Hyrnuo

Overview

sevabertinib

HER2 kinase inhibitor

• CYP3A4 substrate
• CYP1A1 inhibitor
• CYP3A4 inhibitor, weak
• BCRP inhibitor
• P-gp inhibitor, weak
• immunomodulatory effects

Contraindicated

• adenovirus vaccine, live
Hyrnuo (sevabertinib)

+

adenovirus vaccine, live

1 interaction

Contraindicated

sevabertinib + adenovirus vaccine, live

contraindicated; vaccinate at least 4wk before or 3mo after sevabertinib tx: combo may result in inadequate vaccine response, incr. risk of disseminated infection (immunosuppressive effects)

• chikungunya vaccine, live
Hyrnuo (sevabertinib)

+

chikungunya vaccine, live

1 interaction

Contraindicated

sevabertinib + chikungunya vaccine, live

contraindicated; vaccinate at least 4wk before or 3mo after sevabertinib tx: combo may result in inadequate vaccine response, incr. risk of disseminated infection (immunosuppressive effects)

• cholera vaccine, live
Hyrnuo (sevabertinib)

+

cholera vaccine, live

1 interaction

Contraindicated

sevabertinib + cholera vaccine, live

contraindicated; vaccinate at least 4wk before or 3mo after sevabertinib tx: combo may result in inadequate vaccine response, incr. risk of disseminated infection (immunosuppressive effects)

• cisapride
Hyrnuo (sevabertinib)

+

cisapride

1 interaction

Contraindicated

sevabertinib + cisapride

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

• colchicine
Hyrnuo (sevabertinib)

+

colchicine

1 interaction

Contraindicated

sevabertinib + colchicine

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

• dengue vaccine, live
Hyrnuo (sevabertinib)

+

dengue vaccine, live

1 interaction

Contraindicated

sevabertinib + dengue vaccine, live

contraindicated; vaccinate at least 4wk before or 3mo after sevabertinib tx: combo may result in inadequate vaccine response, incr. risk of disseminated infection (immunosuppressive effects)

• eliglustat
Hyrnuo (sevabertinib)

+

eliglustat

1 interaction

Contraindicated

sevabertinib + eliglustat

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

• influenza nasal vaccine, live
Hyrnuo (sevabertinib)

+

influenza nasal vaccine, live

1 interaction

Contraindicated

sevabertinib + influenza nasal vaccine, live

contraindicated; vaccinate at least 4wk before or 3mo after sevabertinib tx: combo may result in inadequate vaccine response, incr. risk of disseminated infection (immunosuppressive effects)

• measles/mumps/rubella vaccine, live
Hyrnuo (sevabertinib)

+

measles/ mumps/ rubella vaccine, live

1 interaction

Contraindicated

sevabertinib + measles/ mumps/ rubella vaccine, live

contraindicated; vaccinate at least 4wk before or 3mo after sevabertinib tx: combo may result in inadequate vaccine response, incr. risk of disseminated infection (immunosuppressive effects)

• rotavirus vaccine, live
Hyrnuo (sevabertinib)

+

rotavirus vaccine, live

1 interaction

Contraindicated

sevabertinib + rotavirus vaccine, live

contraindicated; vaccinate at least 4wk before or 3mo after sevabertinib tx: combo may result in inadequate vaccine response, incr. risk of disseminated infection (immunosuppressive effects)

• smallpox vaccine, live
Hyrnuo (sevabertinib)

+

smallpox vaccine, live

1 interaction

Contraindicated

sevabertinib + smallpox vaccine, live

contraindicated; vaccinate at least 4wk before or 3mo after sevabertinib tx: combo may result in inadequate vaccine response, incr. risk of disseminated infection (immunosuppressive effects)

• typhoid vaccine, live
Hyrnuo (sevabertinib)

+

typhoid vaccine, live

1 interaction

Contraindicated

sevabertinib + typhoid vaccine, live

contraindicated; vaccinate at least 4wk before or 3mo after sevabertinib tx: combo may result in inadequate vaccine response, incr. risk of disseminated infection (immunosuppressive effects)

• varicella vaccine, live
Hyrnuo (sevabertinib)

+

varicella vaccine, live

1 interaction

Contraindicated

sevabertinib + varicella vaccine, live

contraindicated; vaccinate at least 4wk before or 3mo after sevabertinib tx: combo may result in inadequate vaccine response, incr. risk of disseminated infection (immunosuppressive effects)

• yellow fever vaccine, live
Hyrnuo (sevabertinib)

+

yellow fever vaccine, live

1 interaction

Contraindicated

sevabertinib + yellow fever vaccine, live

contraindicated; vaccinate at least 4wk before or 3mo after sevabertinib tx: combo may result in inadequate vaccine response, incr. risk of disseminated infection (immunosuppressive effects)

Avoid/Use Alternative

• adagrasib
Hyrnuo (sevabertinib)

+

adagrasib

1 interaction

Avoid/Use Alternative

sevabertinib + adagrasib

use alternative or decr. sevabertinib dose as follows: if on sevabertinib 20 mg bid, decr. to 10 mg bid; if on sevabertinib 10 mg bid, decr. to 10 mg qd; if on sevabertinib 10 mg qd, hold sevabertinib until adagrasib D/C: combo may incr. sevabertinib levels, risk of adverse effects (hepatic metabolism inhibited)

• alpelisib
Hyrnuo (sevabertinib)

+

alpelisib

1 interaction

Avoid/Use Alternative

sevabertinib + alpelisib

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

• alprazolam
Hyrnuo (sevabertinib)

+

alprazolam

1 interaction

Avoid/Use Alternative

sevabertinib + alprazolam

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

• apalutamide
Hyrnuo (sevabertinib)

+

apalutamide

1 interaction

Avoid/Use Alternative

sevabertinib + apalutamide

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

• apixaban
Hyrnuo (sevabertinib)

+

apixaban

1 interaction

Avoid/Use Alternative

sevabertinib + apixaban

ADULT PATIENTS: monitor bleeding signs/symptoms; if also combined with 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 PATIENTS: monitor bleeding signs/symptoms; if also combined with strong CYP3A4 inhibitor, consider decr. apixaban dose: combo may incr. apixaban levels, risk of bleeding, other adverse effects (P-gp-mediated transport inhibited)

• atazanavir
Hyrnuo (sevabertinib)

+

atazanavir

1 interaction

Avoid/Use Alternative

sevabertinib + atazanavir

use alternative or decr. sevabertinib dose as follows: if on sevabertinib 20 mg bid, decr. to 10 mg bid; if on sevabertinib 10 mg bid, decr. to 10 mg qd; if on sevabertinib 10 mg qd, hold sevabertinib until atazanavir D/C: combo may incr. sevabertinib levels, risk of adverse effects (hepatic metabolism inhibited)

• bosentan
Hyrnuo (sevabertinib)

+

bosentan

1 interaction

Avoid/Use Alternative

sevabertinib + bosentan

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

• butalbital
Hyrnuo (sevabertinib)

+

butalbital

1 interaction

Avoid/Use Alternative

sevabertinib + butalbital

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

• carbamazepine
Hyrnuo (sevabertinib)

+

carbamazepine

1 interaction

Avoid/Use Alternative

sevabertinib + carbamazepine

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

• cenobamate
Hyrnuo (sevabertinib)

+

cenobamate

1 interaction

Avoid/Use Alternative

sevabertinib + cenobamate

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

• ceritinib
Hyrnuo (sevabertinib)

+

ceritinib

1 interaction

Avoid/Use Alternative

sevabertinib + ceritinib

use alternative or decr. sevabertinib dose as follows: if on sevabertinib 20 mg bid, decr. to 10 mg bid; if on sevabertinib 10 mg bid, decr. to 10 mg qd; if on sevabertinib 10 mg qd, hold sevabertinib until ceritinib D/C: combo may incr. sevabertinib levels, risk of adverse effects (hepatic metabolism inhibited)

• chloramphenicol
Hyrnuo (sevabertinib)

+

chloramphenicol

1 interaction

Avoid/Use Alternative

sevabertinib + chloramphenicol

use alternative or decr. sevabertinib dose as follows: if on sevabertinib 20 mg bid, decr. to 10 mg bid; if on sevabertinib 10 mg bid, decr. to 10 mg qd; if on sevabertinib 10 mg qd, hold sevabertinib until chloramphenicol D/C: combo may incr. sevabertinib levels, risk of adverse effects (hepatic metabolism inhibited)

• cladribine oral
Hyrnuo (sevabertinib)

+

cladribine oral

1 interaction

Avoid/Use Alternative

sevabertinib + 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
Hyrnuo (sevabertinib)

+

clarithromycin

1 interaction

Avoid/Use Alternative

sevabertinib + clarithromycin

use alternative or decr. sevabertinib dose as follows: if on sevabertinib 20 mg bid, decr. to 10 mg bid; if on sevabertinib 10 mg bid, decr. to 10 mg qd; if on sevabertinib 10 mg qd, hold sevabertinib until clarithromycin D/C: combo may incr. sevabertinib levels, risk of adverse effects (hepatic metabolism inhibited)

• cobicistat
Hyrnuo (sevabertinib)

+

cobicistat

1 interaction

Avoid/Use Alternative

sevabertinib + cobicistat

use alternative or decr. sevabertinib dose as follows: if on sevabertinib 20 mg bid, decr. to 10 mg bid; if on sevabertinib 10 mg bid, decr. to 10 mg qd; if on sevabertinib 10 mg qd, hold sevabertinib until cobicistat D/C: combo may incr. sevabertinib levels, risk of adverse effects (hepatic metabolism inhibited)

• codeine
Hyrnuo (sevabertinib)

+

codeine

1 interaction

Avoid/Use Alternative

sevabertinib + codeine

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

• dabigatran
Hyrnuo (sevabertinib)

+

dabigatran

1 interaction

Avoid/Use Alternative

sevabertinib + 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)

• dabrafenib
Hyrnuo (sevabertinib)

+

dabrafenib

1 interaction

Avoid/Use Alternative

sevabertinib + dabrafenib

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

• efavirenz
Hyrnuo (sevabertinib)

+

efavirenz

1 interaction

Avoid/Use Alternative

sevabertinib + efavirenz

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

• encorafenib
Hyrnuo (sevabertinib)

+

encorafenib

1 interaction

Avoid/Use Alternative

sevabertinib + encorafenib

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

• ensartinib
Hyrnuo (sevabertinib)

+

ensartinib

1 interaction

Avoid/Use Alternative

sevabertinib + ensartinib

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

• enzalutamide
Hyrnuo (sevabertinib)

+

enzalutamide

1 interaction

Avoid/Use Alternative

sevabertinib + enzalutamide

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

• etravirine
Hyrnuo (sevabertinib)

+

etravirine

1 interaction

Avoid/Use Alternative

sevabertinib + etravirine

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

• fexinidazole
Hyrnuo (sevabertinib)

+

fexinidazole

1 interaction

Avoid/Use Alternative

sevabertinib + fexinidazole

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

• fosphenytoin
Hyrnuo (sevabertinib)

+

fosphenytoin

1 interaction

Avoid/Use Alternative

sevabertinib + fosphenytoin

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

• grapefruit
Hyrnuo (sevabertinib)

+

grapefruit

1 interaction

Avoid/Use Alternative

sevabertinib + grapefruit

avoid combo: combo may incr. sevabertinib levels, risk of adverse effects (GI metabolism inhibited)

• hydrocodone
Hyrnuo (sevabertinib)

+

hydrocodone

1 interaction

Avoid/Use Alternative

sevabertinib + hydrocodone

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

• idelalisib
Hyrnuo (sevabertinib)

+

idelalisib

1 interaction

Avoid/Use Alternative

sevabertinib + idelalisib

use alternative or decr. sevabertinib dose as follows: if on sevabertinib 20 mg bid, decr. to 10 mg bid; if on sevabertinib 10 mg bid, decr. to 10 mg qd; if on sevabertinib 10 mg qd, hold sevabertinib until idelalisib D/C: combo may incr. sevabertinib levels, risk of adverse effects (hepatic metabolism inhibited)

• itraconazole
Hyrnuo (sevabertinib)

+

itraconazole

1 interaction

Avoid/Use Alternative

sevabertinib + itraconazole

use alternative or decr. sevabertinib dose as follows during and x2wk after itraconazole tx: if on sevabertinib 20 mg bid, decr. to 10 mg bid; if on sevabertinib 10 mg bid, decr. to 10 mg qd; if on sevabertinib 10 mg qd, hold sevabertinib until itraconazole D/C; consider decr. itraconazole dose: combo may incr. sevabertinib levels, risk of adverse effects (hepatic metabolism inhibited)

• ivosidenib
Hyrnuo (sevabertinib)

+

ivosidenib

1 interaction

Avoid/Use Alternative

sevabertinib + ivosidenib

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

• ketoconazole
Hyrnuo (sevabertinib)

+

ketoconazole

1 interaction

Avoid/Use Alternative

sevabertinib + ketoconazole

use alternative or decr. sevabertinib dose as follows during and up to 1wk after ketoconazole tx: if on sevabertinib 20 mg bid, decr. to 10 mg bid; if on sevabertinib 10 mg bid, decr. to 10 mg qd; if on sevabertinib 10 mg qd, hold sevabertinib until ketoconazole D/C: combo may incr. sevabertinib levels, risk of adverse effects (hepatic metabolism inhibited)

• levoketoconazole
Hyrnuo (sevabertinib)

+

levoketoconazole

1 interaction

Avoid/Use Alternative

sevabertinib + levoketoconazole

use alternative or consider monitoring ECG and decr. sevabertinib dose as follows x2wk before and during levoketoconazole tx: if on sevabertinib 20 mg bid, decr. to 10 mg bid; if on sevabertinib 10 mg bid, decr. to 10 mg qd; if on sevabertinib 10 mg qd, hold sevabertinib until levoketoconazole D/C: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• lonafarnib
Hyrnuo (sevabertinib)

+

lonafarnib

1 interaction

Avoid/Use Alternative

sevabertinib + lonafarnib

use alternative or consider monitoring HR, ECG, electrolytes and decr. sevabertinib dose as follows: if on sevabertinib 20 mg bid, decr. to 10 mg bid; if on sevabertinib 10 mg bid, decr. to 10 mg qd; if on sevabertinib 10 mg qd, hold sevabertinib until lonafarnib D/C: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• lopinavir/ritonavir
Hyrnuo (sevabertinib)

+

lopinavir/ ritonavir

1 interaction

Avoid/Use Alternative

sevabertinib + lopinavir/ ritonavir

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

• lorlatinib
Hyrnuo (sevabertinib)

+

lorlatinib

1 interaction

Avoid/Use Alternative

sevabertinib + lorlatinib

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

• lumacaftor/ivacaftor
Hyrnuo (sevabertinib)

+

lumacaftor/ ivacaftor

1 interaction

Avoid/Use Alternative

sevabertinib + lumacaftor/ ivacaftor

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

• mavacamten
Hyrnuo (sevabertinib)

+

mavacamten

1 interaction

Avoid/Use Alternative

sevabertinib + mavacamten

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

• meperidine
Hyrnuo (sevabertinib)

+

meperidine

1 interaction

Avoid/Use Alternative

sevabertinib + meperidine

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

• methadone
Hyrnuo (sevabertinib)

+

methadone

1 interaction

Avoid/Use Alternative

sevabertinib + methadone

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

• mifepristone
Hyrnuo (sevabertinib)

+

mifepristone

1 interaction

Avoid/Use Alternative

sevabertinib + mifepristone

use alternative or decr. sevabertinib dose as follows during and x14 days after daily mifepristone use: if on sevabertinib 20 mg bid, decr. to 10 mg bid; if on sevabertinib 10 mg bid, decr. to 10 mg qd; if on sevabertinib 10 mg qd, hold sevabertinib until mifepristone D/C; caution advised if pregnancy termination use: combo may incr. sevabertinib levels, risk of adverse effects (hepatic metabolism inhibited)

• mitapivat
Hyrnuo (sevabertinib)

+

mitapivat

1 interaction

Avoid/Use Alternative

sevabertinib + mitapivat

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

• mitotane
Hyrnuo (sevabertinib)

+

mitotane

1 interaction

Avoid/Use Alternative

sevabertinib + mitotane

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

• modafinil
Hyrnuo (sevabertinib)

+

modafinil

1 interaction

Avoid/Use Alternative

sevabertinib + modafinil

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

• nafcillin
Hyrnuo (sevabertinib)

+

nafcillin

1 interaction

Avoid/Use Alternative

sevabertinib + nafcillin

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

• nefazodone
Hyrnuo (sevabertinib)

+

nefazodone

1 interaction

Avoid/Use Alternative

sevabertinib + nefazodone

use alternative or decr. sevabertinib dose as follows: if on sevabertinib 20 mg bid, decr. to 10 mg bid; if on sevabertinib 10 mg bid, decr. to 10 mg qd; if on sevabertinib 10 mg qd, hold sevabertinib until nefazodone D/C: combo may incr. sevabertinib levels, risk of adverse effects (hepatic metabolism inhibited)

• nelfinavir
Hyrnuo (sevabertinib)

+

nelfinavir

1 interaction

Avoid/Use Alternative

sevabertinib + nelfinavir

use alternative or decr. sevabertinib dose as follows: if on sevabertinib 20 mg bid, decr. to 10 mg bid; if on sevabertinib 10 mg bid, decr. to 10 mg qd; if on sevabertinib 10 mg qd, hold sevabertinib until nelfinavir D/C: combo may incr. sevabertinib levels, risk of adverse effects (hepatic metabolism inhibited)

• neratinib
Hyrnuo (sevabertinib)

+

neratinib

1 interaction

Avoid/Use Alternative

sevabertinib + neratinib

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

• oxycodone
Hyrnuo (sevabertinib)

+

oxycodone

1 interaction

Avoid/Use Alternative

sevabertinib + oxycodone

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

• pacritinib
Hyrnuo (sevabertinib)

+

pacritinib

1 interaction

Avoid/Use Alternative

sevabertinib + pacritinib

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

• pazopanib
Hyrnuo (sevabertinib)

+

pazopanib

1 interaction

Avoid/Use Alternative

sevabertinib + pazopanib

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

• pentobarbital
Hyrnuo (sevabertinib)

+

pentobarbital

1 interaction

Avoid/Use Alternative

sevabertinib + pentobarbital

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

• pexidartinib
Hyrnuo (sevabertinib)

+

pexidartinib

1 interaction

Avoid/Use Alternative

sevabertinib + pexidartinib

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

• phenobarbital
Hyrnuo (sevabertinib)

+

phenobarbital

1 interaction

Avoid/Use Alternative

sevabertinib + phenobarbital

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

• phenytoin
Hyrnuo (sevabertinib)

+

phenytoin

1 interaction

Avoid/Use Alternative

sevabertinib + phenytoin

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

• pimozide
Hyrnuo (sevabertinib)

+

pimozide

1 interaction

Avoid/Use Alternative

sevabertinib + pimozide

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

• posaconazole
Hyrnuo (sevabertinib)

+

posaconazole

1 interaction

Avoid/Use Alternative

sevabertinib + posaconazole

use alternative or decr. sevabertinib dose as follows: if on sevabertinib 20 mg bid, decr. to 10 mg bid; if on sevabertinib 10 mg bid, decr. to 10 mg qd; if on sevabertinib 10 mg qd, hold sevabertinib until posaconazole D/C: combo may incr. sevabertinib levels, risk of adverse effects (hepatic metabolism inhibited)

• pralsetinib
Hyrnuo (sevabertinib)

+

pralsetinib

1 interaction

Avoid/Use Alternative

sevabertinib + 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 metabolism inhibited, P-gp-mediated transport inhibited)

• primidone
Hyrnuo (sevabertinib)

+

primidone

1 interaction

Avoid/Use Alternative

sevabertinib + primidone

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

• propafenone
Hyrnuo (sevabertinib)

+

propafenone

1 interaction

Avoid/Use Alternative

sevabertinib + propafenone

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

• rabies vaccine
Hyrnuo (sevabertinib)

+

rabies vaccine

1 interaction

Avoid/Use Alternative

sevabertinib + rabies vaccine

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

• relugolix
Hyrnuo (sevabertinib)

+

relugolix

1 interaction

Avoid/Use Alternative

sevabertinib + relugolix

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

• repotrectinib
Hyrnuo (sevabertinib)

+

repotrectinib

1 interaction

Avoid/Use Alternative

sevabertinib + repotrectinib

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

• ribociclib
Hyrnuo (sevabertinib)

+

ribociclib

1 interaction

Avoid/Use Alternative

sevabertinib + ribociclib

use alternative or monitor ECG, electrolytes, CBC and decr. sevabertinib dose as follows: if on sevabertinib 20 mg bid, decr. to 10 mg bid; if on sevabertinib 10 mg bid, decr. to 10 mg qd; if on sevabertinib 10 mg qd, hold sevabertinib until ribociclib D/C: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, myelosuppression, other adverse effects (hepatic metabolism inhibited)

• rifabutin
Hyrnuo (sevabertinib)

+

rifabutin

1 interaction

Avoid/Use Alternative

sevabertinib + rifabutin

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

• rifampin
Hyrnuo (sevabertinib)

+

rifampin

1 interaction

Avoid/Use Alternative

sevabertinib + rifampin

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

• rifapentine
Hyrnuo (sevabertinib)

+

rifapentine

1 interaction

Avoid/Use Alternative

sevabertinib + rifapentine

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

• ritonavir
Hyrnuo (sevabertinib)

+

ritonavir

1 interaction

Avoid/Use Alternative

sevabertinib + ritonavir

use alternative or decr. sevabertinib dose as follows: if on sevabertinib 20 mg bid, decr. to 10 mg bid; if on sevabertinib 10 mg bid, decr. to 10 mg qd; if on sevabertinib 10 mg qd, hold sevabertinib until ritonavir D/C: combo may incr. sevabertinib levels, risk of adverse effects (hepatic metabolism inhibited)

• rivaroxaban
Hyrnuo (sevabertinib)

+

rivaroxaban

1 interaction

Avoid/Use Alternative

sevabertinib + rivaroxaban

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

• simvastatin
Hyrnuo (sevabertinib)

+

simvastatin

1 interaction

Avoid/Use Alternative

sevabertinib + simvastatin

use alternative or monitor CK, myopathy symptoms; adjust max simvastatin dose to 20 mg/day: combo may incr. simvastatin levels, risk of myopathy, rhabdomyolysis, other adverse effects (hepatic metabolism inhibited, BCRP-mediated transport inhibited)

• sirolimus albumin-bound
Hyrnuo (sevabertinib)

+

sirolimus albumin-bound

1 interaction

Avoid/Use Alternative

sevabertinib + sirolimus albumin-bound

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

• sotorasib
Hyrnuo (sevabertinib)

+

sotorasib

1 interaction

Avoid/Use Alternative

sevabertinib + sotorasib

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

• St. John's wort
Hyrnuo (sevabertinib)

+

St. John's wort

1 interaction

Avoid/Use Alternative

sevabertinib + St. John's wort

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

• tipranavir
Hyrnuo (sevabertinib)

+

tipranavir

1 interaction

Avoid/Use Alternative

sevabertinib + tipranavir

use alternative or decr. sevabertinib dose as follows: if on sevabertinib 20 mg bid, decr. to 10 mg bid; if on sevabertinib 10 mg bid, decr. to 10 mg qd; if on sevabertinib 10 mg qd, hold sevabertinib until tipranavir D/C: combo may incr. sevabertinib levels, risk of adverse effects (hepatic metabolism inhibited)

• topotecan
Hyrnuo (sevabertinib)

+

topotecan

1 interaction

Avoid/Use Alternative

sevabertinib + topotecan

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

• tucatinib
Hyrnuo (sevabertinib)

+

tucatinib

1 interaction

Avoid/Use Alternative

sevabertinib + tucatinib

use alternative or decr. sevabertinib dose as follows: if on sevabertinib 20 mg bid, decr. to 10 mg bid; if on sevabertinib 10 mg bid, decr. to 10 mg qd; if on sevabertinib 10 mg qd, hold sevabertinib until tucatinib D/C: combo may incr. sevabertinib levels, risk of adverse effects (hepatic metabolism inhibited)

• venetoclax
Hyrnuo (sevabertinib)

+

venetoclax

1 interaction

Avoid/Use Alternative

sevabertinib + venetoclax

monitor CBC, tumor lysis syndrome signs/symptoms; 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 metabolism inhibited, P-gp-mediated transport inhibited)

• voriconazole
Hyrnuo (sevabertinib)

+

voriconazole

1 interaction

Avoid/Use Alternative

sevabertinib + voriconazole

use alternative or decr. sevabertinib dose as follows: if on sevabertinib 20 mg bid, decr. to 10 mg bid; if on sevabertinib 10 mg bid, decr. to 10 mg qd; if on sevabertinib 10 mg qd, hold sevabertinib until voriconazole D/C: combo may incr. sevabertinib levels, risk of adverse effects (hepatic metabolism inhibited)

Monitor/Modify Tx

• abemaciclib
Hyrnuo (sevabertinib)

+

abemaciclib

1 interaction

Monitor/Modify Tx

sevabertinib + abemaciclib

monitor CBC: combo may incr. abemaciclib levels, risk of myelosuppression, other adverse effects (hepatic metabolism inhibited)

• acalabrutinib
Hyrnuo (sevabertinib)

+

acalabrutinib

1 interaction

Monitor/Modify Tx

sevabertinib + acalabrutinib

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

• afatinib
Hyrnuo (sevabertinib)

+

afatinib

1 interaction

Monitor/Modify Tx

sevabertinib + 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)

• alfentanil
Hyrnuo (sevabertinib)

+

alfentanil

1 interaction

Monitor/Modify Tx

sevabertinib + alfentanil

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

• amiodarone
Hyrnuo (sevabertinib)

+

amiodarone

1 interaction

Monitor/Modify Tx

sevabertinib + amiodarone

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

• anthrax vaccine
Hyrnuo (sevabertinib)

+

anthrax vaccine

1 interaction

Monitor/Modify Tx

sevabertinib + anthrax vaccine

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

• atorvastatin
Hyrnuo (sevabertinib)

+

atorvastatin

1 interaction

Monitor/Modify Tx

sevabertinib + atorvastatin

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

• avanafil
Hyrnuo (sevabertinib)

+

avanafil

1 interaction

Monitor/Modify Tx

sevabertinib + avanafil

monitor BP; consider decr. avanafil dose: combo may incr. avanafil levels, risk of hypotension, priapism, other adverse effects (hepatic metabolism inhibited)

• avapritinib
Hyrnuo (sevabertinib)

+

avapritinib

1 interaction

Monitor/Modify Tx

sevabertinib + avapritinib

monitor bleeding signs/symptoms: combo may incr. avapritinib levels, risk of bleeding (including life-threatening), other adverse effects (hepatic metabolism inhibited)

• brigatinib
Hyrnuo (sevabertinib)

+

brigatinib

1 interaction

Monitor/Modify Tx

sevabertinib + brigatinib

monitor BP, HR: combo may incr. brigatinib levels, risk of HTN, bradycardia, other adverse effects (hepatic metabolism inhibited)

• capivasertib
Hyrnuo (sevabertinib)

+

capivasertib

1 interaction

Monitor/Modify Tx

sevabertinib + capivasertib

monitor glucose: combo may incr. capivasertib levels, risk of severe hyperglycemia, other adverse effects (hepatic metabolism inhibited)

• chikungunya vaccine
Hyrnuo (sevabertinib)

+

chikungunya vaccine

1 interaction

Monitor/Modify Tx

sevabertinib + chikungunya vaccine

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

• clozapine
Hyrnuo (sevabertinib)

+

clozapine

1 interaction

Monitor/Modify Tx

sevabertinib + 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 metabolism inhibited)

• COVID-19 vaccine
Hyrnuo (sevabertinib)

+

COVID-19 vaccine

1 interaction

Monitor/Modify Tx

sevabertinib + COVID-19 vaccine

if possible, vaccinate at least 2wk before or 3mo after sevabertinib tx; otherwise, consider post-immunization titer check or revaccination after immunocompetence restored: combo may result in inadequate vaccine response (immunosuppressive effects)

• cyclosporine
Hyrnuo (sevabertinib)

+

cyclosporine

1 interaction

Monitor/Modify Tx

sevabertinib + cyclosporine

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

• digoxin
Hyrnuo (sevabertinib)

+

digoxin

1 interaction

Monitor/Modify Tx

sevabertinib + 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)

• diphtheria/tetanus vaccine
Hyrnuo (sevabertinib)

+

diphtheria/ tetanus vaccine

1 interaction

Monitor/Modify Tx

sevabertinib + diphtheria/ tetanus vaccine

if possible, vaccinate at least 2wk before starting sevabertinib 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
Hyrnuo (sevabertinib)

+

diphtheria/ tetanus/ pertussis vaccine

1 interaction

Monitor/Modify Tx

sevabertinib + diphtheria/ tetanus/ pertussis vaccine

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

• disopyramide
Hyrnuo (sevabertinib)

+

disopyramide

1 interaction

Monitor/Modify Tx

sevabertinib + disopyramide

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

• docetaxel
Hyrnuo (sevabertinib)

+

docetaxel

1 interaction

Monitor/Modify Tx

sevabertinib + docetaxel

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

• dofetilide
Hyrnuo (sevabertinib)

+

dofetilide

1 interaction

Monitor/Modify Tx

sevabertinib + dofetilide

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

• domperidone
Hyrnuo (sevabertinib)

+

domperidone

1 interaction

Monitor/Modify Tx

sevabertinib + domperidone

monitor ECG, HR, electrolytes: combo may incr. domperidone levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• ebola vaccine, live
Hyrnuo (sevabertinib)

+

ebola vaccine, live

1 interaction

Monitor/Modify Tx

sevabertinib + ebola vaccine, live

consider vaccinating at least 4wk before or 3mo after sevabertinib tx: combo may result in inadequate vaccine response; may incr. risk of mild vesicular stomatitis virus infection (immunosuppressive effects, recombinant vaccine with vesicular stomatitis virus vector)

• edoxaban
Hyrnuo (sevabertinib)

+

edoxaban

1 interaction

Monitor/Modify Tx

sevabertinib + edoxaban

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

• enfortumab vedotin
Hyrnuo (sevabertinib)

+

enfortumab vedotin

1 interaction

Monitor/Modify Tx

sevabertinib + 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)

• entrectinib
Hyrnuo (sevabertinib)

+

entrectinib

1 interaction

Monitor/Modify Tx

sevabertinib + entrectinib

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

• eplerenone
Hyrnuo (sevabertinib)

+

eplerenone

1 interaction

Monitor/Modify Tx

sevabertinib + eplerenone

monitor potassium: combo may incr. eplerenone levels, risk of hyperkalemia, other adverse effects (hepatic metabolism inhibited)

• erythromycin
Hyrnuo (sevabertinib)

+

erythromycin

1 interaction

Monitor/Modify Tx

sevabertinib + erythromycin

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

• everolimus
Hyrnuo (sevabertinib)

+

everolimus

1 interaction

Monitor/Modify Tx

sevabertinib + 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 myelosuppression, other adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• fedratinib
Hyrnuo (sevabertinib)

+

fedratinib

1 interaction

Monitor/Modify Tx

sevabertinib + fedratinib

if fedratinib also combined with CYP2C19 inhibitor, monitor CBC, LFTs; otherwise, caution advised: combo may incr. levels of both drugs, risk myelosuppression, hepatotoxicity, other adverse effects (hepatic metabolism inhibited)

• felodipine
Hyrnuo (sevabertinib)

+

felodipine

1 interaction

Monitor/Modify Tx

sevabertinib + felodipine

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

• fentanyl
Hyrnuo (sevabertinib)

+

fentanyl

1 interaction

Monitor/Modify Tx

sevabertinib + fentanyl

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

• finerenone
Hyrnuo (sevabertinib)

+

finerenone

1 interaction

Monitor/Modify Tx

sevabertinib + finerenone

monitor potassium: combo may incr. finerenone levels, risk of hyperkalemia, other adverse effects (hepatic metabolism inhibited)

• flibanserin
Hyrnuo (sevabertinib)

+

flibanserin

1 interaction

Monitor/Modify Tx

sevabertinib + flibanserin

monitor BP, especially if flibanserin also combined with other weak CYP3A4 inhibitors: combo may incr. flibanserin levels, risk of CNS depression, psychomotor impairment, severe hypotension (including syncope), other adverse effects (hepatic metabolism inhibited)

• fluvastatin
Hyrnuo (sevabertinib)

+

fluvastatin

1 interaction

Monitor/Modify Tx

sevabertinib + fluvastatin

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

• gepirone
Hyrnuo (sevabertinib)

+

gepirone

1 interaction

Monitor/Modify Tx

sevabertinib + gepirone

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

• Haemophilus b vaccine
Hyrnuo (sevabertinib)

+

Haemophilus b vaccine

1 interaction

Monitor/Modify Tx

sevabertinib + Haemophilus b vaccine

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

• hepatitis A vaccine
Hyrnuo (sevabertinib)

+

hepatitis A vaccine

1 interaction

Monitor/Modify Tx

sevabertinib + hepatitis A vaccine

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

• hepatitis B vaccine
Hyrnuo (sevabertinib)

+

hepatitis B vaccine

1 interaction

Monitor/Modify Tx

sevabertinib + hepatitis B vaccine

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

• human papillomavirus vaccine
Hyrnuo (sevabertinib)

+

human papillomavirus vaccine

1 interaction

Monitor/Modify Tx

sevabertinib + human papillomavirus vaccine

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

• ibrutinib
Hyrnuo (sevabertinib)

+

ibrutinib

1 interaction

Monitor/Modify Tx

sevabertinib + ibrutinib

consider decr. ibrutinib dose: combo may incr. ibrutinib levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metabolism inhibited)

• influenza H5N1 vaccine
Hyrnuo (sevabertinib)

+

influenza H5N1 vaccine

1 interaction

Monitor/Modify Tx

sevabertinib + influenza H5N1 vaccine

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

• influenza vaccine
Hyrnuo (sevabertinib)

+

influenza vaccine

1 interaction

Monitor/Modify Tx

sevabertinib + influenza vaccine

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

• irinotecan
Hyrnuo (sevabertinib)

+

irinotecan

1 interaction

Monitor/Modify Tx

sevabertinib + irinotecan

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

• ivabradine
Hyrnuo (sevabertinib)

+

ivabradine

1 interaction

Monitor/Modify Tx

sevabertinib + ivabradine

monitor HR, ECG: combo may incr. ivabradine levels, risk of bradycardia, QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• ixabepilone
Hyrnuo (sevabertinib)

+

ixabepilone

1 interaction

Monitor/Modify Tx

sevabertinib + ixabepilone

monitor CBC: combo may incr. ixabepilone levels, risk of serious infection, myelosuppression, other toxicity (hepatic metabolism inhibited)

• Japanese encephalitis vaccine
Hyrnuo (sevabertinib)

+

Japanese encephalitis vaccine

1 interaction

Monitor/Modify Tx

sevabertinib + Japanese encephalitis vaccine

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

• lapatinib
Hyrnuo (sevabertinib)

+

lapatinib

1 interaction

Monitor/Modify Tx

sevabertinib + lapatinib

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

• lemborexant
Hyrnuo (sevabertinib)

+

lemborexant

1 interaction

Monitor/Modify Tx

sevabertinib + lemborexant

adjust max lemborexant dose to 5 mg/day: combo may incr. lemborexant levels, risk of CNS depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited)

• lomitapide
Hyrnuo (sevabertinib)

+

lomitapide

1 interaction

Monitor/Modify Tx

sevabertinib + lomitapide

ADULT PATIENTS: if patient on stable sevabertinib dose and starting lomitapide, adjust max lomitapide dose to 30 mg/day; if patient on stable lomitapide dose and starting sevabertinib, decr. lomitapide dose by 50% and adjust max lomitapide dose to 30 mg/day; PEDIATRIC PATIENTS: if patient on stable sevabertinib dose and starting lomitapide, adjust max lomitapide dose to 10 mg/day if 2-10 yo or 20 mg/day if 11-17 yo; if patient on stable lomitapide dose and starting sevabertinib, decr. lomitapide dose by 50% and adjust max lomitapide dose to 10 mg/day if 2-10 yo or 20 mg/day if 11-17 yo: combo may incr. lomitapide levels, risk of hepatotoxicity, other adverse effects (hepatic metabolism inhibited)

• lovastatin
Hyrnuo (sevabertinib)

+

lovastatin

1 interaction

Monitor/Modify Tx

sevabertinib + lovastatin

monitor CK, myopathy symptoms: combo may incr. lovastatin levels, risk of myopathy, rhabdomyolysis, other adverse effects (hepatic metabolism inhibited)

• lumateperone
Hyrnuo (sevabertinib)

+

lumateperone

1 interaction

Monitor/Modify Tx

sevabertinib + lumateperone

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

• lurasidone
Hyrnuo (sevabertinib)

+

lurasidone

1 interaction

Monitor/Modify Tx

sevabertinib + lurasidone

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

• lurbinectedin
Hyrnuo (sevabertinib)

+

lurbinectedin

1 interaction

Monitor/Modify Tx

sevabertinib + lurbinectedin

monitor CBC: combo may incr. lurbinectedin levels, risk of myelosuppression, other adverse effects (hepatic metabolism inhibited)

• mavorixafor
Hyrnuo (sevabertinib)

+

mavorixafor

1 interaction

Monitor/Modify Tx

sevabertinib + mavorixafor

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

• meningococcal vaccine
Hyrnuo (sevabertinib)

+

meningococcal vaccine

1 interaction

Monitor/Modify Tx

sevabertinib + meningococcal vaccine

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

• methotrexate
Hyrnuo (sevabertinib)

+

methotrexate

1 interaction

Monitor/Modify Tx

sevabertinib + methotrexate

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

• midazolam
Hyrnuo (sevabertinib)

+

midazolam

1 interaction

Monitor/Modify Tx

sevabertinib + midazolam

monitor respiratory rate: combo may incr. midazolam and active metabolite levels, risk of profound CNS and respiratory depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited)

• mitoxantrone
Hyrnuo (sevabertinib)

+

mitoxantrone

1 interaction

Monitor/Modify Tx

sevabertinib + 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)

• mobocertinib
Hyrnuo (sevabertinib)

+

mobocertinib

1 interaction

Monitor/Modify Tx

sevabertinib + mobocertinib

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

• morphine
Hyrnuo (sevabertinib)

+

morphine

1 interaction

Monitor/Modify Tx

sevabertinib + morphine

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

• nifedipine
Hyrnuo (sevabertinib)

+

nifedipine

1 interaction

Monitor/Modify Tx

sevabertinib + nifedipine

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

• nimodipine
Hyrnuo (sevabertinib)

+

nimodipine

1 interaction

Monitor/Modify Tx

sevabertinib + nimodipine

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

• nisoldipine
Hyrnuo (sevabertinib)

+

nisoldipine

1 interaction

Monitor/Modify Tx

sevabertinib + nisoldipine

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

• oliceridine
Hyrnuo (sevabertinib)

+

oliceridine

1 interaction

Monitor/Modify Tx

sevabertinib + oliceridine

monitor respiratory rate, ECG: combo may incr. oliceridine levels, risk of CNS and respiratory depression, psychomotor impairment, QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• pemigatinib
Hyrnuo (sevabertinib)

+

pemigatinib

1 interaction

Monitor/Modify Tx

sevabertinib + pemigatinib

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

• pitavastatin
Hyrnuo (sevabertinib)

+

pitavastatin

1 interaction

Monitor/Modify Tx

sevabertinib + pitavastatin

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

• pneumococcal vaccine
Hyrnuo (sevabertinib)

+

pneumococcal vaccine

1 interaction

Monitor/Modify Tx

sevabertinib + pneumococcal vaccine

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

• poliovirus vaccine
Hyrnuo (sevabertinib)

+

poliovirus vaccine

1 interaction

Monitor/Modify Tx

sevabertinib + poliovirus vaccine

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

• pravastatin
Hyrnuo (sevabertinib)

+

pravastatin

1 interaction

Monitor/Modify Tx

sevabertinib + pravastatin

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

• quinidine (antiarrhythmic)
Hyrnuo (sevabertinib)

+

quinidine (antiarrhythmic)

1 interaction

Monitor/Modify Tx

sevabertinib + quinidine (antiarrhythmic)

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

• ranolazine
Hyrnuo (sevabertinib)

+

ranolazine

1 interaction

Monitor/Modify Tx

sevabertinib + ranolazine

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

• red yeast rice
Hyrnuo (sevabertinib)

+

red yeast rice

1 interaction

Monitor/Modify Tx

sevabertinib + red yeast rice

monitor CK, myopathy symptoms with large amounts of red yeast rice: combo may incr. lovastatin levels, risk of myopathy, rhabdomyolysis, other adverse effects (hepatic metabolism inhibited, red yeast rice contains varying amounts of lovastatin)

• respiratory syncytial virus vaccine
Hyrnuo (sevabertinib)

+

respiratory syncytial virus vaccine

1 interaction

Monitor/Modify Tx

sevabertinib + respiratory syncytial virus vaccine

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

• riociguat
Hyrnuo (sevabertinib)

+

riociguat

1 interaction

Monitor/Modify Tx

sevabertinib + 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 metabolism inhibited, BCRP-mediated transport inhibited)

• rosuvastatin
Hyrnuo (sevabertinib)

+

rosuvastatin

1 interaction

Monitor/Modify Tx

sevabertinib + rosuvastatin

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

• selpercatinib
Hyrnuo (sevabertinib)

+

selpercatinib

1 interaction

Monitor/Modify Tx

sevabertinib + selpercatinib

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

• sirolimus
Hyrnuo (sevabertinib)

+

sirolimus

1 interaction

Monitor/Modify Tx

sevabertinib + sirolimus

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

• smallpox/mpox vaccine, live
Hyrnuo (sevabertinib)

+

smallpox/ mpox vaccine, live

1 interaction

Monitor/Modify Tx

sevabertinib + smallpox/ mpox vaccine, live

consider vaccinating at least 4wk before or 3mo after sevabertinib tx: combo may result in inadequate vaccine response (immunosuppressive effects)

• sufentanil
Hyrnuo (sevabertinib)

+

sufentanil

1 interaction

Monitor/Modify Tx

sevabertinib + sufentanil

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

• tacrolimus
Hyrnuo (sevabertinib)

+

tacrolimus

1 interaction

Monitor/Modify Tx

sevabertinib + tacrolimus

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

• tadalafil
Hyrnuo (sevabertinib)

+

tadalafil

1 interaction

Monitor/Modify Tx

sevabertinib + tadalafil

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

• talazoparib
Hyrnuo (sevabertinib)

+

talazoparib

1 interaction

Monitor/Modify Tx

sevabertinib + talazoparib

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

• taletrectinib
Hyrnuo (sevabertinib)

+

taletrectinib

1 interaction

Monitor/Modify Tx

sevabertinib + taletrectinib

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

• tamsulosin
Hyrnuo (sevabertinib)

+

tamsulosin

1 interaction

Monitor/Modify Tx

sevabertinib + tamsulosin

monitor BP, especially with tamsulosin dose >0.4 mg: combo may incr. tamsulosin levels, risk of hypotension (including orthostasis, syncope), other adverse effects (hepatic metabolism inhibited)

• temsirolimus
Hyrnuo (sevabertinib)

+

temsirolimus

1 interaction

Monitor/Modify Tx

sevabertinib + temsirolimus

monitor CBC: combo may incr. temsirolimus and active metabolite sirolimus levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metabolism inhibited)

• tenofovir alafenamide
Hyrnuo (sevabertinib)

+

tenofovir alafenamide

1 interaction

Monitor/Modify Tx

sevabertinib + 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 inhibited, gut BCRP-mediated transport inhibited)

• tenofovir disoproxil
Hyrnuo (sevabertinib)

+

tenofovir disoproxil

1 interaction

Monitor/Modify Tx

sevabertinib + 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)

• tick-borne encephalitis vaccine
Hyrnuo (sevabertinib)

+

tick-borne encephalitis vaccine

1 interaction

Monitor/Modify Tx

sevabertinib + tick-borne encephalitis vaccine

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

• tolvaptan
Hyrnuo (sevabertinib)

+

tolvaptan

1 interaction

Monitor/Modify Tx

sevabertinib + tolvaptan

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

• triazolam
Hyrnuo (sevabertinib)

+

triazolam

1 interaction

Monitor/Modify Tx

sevabertinib + triazolam

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

• typhoid vaccine
Hyrnuo (sevabertinib)

+

typhoid vaccine

1 interaction

Monitor/Modify Tx

sevabertinib + typhoid vaccine

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

• ubrogepant
Hyrnuo (sevabertinib)

+

ubrogepant

1 interaction

Monitor/Modify Tx

sevabertinib + ubrogepant

limit ubrogepant dose to 50 mg, may give second 50 mg dose after 24h if needed: combo may incr. ubrogepant levels, risk of adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited, BCRP-mediated transport inhibited)

• vardenafil
Hyrnuo (sevabertinib)

+

vardenafil

1 interaction

Monitor/Modify Tx

sevabertinib + vardenafil

monitor ECG: combo may incr. vardenafil levels, risk of QT prolongation, cardiac arrhythmias, hypotension, priapism, other adverse effects (hepatic metabolism inhibited)

• vinblastine
Hyrnuo (sevabertinib)

+

vinblastine

1 interaction

Monitor/Modify Tx

sevabertinib + vinblastine

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

• vincristine
Hyrnuo (sevabertinib)

+

vincristine

1 interaction

Monitor/Modify Tx

sevabertinib + vincristine

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

• vinorelbine
Hyrnuo (sevabertinib)

+

vinorelbine

1 interaction

Monitor/Modify Tx

sevabertinib + vinorelbine

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

• warfarin
Hyrnuo (sevabertinib)

+

warfarin

1 interaction

Monitor/Modify Tx

sevabertinib + warfarin

monitor INR, bleeding signs/symptoms, especially during initiation/titration: combo may incr. warfarin levels, risk of bleeding (including life-threatening), other adverse effects (hepatic metabolism inhibited)

• zanubrutinib
Hyrnuo (sevabertinib)

+

zanubrutinib

1 interaction

Monitor/Modify Tx

sevabertinib + zanubrutinib

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

Caution Advised

• aprepitant
Hyrnuo (sevabertinib)

+

aprepitant

1 interaction

Caution Advised

sevabertinib + aprepitant

if aprepitant 3-day regimen, caution advised; aprepitant single dose-regimen OK: combo may incr. sevabertinib levels, risk of adverse effects (hepatic metabolism inhibited)

• avacopan
Hyrnuo (sevabertinib)

+

avacopan

1 interaction

Caution Advised

sevabertinib + avacopan

caution advised: combo may incr. sevabertinib levels, risk of adverse effects (hepatic metabolism inhibited)

• berotralstat
Hyrnuo (sevabertinib)

+

berotralstat

1 interaction

Caution Advised

sevabertinib + berotralstat

caution advised: combo may incr. sevabertinib levels, risk of adverse effects (hepatic metabolism inhibited)

• cariprazine
Hyrnuo (sevabertinib)

+

cariprazine

1 interaction

Caution Advised

sevabertinib + cariprazine

caution advised: combo may incr. cariprazine and active metabolite levels, risk of adverse effects (hepatic metabolism inhibited)

• ciprofloxacin
Hyrnuo (sevabertinib)

+

ciprofloxacin

1 interaction

Caution Advised

sevabertinib + ciprofloxacin

caution advised: combo may incr. sevabertinib levels, risk of adverse effects (hepatic metabolism inhibited)

• clofazimine
Hyrnuo (sevabertinib)

+

clofazimine

1 interaction

Caution Advised

sevabertinib + clofazimine

caution advised: combo may incr. sevabertinib levels, risk of adverse effects (hepatic metabolism inhibited)

• cobimetinib
Hyrnuo (sevabertinib)

+

cobimetinib

1 interaction

Caution Advised

sevabertinib + cobimetinib

caution advised: combo may incr. cobimetinib levels, risk of adverse effects (hepatic metabolism inhibited)

• conivaptan
Hyrnuo (sevabertinib)

+

conivaptan

1 interaction

Caution Advised

sevabertinib + conivaptan

caution advised during and x7 days after conivaptan tx: combo may incr. levels of both drugs, risk of overly rapid serum sodium correction, neurologic sequelae, other adverse effects (hepatic metabolism inhibited)

• crizotinib
Hyrnuo (sevabertinib)

+

crizotinib

1 interaction

Caution Advised

sevabertinib + crizotinib

caution advised: combo may incr. sevabertinib levels, risk of adverse effects (hepatic metabolism inhibited)

• cyclophosphamide
Hyrnuo (sevabertinib)

+

cyclophosphamide

1 interaction

Caution Advised

sevabertinib + cyclophosphamide

caution advised: combo may decr. cyclophosphamide active metabolite levels, efficacy (hepatic metabolism possibly inhibited, decreased conversion to active metabolite)

• danazol
Hyrnuo (sevabertinib)

+

danazol

1 interaction

Caution Advised

sevabertinib + danazol

caution advised: combo may incr. sevabertinib levels, risk of adverse effects (hepatic metabolism inhibited)

• daridorexant
Hyrnuo (sevabertinib)

+

daridorexant

1 interaction

Caution Advised

sevabertinib + daridorexant

caution advised: combo may incr. daridorexant levels, risk of CNS depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited)

• darolutamide
Hyrnuo (sevabertinib)

+

darolutamide

1 interaction

Caution Advised

sevabertinib + darolutamide

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

• darunavir
Hyrnuo (sevabertinib)

+

darunavir

1 interaction

Caution Advised

sevabertinib + darunavir

caution advised: combo may incr. sevabertinib levels, risk of adverse effects (hepatic metabolism inhibited)

• dihydroergotamine
Hyrnuo (sevabertinib)

+

dihydroergotamine

1 interaction

Caution Advised

sevabertinib + dihydroergotamine

caution advised: combo may incr. dihydroergotamine levels, risk of ergot toxicity, severe vasospasm, ischemia, other adverse effects (hepatic metabolism inhibited)

• diltiazem
Hyrnuo (sevabertinib)

+

diltiazem

1 interaction

Caution Advised

sevabertinib + diltiazem

caution advised: combo may incr. sevabertinib levels, risk of adverse effects (hepatic metabolism inhibited)

• dronedarone
Hyrnuo (sevabertinib)

+

dronedarone

1 interaction

Caution Advised

sevabertinib + dronedarone

caution advised: combo may incr. sevabertinib levels, risk of adverse effects (hepatic metabolism inhibited)

• duvelisib
Hyrnuo (sevabertinib)

+

duvelisib

1 interaction

Caution Advised

sevabertinib + duvelisib

caution advised: combo may incr. sevabertinib levels, risk of adverse effects (hepatic metabolism inhibited)

• elinzanetant
Hyrnuo (sevabertinib)

+

elinzanetant

1 interaction

Caution Advised

sevabertinib + elinzanetant

caution advised: combo may incr. elinzanetant levels, risk of CNS depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited)

• ergotamine
Hyrnuo (sevabertinib)

+

ergotamine

1 interaction

Caution Advised

sevabertinib + ergotamine

caution advised: combo may incr. ergotamine levels, risk of ergot toxicity, severe vasospasm, ischemia, other adverse effects (hepatic metabolism inhibited)

• fluconazole
Hyrnuo (sevabertinib)

+

fluconazole

1 interaction

Caution Advised

sevabertinib + fluconazole

caution advised: combo may incr. sevabertinib levels, risk of adverse effects (hepatic metabolism inhibited)

• fosamprenavir
Hyrnuo (sevabertinib)

+

fosamprenavir

1 interaction

Caution Advised

sevabertinib + fosamprenavir

caution advised: combo may incr. sevabertinib levels, risk of adverse effects (hepatic metabolism inhibited)

• glecaprevir
Hyrnuo (sevabertinib)

+

glecaprevir

1 interaction

Caution Advised

sevabertinib + glecaprevir

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

• imatinib
Hyrnuo (sevabertinib)

+

imatinib

1 interaction

Caution Advised

sevabertinib + imatinib

caution advised: combo may incr. sevabertinib levels, risk of adverse effects (hepatic metabolism inhibited)

• isavuconazonium
Hyrnuo (sevabertinib)

+

isavuconazonium

1 interaction

Caution Advised

sevabertinib + isavuconazonium

caution advised: combo may incr. sevabertinib levels, risk of adverse effects (hepatic metabolism inhibited)

• lefamulin
Hyrnuo (sevabertinib)

+

lefamulin

1 interaction

Caution Advised

sevabertinib + lefamulin

ORAL LEFAMULIN: caution advised; IV lefamulin use OK: combo may incr. sevabertinib levels, risk of adverse effects (hepatic metabolism inhibited)

• lenacapavir
Hyrnuo (sevabertinib)

+

lenacapavir

1 interaction

Caution Advised

sevabertinib + lenacapavir

caution advised during and x9 mo after lenacapavir tx: combo may incr. sevabertinib levels, risk of adverse effects (hepatic metabolism inhibited)

• letermovir
Hyrnuo (sevabertinib)

+

letermovir

1 interaction

Caution Advised

sevabertinib + letermovir

caution advised: combo may incr. sevabertinib levels, risk of adverse effects (hepatic metabolism inhibited)

• methylergonovine
Hyrnuo (sevabertinib)

+

methylergonovine

1 interaction

Caution Advised

sevabertinib + methylergonovine

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

• naldemedine
Hyrnuo (sevabertinib)

+

naldemedine

1 interaction

Caution Advised

sevabertinib + naldemedine

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

• netupitant
Hyrnuo (sevabertinib)

+

netupitant

1 interaction

Caution Advised

sevabertinib + netupitant

caution advised during and x1wk after (fos)netupitant tx: combo may incr. sevabertinib levels, risk of adverse effects (hepatic metabolism inhibited)

• nilotinib
Hyrnuo (sevabertinib)

+

nilotinib

1 interaction

Caution Advised

sevabertinib + nilotinib

caution advised: combo may incr. sevabertinib levels, risk of adverse effects (hepatic metabolism inhibited)

• nirogacestat
Hyrnuo (sevabertinib)

+

nirogacestat

1 interaction

Caution Advised

sevabertinib + nirogacestat

caution advised: combo may incr. sevabertinib levels, risk of adverse effects (hepatic metabolism inhibited)

• palovarotene
Hyrnuo (sevabertinib)

+

palovarotene

1 interaction

Caution Advised

sevabertinib + palovarotene

caution advised: combo may incr. palovarotene levels, risk of adverse effects (hepatic metabolism inhibited)

• pibrentasvir
Hyrnuo (sevabertinib)

+

pibrentasvir

1 interaction

Caution Advised

sevabertinib + pibrentasvir

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

• rilzabrutinib
Hyrnuo (sevabertinib)

+

rilzabrutinib

1 interaction

Caution Advised

sevabertinib + rilzabrutinib

caution advised: combo may incr. levels of both drugs, risk of adverse effects (hepatic metabolism inhibited)

• roflumilast
Hyrnuo (sevabertinib)

+

roflumilast

1 interaction

Caution Advised

sevabertinib + roflumilast

caution advised: combo may incr. roflumilast levels, risk of adverse effects (hepatic metabolism inhibited)

• roflumilast topical
Hyrnuo (sevabertinib)

+

roflumilast topical

1 interaction

Caution Advised

sevabertinib + roflumilast topical

caution advised: combo may incr. roflumilast levels, risk of adverse effects (hepatic metabolism inhibited)

• seladelpar
Hyrnuo (sevabertinib)

+

seladelpar

1 interaction

Caution Advised

sevabertinib + 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)

• sirolimus topical
Hyrnuo (sevabertinib)

+

sirolimus topical

1 interaction

Caution Advised

sevabertinib + sirolimus topical

caution advised: combo may incr. sirolimus levels, risk of adverse effects (hepatic metabolism inhibited)

• sulfasalazine
Hyrnuo (sevabertinib)

+

sulfasalazine

1 interaction

Caution Advised

sevabertinib + sulfasalazine

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

• verapamil
Hyrnuo (sevabertinib)

+

verapamil

1 interaction

Caution Advised

sevabertinib + verapamil

caution advised: combo may incr. levels of both drugs, risk of hypotension, bradycardia, AV block, other adverse effects (hepatic metabolism inhibited)