doxorubicin

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• edoxaban
Tagrisso (osimertinib)

+

edoxaban

1 interaction

Monitor/Modify Tx

osimertinib + edoxaban

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

• eliglustat
Tagrisso (osimertinib)

+

eliglustat

1 interaction

Monitor/Modify Tx

osimertinib + eliglustat

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• enfortumab vedotin
Tagrisso (osimertinib)

+

enfortumab vedotin

1 interaction

Monitor/Modify Tx

osimertinib + 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 inhibited)

• escitalopram
Tagrisso (osimertinib)

+

escitalopram

1 interaction

Monitor/Modify Tx

osimertinib + escitalopram

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• everolimus
Tagrisso (osimertinib)

+

everolimus

1 interaction

Monitor/Modify Tx

osimertinib + everolimus

TSC-ASSOC. SEGA, TSC-ASSOC. PARTIAL ONSET SEIZURES, TRANSPLANT: monitor everolimus levels, CBC; OTHER INDICATIONS: monitor CBC: combo may incr. everolimus levels, risk of serious infection, myelosuppression, other adverse effects (P-gp-mediated transport inhibited, additive effects)

• fam-trastuzumab deruxtecan
Tagrisso (osimertinib)

+

fam-trastuzumab deruxtecan

1 interaction

Monitor/Modify Tx

osimertinib + fam-trastuzumab deruxtecan

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• fingolimod
Tagrisso (osimertinib)

+

fingolimod

1 interaction

Monitor/Modify Tx

osimertinib + fingolimod

monitor electrolytes, ECG overnight during fingolimod initiation/titration: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• fluconazole
Tagrisso (osimertinib)

+

fluconazole

1 interaction

Monitor/Modify Tx

osimertinib + fluconazole

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• fluvastatin
Tagrisso (osimertinib)

+

fluvastatin

1 interaction

Monitor/Modify Tx

osimertinib + fluvastatin

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

• formoterol inhaled
Tagrisso (osimertinib)

+

formoterol inhaled

1 interaction

Monitor/Modify Tx

osimertinib + formoterol inhaled

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• fostemsavir
Tagrisso (osimertinib)

+

fostemsavir

1 interaction

Monitor/Modify Tx

osimertinib + fostemsavir

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• gemtuzumab ozogamicin
Tagrisso (osimertinib)

+

gemtuzumab ozogamicin

1 interaction

Monitor/Modify Tx

osimertinib + gemtuzumab ozogamicin

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• gepirone
Tagrisso (osimertinib)

+

gepirone

1 interaction

Monitor/Modify Tx

osimertinib + gepirone

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• granisetron
Tagrisso (osimertinib)

+

granisetron

1 interaction

Monitor/Modify Tx

osimertinib + granisetron

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• hydrocodone
Tagrisso (osimertinib)

+

hydrocodone

1 interaction

Monitor/Modify Tx

osimertinib + hydrocodone

monitor ECG, electrolytes, especially if hydrocodone ER doses >160 mg/day: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• ibrutinib
Tagrisso (osimertinib)

+

ibrutinib

1 interaction

Monitor/Modify Tx

osimertinib + ibrutinib

monitor cardiac fxn: combo may incr. risk of cardiotoxicity (additive effects)

• ifosfamide
Tagrisso (osimertinib)

+

ifosfamide

1 interaction

Monitor/Modify Tx

osimertinib + ifosfamide

monitor cardiac fxn: combo may incr. risk of cardiotoxicity (additive effects)

• imatinib
Tagrisso (osimertinib)

+

imatinib

1 interaction

Monitor/Modify Tx

osimertinib + imatinib

monitor cardiac function: combo may increase risk of cardiotoxicity (additive effects)

• infliximab
Tagrisso (osimertinib)

+

infliximab

1 interaction

Monitor/Modify Tx

osimertinib + infliximab

monitor cardiac fxn: combo may incr. risk of cardiotoxicity (additive effects)

• interferon beta 1a
Tagrisso (osimertinib)

+

interferon beta 1a

1 interaction

Monitor/Modify Tx

osimertinib + interferon beta 1a

monitor cardiac fxn: combo may incr. risk of cardiotoxicity (additive effects)

• interferon beta 1b
Tagrisso (osimertinib)

+

interferon beta 1b

1 interaction

Monitor/Modify Tx

osimertinib + interferon beta 1b

monitor cardiac fxn: combo may incr. risk of cardiotoxicity (additive effects)

• interferon gamma 1b
Tagrisso (osimertinib)

+

interferon gamma 1b

1 interaction

Monitor/Modify Tx

osimertinib + interferon gamma 1b

monitor cardiac fxn: combo may incr. risk of cardiotoxicity (additive effects)

• irinotecan
Tagrisso (osimertinib)

+

irinotecan

1 interaction

Monitor/Modify Tx

osimertinib + irinotecan

monitor CBC: combo may incr. irinotecan levels, risk of serious infection, myelosuppression, other adverse effects (BCRP-mediated transport inhibited)

• lapatinib
Tagrisso (osimertinib)

+

lapatinib

1 interaction

Monitor/Modify Tx

osimertinib + lapatinib

monitor ECG, electrolytes: combo may incr. lapatinib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (BCRP-mediated transport inhibited, additive effects)

• leflunomide
Tagrisso (osimertinib)

+

leflunomide

1 interaction

Monitor/Modify Tx

osimertinib + leflunomide

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• lenvatinib
Tagrisso (osimertinib)

+

lenvatinib

1 interaction

Monitor/Modify Tx

osimertinib + lenvatinib

monitor ECG, electrolytes, cardiac fxn: combo may incr. risk of QT prolongation, cardiac arrhythmias, cardiotoxicity (additive effects)

• levalbuterol inhaled
Tagrisso (osimertinib)

+

levalbuterol inhaled

1 interaction

Monitor/Modify Tx

osimertinib + levalbuterol inhaled

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• linagliptin
Tagrisso (osimertinib)

+

linagliptin

1 interaction

Monitor/Modify Tx

osimertinib + linagliptin

monitor cardiac fxn: combo may incr. risk of cardiotoxicity (additive effects)

• lumateperone
Tagrisso (osimertinib)

+

lumateperone

1 interaction

Monitor/Modify Tx

osimertinib + lumateperone

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• lurasidone
Tagrisso (osimertinib)

+

lurasidone

1 interaction

Monitor/Modify Tx

osimertinib + lurasidone

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• margetuximab
Tagrisso (osimertinib)

+

margetuximab

1 interaction

Monitor/Modify Tx

osimertinib + margetuximab

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• mavacamten
Tagrisso (osimertinib)

+

mavacamten

1 interaction

Monitor/Modify Tx

osimertinib + mavacamten

monitor cardiac fxn, incl. LVEF: combo may decr. osimertinib levels, efficacy; may incr. risk of cardiotoxicity (hepatic metabolism induced; additive effects)

• mavorixafor
Tagrisso (osimertinib)

+

mavorixafor

1 interaction

Monitor/Modify Tx

osimertinib + mavorixafor

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

• mefloquine
Tagrisso (osimertinib)

+

mefloquine

1 interaction

Monitor/Modify Tx

osimertinib + mefloquine

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• meperidine
Tagrisso (osimertinib)

+

meperidine

1 interaction

Monitor/Modify Tx

osimertinib + meperidine

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• mercaptopurine
Tagrisso (osimertinib)

+

mercaptopurine

1 interaction

Monitor/Modify Tx

osimertinib + mercaptopurine

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• mesalamine
Tagrisso (osimertinib)

+

mesalamine

1 interaction

Monitor/Modify Tx

osimertinib + mesalamine

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• mesalamine rectal
Tagrisso (osimertinib)

+

mesalamine rectal

1 interaction

Monitor/Modify Tx

osimertinib + mesalamine rectal

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• methotrexate
Tagrisso (osimertinib)

+

methotrexate

1 interaction

Monitor/Modify Tx

osimertinib + methotrexate

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

• metronidazole
Tagrisso (osimertinib)

+

metronidazole

1 interaction

Monitor/Modify Tx

osimertinib + metronidazole

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• midostaurin
Tagrisso (osimertinib)

+

midostaurin

1 interaction

Monitor/Modify Tx

osimertinib + midostaurin

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• mirdametinib
Tagrisso (osimertinib)

+

mirdametinib

1 interaction

Monitor/Modify Tx

osimertinib + mirdametinib

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• mirtazapine
Tagrisso (osimertinib)

+

mirtazapine

1 interaction

Monitor/Modify Tx

osimertinib + mirtazapine

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• mitoxantrone
Tagrisso (osimertinib)

+

mitoxantrone

1 interaction

Monitor/Modify Tx

osimertinib + mitoxantrone

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

• morphine
Tagrisso (osimertinib)

+

morphine

1 interaction

Monitor/Modify Tx

osimertinib + morphine

monitor respiratory rate; consider decr. morphine dose: combo may incr. morphine levels, risk of CNS and respiratory depression, psychomotor impairment, other adverse effects (P-gp-mediated transport inhibited)

• ofloxacin
Tagrisso (osimertinib)

+

ofloxacin

1 interaction

Monitor/Modify Tx

osimertinib + ofloxacin

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• olodaterol inhaled
Tagrisso (osimertinib)

+

olodaterol inhaled

1 interaction

Monitor/Modify Tx

osimertinib + olodaterol inhaled

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• osilodrostat
Tagrisso (osimertinib)

+

osilodrostat

1 interaction

Monitor/Modify Tx

osimertinib + osilodrostat

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• pegfilgrastim (G-CSF)
Tagrisso (osimertinib)

+

pegfilgrastim (G-CSF)

1 interaction

Monitor/Modify Tx

osimertinib + pegfilgrastim (G-CSF)

admin. pegfilgrastim >24h after or >14 days before myelosuppressive chemo: combo may decr. pegfilgrastim efficacy (antagonistic effects)

• peginterferon beta 1a
Tagrisso (osimertinib)

+

peginterferon beta 1a

1 interaction

Monitor/Modify Tx

osimertinib + peginterferon beta 1a

monitor cardiac fxn: combo may incr. risk of cardiotoxicity (additive effects)

• pertuzumab
Tagrisso (osimertinib)

+

pertuzumab

1 interaction

Monitor/Modify Tx

osimertinib + pertuzumab

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• pitavastatin
Tagrisso (osimertinib)

+

pitavastatin

1 interaction

Monitor/Modify Tx

osimertinib + pitavastatin

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

• ponatinib
Tagrisso (osimertinib)

+

ponatinib

1 interaction

Monitor/Modify Tx

osimertinib + ponatinib

monitor cardiac fxn: combo may incr. risk of cardiotoxicity (additive effects)

• posaconazole
Tagrisso (osimertinib)

+

posaconazole

1 interaction

Monitor/Modify Tx

osimertinib + posaconazole

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• primaquine
Tagrisso (osimertinib)

+

primaquine

1 interaction

Monitor/Modify Tx

osimertinib + primaquine

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• promethazine
Tagrisso (osimertinib)

+

promethazine

1 interaction

Monitor/Modify Tx

osimertinib + promethazine

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• ranolazine
Tagrisso (osimertinib)

+

ranolazine

1 interaction

Monitor/Modify Tx

osimertinib + ranolazine

monitor ECG, electrolytes: combo may incr. ranolazine levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (P-gp-mediated transport inhibited, additive effects)

• riociguat
Tagrisso (osimertinib)

+

riociguat

1 interaction

Monitor/Modify Tx

osimertinib + 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 (BCRP-mediated transport inhibited)

• ripretinib
Tagrisso (osimertinib)

+

ripretinib

1 interaction

Monitor/Modify Tx

osimertinib + ripretinib

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• rituximab
Tagrisso (osimertinib)

+

rituximab

1 interaction

Monitor/Modify Tx

osimertinib + rituximab

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• ropeginterferon alfa-2b
Tagrisso (osimertinib)

+

ropeginterferon alfa-2b

1 interaction

Monitor/Modify Tx

osimertinib + ropeginterferon alfa-2b

monitor cardiac fxn: combo may incr. risk of cardiotoxicity (additive effects)

• rosuvastatin
Tagrisso (osimertinib)

+

rosuvastatin

1 interaction

Monitor/Modify Tx

osimertinib + rosuvastatin

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

• sacituzumab govitecan
Tagrisso (osimertinib)

+

sacituzumab govitecan

1 interaction

Monitor/Modify Tx

osimertinib + sacituzumab govitecan

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• salmeterol inhaled
Tagrisso (osimertinib)

+

salmeterol inhaled

1 interaction

Monitor/Modify Tx

osimertinib + salmeterol inhaled

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• sargramostim (GM-CSF)
Tagrisso (osimertinib)

+

sargramostim (GM-CSF)

1 interaction

Monitor/Modify Tx

osimertinib + sargramostim (GM-CSF)

admin. sargramostim >24h before or after myelosuppressive chemo: combo may decr. sargramostim efficacy (antagonistic effects)

• satralizumab
Tagrisso (osimertinib)

+

satralizumab

1 interaction

Monitor/Modify Tx

osimertinib + satralizumab

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• saxagliptin
Tagrisso (osimertinib)

+

saxagliptin

1 interaction

Monitor/Modify Tx

osimertinib + saxagliptin

monitor cardiac fxn: combo may incr. risk of cardiotoxicity (additive effects)

• sebetralstat
Tagrisso (osimertinib)

+

sebetralstat

1 interaction

Monitor/Modify Tx

osimertinib + sebetralstat

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• selumetinib
Tagrisso (osimertinib)

+

selumetinib

1 interaction

Monitor/Modify Tx

osimertinib + selumetinib

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• sirolimus
Tagrisso (osimertinib)

+

sirolimus

1 interaction

Monitor/Modify Tx

osimertinib + sirolimus

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

• sitagliptin
Tagrisso (osimertinib)

+

sitagliptin

1 interaction

Monitor/Modify Tx

osimertinib + sitagliptin

monitor cardiac fxn: combo may incr. risk of cardiotoxicity (additive effects)

• sunitinib
Tagrisso (osimertinib)

+

sunitinib

1 interaction

Monitor/Modify Tx

osimertinib + sunitinib

monitor ECG, electrolytes, cardiac fxn; consider monitoring LVEF: combo may incr. risk of QT prolongation, cardiac arrhythmias, cardiotoxicity (additive effects)

• tacrolimus
Tagrisso (osimertinib)

+

tacrolimus

1 interaction

Monitor/Modify Tx

osimertinib + tacrolimus

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

• talazoparib
Tagrisso (osimertinib)

+

talazoparib

1 interaction

Monitor/Modify Tx

osimertinib + talazoparib

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

• tazemetostat
Tagrisso (osimertinib)

+

tazemetostat

1 interaction

Monitor/Modify Tx

osimertinib + tazemetostat

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• tenofovir alafenamide
Tagrisso (osimertinib)

+

tenofovir alafenamide

1 interaction

Monitor/Modify Tx

osimertinib + tenofovir alafenamide

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

• tenofovir disoproxil
Tagrisso (osimertinib)

+

tenofovir disoproxil

1 interaction

Monitor/Modify Tx

osimertinib + tenofovir disoproxil

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

• terbutaline
Tagrisso (osimertinib)

+

terbutaline

1 interaction

Monitor/Modify Tx

osimertinib + terbutaline

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• tivozanib
Tagrisso (osimertinib)

+

tivozanib

1 interaction

Monitor/Modify Tx

osimertinib + tivozanib

monitor cardiac fxn: combo may incr. risk of cardiotoxicity (additive effects)

• tolterodine
Tagrisso (osimertinib)

+

tolterodine

1 interaction

Monitor/Modify Tx

osimertinib + tolterodine

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• trabectedin
Tagrisso (osimertinib)

+

trabectedin

1 interaction

Monitor/Modify Tx

osimertinib + trabectedin

monitor cardiac function, including LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• trastuzumab
Tagrisso (osimertinib)

+

trastuzumab

1 interaction

Monitor/Modify Tx

osimertinib + trastuzumab

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• trimethoprim
Tagrisso (osimertinib)

+

trimethoprim

1 interaction

Monitor/Modify Tx

osimertinib + trimethoprim

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• ubrogepant
Tagrisso (osimertinib)

+

ubrogepant

1 interaction

Monitor/Modify Tx

osimertinib + 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 (BCRP-mediated transport inhibited, P-gp-mediated transport inhibited)

• valbenazine
Tagrisso (osimertinib)

+

valbenazine

1 interaction

Monitor/Modify Tx

osimertinib + valbenazine

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• vardenafil
Tagrisso (osimertinib)

+

vardenafil

1 interaction

Monitor/Modify Tx

osimertinib + vardenafil

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• venlafaxine
Tagrisso (osimertinib)

+

venlafaxine

1 interaction

Monitor/Modify Tx

osimertinib + venlafaxine

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• vilanterol inhaled
Tagrisso (osimertinib)

+

vilanterol inhaled

1 interaction

Monitor/Modify Tx

osimertinib + vilanterol inhaled

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• voclosporin
Tagrisso (osimertinib)

+

voclosporin

1 interaction

Monitor/Modify Tx

osimertinib + voclosporin

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• voriconazole
Tagrisso (osimertinib)

+

voriconazole

1 interaction

Monitor/Modify Tx

osimertinib + voriconazole

monitor ECG, electrolytes: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)

• zanidatamab
Tagrisso (osimertinib)

+

zanidatamab

1 interaction

Monitor/Modify Tx

osimertinib + zanidatamab

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• zenocutuzumab
Tagrisso (osimertinib)

+

zenocutuzumab

1 interaction

Monitor/Modify Tx

osimertinib + zenocutuzumab

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• zongertinib
Tagrisso (osimertinib)

+

zongertinib

1 interaction

Monitor/Modify Tx

osimertinib + zongertinib

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

Caution Advised

• bosentan
Tagrisso (osimertinib)

+

bosentan

1 interaction

Caution Advised

osimertinib + bosentan

caution advised: combo may decr. osimertinib levels, efficacy (hepatic metabolism induced)

• cenobamate
Tagrisso (osimertinib)

+

cenobamate

1 interaction

Caution Advised

osimertinib + cenobamate

caution advised: combo may decr. osimertinib levels, efficacy (hepatic metabolism induced)

• darolutamide
Tagrisso (osimertinib)

+

darolutamide

1 interaction

Caution Advised

osimertinib + darolutamide

if also combined w/ strong CYP3A4 inhibitor, caution advised: combo may incr. darolutamide levels, risk of adverse effects (P-gp-mediated transport inhibited)

• etravirine
Tagrisso (osimertinib)

+

etravirine

1 interaction

Caution Advised

osimertinib + etravirine

caution advised: combo may decr. osimertinib levels, efficacy (hepatic metabolism induced)

• glecaprevir
Tagrisso (osimertinib)

+

glecaprevir

1 interaction

Caution Advised

osimertinib + glecaprevir

caution advised: combo may incr. glecaprevir levels, risk of adverse effects (BCRP-mediated transport inhibited, P-gp-mediated transport inhibited)

• lorlatinib
Tagrisso (osimertinib)

+

lorlatinib

1 interaction

Caution Advised

osimertinib + lorlatinib

caution advised: combo may decr. osimertinib levels, efficacy (hepatic metabolism induced)

• mitapivat
Tagrisso (osimertinib)

+

mitapivat

1 interaction

Caution Advised

osimertinib + mitapivat

caution advised: combo may decr. osimertinib levels, efficacy (hepatic metabolism induced)

• modafinil
Tagrisso (osimertinib)

+

modafinil

1 interaction

Caution Advised

osimertinib + modafinil

caution advised: combo may decr. osimertinib levels, efficacy (hepatic metabolism induced)

• nafcillin
Tagrisso (osimertinib)

+

nafcillin

1 interaction

Caution Advised

osimertinib + nafcillin

caution advised: combo may decr. osimertinib levels, efficacy (hepatic metabolism induced)

• naldemedine
Tagrisso (osimertinib)

+

naldemedine

1 interaction

Caution Advised

osimertinib + naldemedine

caution advised: combo may incr. naldemedine levels, risk of adverse effects (P-gp-mediated transport inhibited)

• pexidartinib
Tagrisso (osimertinib)

+

pexidartinib

1 interaction

Caution Advised

osimertinib + pexidartinib

caution advised: combo may decr. osimertinib levels, efficacy (hepatic metabolism induced)

• pibrentasvir
Tagrisso (osimertinib)

+

pibrentasvir

1 interaction

Caution Advised

osimertinib + pibrentasvir

caution advised: combo may incr. pibrentasvir levels, risk of adverse effects (BCRP-mediated transport inhibited, P-gp-mediated transport inhibited)

• rifapentine
Tagrisso (osimertinib)

+

rifapentine

1 interaction

Caution Advised

osimertinib + rifapentine

caution advised: combo may decr. osimertinib levels, efficacy (hepatic metabolism induced)

• seladelpar
Tagrisso (osimertinib)

+

seladelpar

1 interaction

Caution Advised

osimertinib + seladelpar

caution advised if also combined with OATP1B1 and/or OATP1B3 inhibitor: combo may incr. seladelpar levels, risk of adverse effects (BCRP-mediated transport inhibited)

• sotorasib
Tagrisso (osimertinib)

+

sotorasib

1 interaction

Caution Advised

osimertinib + sotorasib

caution advised: combo may decr. osimertinib levels, efficacy (hepatic metabolism induced)

• sulfasalazine
Tagrisso (osimertinib)

+

sulfasalazine

1 interaction

Caution Advised

osimertinib + sulfasalazine

caution advised: combo may incr. sulfasalazine levels, risk of adverse effects; may decr. IBD tx efficacy (gut BCRP-mediated transport inhibited)