Dosing & Uses
Dosage Forms & Strengths
capsules
- 200mg
- 250mg
oral pellets
- 20mg
- 50mg
- 150mg
Non-Small Cell Lung Cancer
Indicated for metastatic non-small cell lung cancer (NSCLC) in adults whose tumors are anaplastic lymphoma kinase (ALK)- or ROS1-positive
250 mg PO BID
Continue until disease progression or unacceptable toxicity
Inflammatory Myofibroblastic tumors
Indicated for unresectable, recurrent, or refractory inflammatory myofibroblastic tumors (IMT) in adults who are ALK-positive
250 mg PO BID
Continue until disease progression or unacceptable toxicity
Dosage Modifications
Dosage reductions
- First dose reduction: 200 mg PO BID
- Second dose reduction: 250 mg PO qDay
- Unable to tolerate 250 mg PO qDay: Permanently discontinue
Hematologic toxicities
- For all hematologic toxicities except lymphopenia (unless associated with clinical events, eg, opportunistic infections)
- Grade 3: Withhold until recovery to Grade ≤2, then resume at same dose
- Grade 4: Withhold until recovery to Grade ≤2, then resume at next dose reduction
Hepatotoxicity
- ALT or AST >5x ULN with total bilirubin [TB] ≤1.5x ULN: Withhold until recovery to baseline or ≤3x ULN, then resume at next dose reduction
- ALT or AST >3x with concurrent TB >1.5x ULN (in the absence of cholestasis or hemolysis): Permanently discontinue
Interstitial lung disease
- Any grade pneumonitis: Permanently discontinue
QT prolongation
- Correct QT (QTc) >500 ms on at least 2 separate electrocardiograms (ECGs): Withhold until recovery to baseline or at QTc <481 ms, then resume at next dose reduction
- QTc >500 ms or ≥60 ms change from baseline with Torsade de pointes or polymorphic ventricular tachycardia or signs/symptoms of serious arrhythmia: Permanently discontinue
Bradycardia
Symptomatic, may be severe and medically intervention indicated
- Withhold until recovery to asymptomatic bradycardia or HR ≥60 bpm
- Evaluate concomitant medications known to cause bradycardia (eg, antihypertensives)
- Discontinue or adjust dose of any contributing medication; resume at previous dose upon recovery to asymptomatic bradycardia or HR ≥60 bpm
- Contributing medication not identified, or if contributing medications not discontinue or dose modified: Resume at next dose reduction upon recovery to asymptomatic bradycardia or to a HR ≥60 bpm
Life-threatening consequences, urgent intervention indicated
- No contributing medications identified: Permanently discontinue
- If contributing medication identified AND discontinued, or its dose adjusted: Resume at 250 mg qDay upon recovery to asymptomatic bradycardia or to a HR ≥60 bpm, closely monitor
- Permanently discontinue for recurrence
Visual loss
- Grade 4 ocular disorder: Discontinue during evaluation of severe visual loss
Strong CYP3A4 inhibitors
- Avoid coadministration
- If use is unavoidable, reduce crizotinib dose to 250 mg PO qDay
- After discontinuation of strong CYP3A inhibitor, resume crizotinib dose used before initiating strong CYP3A inhibitor
Renal impairment
- Mild-to-moderate (CrCl 30-89 mL/min): No dosage adjustment necessary
- Severe (CrCl <30 mL/min) and not requiring dialysis: 250 mg PO qDay
Hepatic impairment
- Mild (AST >ULN and TB ≤1x ULN or any AST and TB >1x to ≤1.5x ULN): Steady-state mean AUC and Cmax decreased by 9%
- Moderate (any AST and TB >1.5x ULN and ≤3x ULN): 200 mg PO BID
- Severe (any AST and TB>3x ULN): 250 mg PO qDay
Dosing Considerations
Verify pregnancy status in females of reproductive potential before initiation
Monitoring parameters
- CBC including differential WBC counts: Monthly and as clinically indicated, more frequently test if Grade 3 or 4 abnormalities are observed or if fever or infection occurs
- Liver function tests: Every 2 weeks during the first 2 months of treatment, then monthly, and as clinically needed
Limitation of use
- Safety and efficacy not established in adults with relapsed or refractory, systemic ALK-positive ALCL
Patient selection
- Select based presence of ALK- or ROS1- positive tumor specimens
- Information is available at http://www.fda.gov/companiondiagnostics
Dosage Forms & Strengths
capsules
- 200mg
- 250mg
oral pellets
- 20mg
- 50mg
- 150mg
Anaplastic Large Cell Lymphoma
Indicated for relapsed or refractory, systemic ALK-positive anaplastic large cell lymphoma (ALCL) in children and young adults aged ≥1 year
Assess the ability to swallow intact capsules before prescribing
Continue until disease progression or unacceptable toxicity
Recommended dosage based on BSA
- <0.38 m2: Dose not established
- 0.38-0.46 m2: 120 mg PO BID
- 0.47-0.51 m2: 140 mg PO BID
- 0.52-0.61 m2: 150 mg PO BID
- 0.62-0.8 m2: 200 mg PO BID
- 0.81-0.97 m2: 250 mg PO BID
- 0.98-1.16 m2: 300 mg PO BID
- 1.17-1.33 m2: 350 mg PO BID
- 1.34-1.51 m2: 400 mg PO BID
- 1.52-1.69 m2: 450 mg PO BID
- ≥1.7 m2: 500 mg PO BID
Inflammatory Myofibroblastic Tumors
Indicated for unresectable, recurrent, or refractory inflammatory myofibroblastic tumors (IMT) in adults and pediatric patients aged ≥1 year who are ALK-positive
<1 year: Safety and efficacy not established
≥1 year
- 280 mg/m2 PO BID
-
Recommended dosage based on body surface area (BSA)
- <0.38 m2: Dose not established
- 0.38-0.46 m2: 120 mg PO BID
- 0.47-0.51 m2: 140 mg PO BID
- 0.52-0.61 m2: 150 mg PO BID
- 0.62-0.8 m2: 200 mg PO BID
- 0.81-0.97 m2: 250 mg PO BID
- 0.98-1.16 m2: 300 mg PO BID
- 1.17-1.33 m2: 350 mg PO BID
- 1.34-1.51 m2: 400 mg PO BID
- 1.52-1.69 m2: 450 mg PO BID
- ≥1.7 m2: 500 mg PO BID
Dosage Modifications
Premedication for ALCL or IMT
- Provide standard antiemetic and antidiarrheal agents
- Antiemetics are recommended before and during treatment
- Consider IV or oral hydration for patients at risk of dehydration, and replace electrolytes as clinically indicated
Dose reductions based on BSA
-
First dose reduction
- 0.6-0.8 m2: 250 mg PO qDay
- 0.81-1.16 m2: 200 mg PO BID
- 1.17-1.69 m2: 250 mg PO BID
- ≥1.70 m2: 400 mg PO BID
-
Second dose reduction
- 0.6-0.8 m2: Permanently discontinue
- 0.81-1.16 m2: 250 mg PO qDay
- 1.17-1.69 m2: 200 mg PO BID
- ≥1.70 m2: 250 mg PO BID
-
Unable to tolerate after 2 dose reductions
- Permanently discontinue
Absolute neutrophil count (ANC)
- ANC <0.5 x 109/L
-
First occurrence
- Withhold until recovery to ANC >1 x 109/L, then resume at next dose reduction
-
Second occurrence
- Recurrence complicated by febrile neutropenia: Permanently discontinue
- Uncomplicated Grade 4: Either permanently discontinue or withhold until recovery to ANC >1 x 109/L, then resume at next dose reduction
- Unable to tolerate 2 dose reductions: Permanently discontinue
Platelet count
- 25-50 x 109/L with concurrent bleeding: Withhold until recovery to platelet count >50 x 109/L and bleeding resolves, then resume at same dose
- <25 x 109/L: Withhold until recovery to platelet count >50 x 109/L and bleeding resolves, then resume at next dose reduction
- Permanently discontinue for recurrence
Anemia
- Hemoglobin (Hgb) <8 g/dL: Withhold until recovery to Hgb >8 g/dL, then resume at same dose
- Life-threatening anemia (urgent intervention indicated): Withhold until recovery to Hgb >8 g/dL, then resume at next dose reduction
- Permanently discontinue for recurrence
Hepatotoxicity
- ALT or AST >5x ULN with total bilirubin [TB] ≤1.5x ULN: Withhold until recovery to baseline or ≤3x ULN, then resume at next dose reduction
- ALT or AST >3x AND TB >1.5x ULN (in the absence of cholestasis or hemolysis): Permanently discontinue
Interstitial lung disease/pneumonitis
- Any grade (drug-related): Permanently discontinue
QT prolongation
- Correct QT (QTc) >500 ms on at least 2 separate ECG: Withhold until recovery to baseline or at QTc <481 ms, then resume at next dose reduction
- QTc >500 ms or ≥60 ms change from baseline with torsade de pointes or polymorphic ventricular tachycardia or signs/symptoms of serious arrhythmia: Permanently discontinue
Bradycardia
-
Resting HR <2.5th percentile per age-specific norms
- 1 to <2 years: ≥91 bpm
- 2-3 years: ≥82 bpm
- 4-5 years: ≥72 bpm
- 6-8 years: ≥64 bpm
- >8 years: ≥60 bpm
-
Symptomatic, may be severe and medically intervention indicated
- Withhold until recovery to resting HR according to age (based on 2.5th percentile per age-specific norms)
-
Life-threatening consequences (urgent intervention indicated)
- No contributing medications identified: Permanently discontinue
- If contributing medication is identified, and discontinued, or its dose adjusted: Resume at second dose reduction upon recovery to asymptomatic bradycardia or manage HR based on criteria of symptomatic or severe, medically significant bradycardia, with frequent monitoring
- Permanently discontinue for recurrence
Ocular toxicity
-
Grade 1 or 2 (mild or moderate visual symptoms affecting ability to perform age-appropriate activities of daily living)
- Monitor and report any symptoms to an eye specialist
- Grade 2 visual disorders: Consider dose reduction
-
Grade 3 or 4 ocular disorder (marked decrease in vision)
- Withhold pending evaluation of severe visual loss
- Permanently discontinue, if no other cause found on evaluation
Gastrointestinal toxicity
- Occurs despite maximum medical therapy
- Grade 3 nausea (inadequate oral intake for >3 days, medical intervention required)
- Grade 3 vomiting (> 6 episodes in 24 hr for >3 days, medical intervention required [eg, tube feeding or hospitalization)
- Grade 3 diarrhea (increase of ≥7 stools/day over baseline; incontinence; hospitalization indicated)
- Grade 4 vomiting or diarrhea (life-threatening consequences, urgent intervention indicated)
- Withhold until resolved for any of of above descriptions, then resume at next dose reduction
- Permanently discontinue if unable to tolerate after 2 dose reductions, unless otherwise indicated
Strong CYP3A4 inhibitors
- Avoid coadministration
- If use is unavoidable, reduce criztotinib dose to second dose reduction
- After discontinuation of strong CYP3A inhibitor, resume crizotinib dose used before initiating strong CYP3A inhibitor
Renal impairment
- Calculate CrCl with Schwartz equation
- Mild-to-moderate (CrCl 30-89 mL/min): No dosage adjustment necessary
- Severe (CrCl <30 mL/min) and not requiring dialysis: Second dose reduction
Hepatic impairment
- Moderate (any AST and TB >1.5x ULN and ≤3x ULN): First dose reduction
- Severe (any AST and TB >3x ULN): Second dose reduction
Dosing Considerations
Verify pregnancy status in females of reproductive potential before initiation
Monitoring parameters
- CBC including differential WBC counts: Monthly and as clinically indicated, more frequently if Grade 3 or 4 abnormalities are observed or if fever or infection occurs
- Ophthalmologic examination: Obtain at baseline before initiation; consider follow-up including retinal examination within 1 month of initiation, every 3 months thereafter, and upon any new visual symptoms; assess symptoms regularly during treatment
- Liver function tests: Every 2 weeks during the first 2 months of treatment, then monthly, and as clinically needed
Supportive care
- Provide standard antiemetic and antidiarrheal agents before and during treatment
- Consider IV or oral hydration and replace electrolytes as clinically indicated
Limitation of use
- Safety and efficacy not established in older adults with relapsed or refractory, systemic ALK-positive ALCL
No overall differences in safety or efficacy were observed in comparison with younger patients
Interactions
Interaction Checker
No Results

Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor

Contraindicated (9)
- dronedarone
crizotinib and dronedarone both increase QTc interval. Contraindicated. Dronedarone is contraindicated with drugs that may prolong the QT interval. Coadministration of crizotinib with CYP3A substrates with narrow therapeutic indices should be avoided.
- flibanserin
crizotinib will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of flibanserin with moderate or strong CYP3A4 inhibitors is contraindicated. Severe hypotension or syncope can occur.
- lefamulin
lefamulin will increase the level or effect of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Lefamulin is contraindicated with CYP3A substrates know to prolong the QT interval.
- lomitapide
crizotinib increases levels of lomitapide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Increases lomitapide levels several folds.
- lonafarnib
crizotinib will increase the level or effect of lonafarnib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Lonafarnib is a sensitive CYP3A4 substrate. Coadministration with strong or moderate CYP3A4 inhibitors is contraindicated.
- pimozide
crizotinib and pimozide both increase QTc interval. Contraindicated. Pimozide is contraindicated with drugs that may prolong the QT interval. Coadministration of crizotinib with CYP3A substrates with narrow therapeutic indices should be avoided.
- posaconazole
crizotinib and posaconazole both increase QTc interval. Contraindicated.
- saquinavir
crizotinib and saquinavir both increase QTc interval. Contraindicated.
- thioridazine
crizotinib and thioridazine both increase QTc interval. Contraindicated. Thioridazine is contraindicated with drugs that may prolong the QT interval.
Serious - Use Alternative (130)
- adagrasib
adagrasib, crizotinib. Either increases effects of the other by QTc interval. Avoid or Use Alternate Drug. Each drug prolongs the QTc interval, which may increased the risk of Torsade de pointes, other serious arryhthmias, and sudden death. If coadministration unavoidable, more frequent monitoring is recommended for such patients.
- alfuzosin
alfuzosin and crizotinib both increase QTc interval. Avoid or Use Alternate Drug.
- amiodarone
crizotinib and amiodarone both increase QTc interval. Avoid or Use Alternate Drug.
- amisulpride
crizotinib and amisulpride both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.
- anagrelide
crizotinib and anagrelide both increase QTc interval. Avoid or Use Alternate Drug.
- apalutamide
apalutamide will decrease the level or effect of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Adjust dose according to prescribing information if needed.
- aripiprazole
aripiprazole and crizotinib both increase QTc interval. Avoid or Use Alternate Drug.
- artemether
artemether and crizotinib both increase QTc interval. Avoid or Use Alternate Drug.
- atomoxetine
atomoxetine and crizotinib both increase QTc interval. Avoid or Use Alternate Drug.
- avapritinib
crizotinib will increase the level or effect of avapritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of avapritinib with moderate CYP3A4 inhibitors. If unable to avoid, reduce avapritinib starting dose. See drug monograph Dosage Modifications.
- bosutinib
crizotinib increases levels of bosutinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- buprenorphine
crizotinib and buprenorphine both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine buccal
buprenorphine buccal and crizotinib both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine subdermal implant
buprenorphine subdermal implant and crizotinib both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine transdermal
buprenorphine transdermal and crizotinib both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine, long-acting injection
buprenorphine, long-acting injection and crizotinib both increase QTc interval. Avoid or Use Alternate Drug.
- ceritinib
ceritinib and crizotinib both increase QTc interval. Avoid or Use Alternate Drug.
- chloramphenicol
chloramphenicol will increase the level or effect of crizotinib by aldehyde dehydrogenase inhibition. Avoid or Use Alternate Drug.
- citalopram
citalopram and crizotinib both increase QTc interval. Avoid or Use Alternate Drug.
- clarithromycin
clarithromycin and crizotinib both increase QTc interval. Avoid or Use Alternate Drug.
- clozapine
clozapine and crizotinib both increase QTc interval. Avoid or Use Alternate Drug.
- cobicistat
cobicistat will increase the level or effect of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Increase in crizotinib levels may result in QT prolongation; May reduce crizotinib dose to 250 mg PO qDay if concomitant administration cannot be avoided.
- cobimetinib
crizotinib will increase the level or effect of cobimetinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If concurrent short term (14 days or less) use of moderate CYP3A inhibitors is unavoidable for patients who are taking cobimetinib 60 mg, reduce the cobimetinib dose to 20 mg. After discontinuation of a moderate CYP3A inhibitor, resume cobimetinib 60 mg. Use an alternative to a moderate CYP3A inhibitor in patients who are taking a reduced dose of cobimetinib (40 or 20 mg daily).
- conivaptan
conivaptan will increase the level or effect of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Increase in crizotinib levels may result in QT prolongation
- dasatinib
crizotinib and dasatinib both increase QTc interval. Avoid or Use Alternate Drug.
- desflurane
desflurane and crizotinib both increase QTc interval. Avoid or Use Alternate Drug.
- disopyramide
crizotinib increases levels of disopyramide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of crizotinib with CYP3A substrates with narrow therapeutic indices should be avoided. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
crizotinib and disopyramide both increase QTc interval. Avoid or Use Alternate Drug. - donepezil
donepezil and crizotinib both increase QTc interval. Avoid or Use Alternate Drug.
- edoxaban
crizotinib will increase the level or effect of edoxaban by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. Dose adjustment may be required with strong P-gp inhibitors. DVT/PE treatment: Decrease dose to 30 mg PO once daily. NVAF: No dose reduction recommended
- efavirenz
efavirenz and crizotinib both increase QTc interval. Avoid or Use Alternate Drug.
- elacestrant
crizotinib will increase the level or effect of elacestrant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- eliglustat
crizotinib increases levels of eliglustat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Moderate CYP3A4 inhibitors are not recommended with eliglustat poor or intermediate metabolizers; reduce eliglustat dose from 84 mg BID to 84 mg once daily in extensive metabolizers .
crizotinib and eliglustat both increase QTc interval. Avoid or Use Alternate Drug. - encorafenib
crizotinib will increase the level or effect of encorafenib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If concomitant use of a moderate CYP3A4 inhibitor is unavoidable, reduce encorafenib dose to one-half of the dose (eg, reduce from 450 mg/day to 225 mg/day). After discontinuing the inhibitor for 3-5 elimination half-lives, resume previous encorafenib dose.
crizotinib and encorafenib both increase QTc interval. Avoid or Use Alternate Drug. - entrectinib
crizotinib and entrectinib both increase QTc interval. Avoid or Use Alternate Drug.
crizotinib will increase the level or effect of entrectinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of moderate CYP3A4 inhibitors with entrectinib, a CYP3A4 substrate. If coadministration unavoidable, reduce dose to 200 mg/day for patients aged 12 y or older with BSA >1.50m2. Resume previous entrectinib dose after discontinuing moderate CYP3A inhibitor for 3-5 elimination half-lives. - erdafitinib
erdafitinib will increase the level or effect of crizotinib by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. If coadministration unavoidable, separate administration by at least 6 hr before or after administration of P-gp substrates with narrow therapeutic index.
- eribulin
crizotinib and eribulin both increase QTc interval. Avoid or Use Alternate Drug.
- erythromycin base
crizotinib and erythromycin base both increase QTc interval. Avoid or Use Alternate Drug.
- erythromycin ethylsuccinate
crizotinib and erythromycin ethylsuccinate both increase QTc interval. Avoid or Use Alternate Drug.
- erythromycin lactobionate
crizotinib and erythromycin lactobionate both increase QTc interval. Avoid or Use Alternate Drug.
- erythromycin stearate
crizotinib and erythromycin stearate both increase QTc interval. Avoid or Use Alternate Drug.
- escitalopram
escitalopram increases toxicity of crizotinib by QTc interval. Avoid or Use Alternate Drug.
- eslicarbazepine acetate
eslicarbazepine acetate will decrease the level or effect of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- etrasimod
etrasimod, crizotinib. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Risk of additive immune system effects with etrasimod has not been studied in combination with antineoplastic, immune-modulating, or noncorticosteroid immunosuppressive therapies. Avoid coadministration during and in the weeks following administration of etrasimod.
- fentanyl
crizotinib will increase the level or effect of fentanyl by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of CYP3A4 inhibitors with fentanyl is necessary, monitor patients for respiratory depression and sedation at frequent intervals and consider fentanyl dose adjustments until stable drug effects are achieved.
- fentanyl intranasal
crizotinib will increase the level or effect of fentanyl intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of CYP3A4 inhibitors with fentanyl is necessary, monitor patients for respiratory depression and sedation at frequent intervals and consider fentanyl dose adjustments until stable drug effects are achieved.
- fentanyl transdermal
crizotinib will increase the level or effect of fentanyl transdermal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of CYP3A4 inhibitors with fentanyl is necessary, monitor patients for respiratory depression and sedation at frequent intervals and consider fentanyl dose adjustments until stable drug effects are achieved.
- fentanyl transmucosal
crizotinib will increase the level or effect of fentanyl transmucosal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of CYP3A4 inhibitors with fentanyl is necessary, monitor patients for respiratory depression and sedation at frequent intervals and consider fentanyl dose adjustments until stable drug effects are achieved.
- fexinidazole
fexinidazole and crizotinib both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval.
fexinidazole will increase the level or effect of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Fexinidazole inhibits CYP3A4. Coadministration may increase risk for adverse effects of CYP3A4 substrates. - fingolimod
fingolimod and crizotinib both increase QTc interval. Avoid or Use Alternate Drug.
- gilteritinib
crizotinib and gilteritinib both increase QTc interval. Avoid or Use Alternate Drug.
- glasdegib
crizotinib and glasdegib both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, monitor for increased risk of QTc interval prolongation.
- granisetron
crizotinib and granisetron both increase QTc interval. Avoid or Use Alternate Drug.
- haloperidol
crizotinib and haloperidol both increase QTc interval. Avoid or Use Alternate Drug.
- hydroxychloroquine sulfate
hydroxychloroquine sulfate and crizotinib both increase QTc interval. Avoid or Use Alternate Drug.
- hydroxyzine
crizotinib and hydroxyzine both increase QTc interval. Avoid or Use Alternate Drug.
- idelalisib
idelalisib will increase the level or effect of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Idelalisib is a strong CYP3A inhibitor; avoid coadministration with sensitive CYP3A substrates
- indacaterol, inhaled
crizotinib and indacaterol, inhaled both increase QTc interval. Avoid or Use Alternate Drug.
- infigratinib
crizotinib will increase the level or effect of infigratinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- inotuzumab
inotuzumab and crizotinib both increase QTc interval. Avoid or Use Alternate Drug. If unable to avoid concomitant use, obtain ECGs and electrolytes before and after initiation of any drug known to prolong QTc, and periodically monitor as clinically indicated during treatment.
- irinotecan
crizotinib will increase the level or effect of irinotecan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- irinotecan liposomal
crizotinib will increase the level or effect of irinotecan liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- isoflurane
crizotinib and isoflurane both increase QTc interval. Avoid or Use Alternate Drug.
- itraconazole
itraconazole increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If combination cannot be avoided, decrease crizotinib dose to 250 mg daily. Monitor for increased crizotinib toxicities, including QTc interval prolongation and ventricular arrhythmias. .
crizotinib and itraconazole both increase QTc interval. Avoid or Use Alternate Drug. - ivabradine
crizotinib will increase the level or effect of ivabradine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of ivabradine with moderate CYP3A4 inhibitors.
- ivosidenib
ivosidenib and crizotinib both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of QTc prolonging drugs with ivosidenib or replace with alternate therapies. If coadministration of a QTc prolonging drug is unavoidable, monitor for increased risk of QTc interval prolongation.
ivosidenib will decrease the level or effect of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP3A4 substrates with ivosidenib or replace with alternate therapies. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs. - ketoconazole
ketoconazole increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. See prescribing information for precise dosage modification.
- larotrectinib
crizotinib will decrease the level or effect of larotrectinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- lasmiditan
lasmiditan increases levels of crizotinib by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.
- lefamulin
crizotinib and lefamulin both increase QTc interval. Avoid or Use Alternate Drug.
- lemborexant
crizotinib will increase the level or effect of lemborexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of lemborexant with moderate or strong CYP3A inhibitors.
- levoketoconazole
levoketoconazole increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. See prescribing information for precise dosage modification.
- lithium
crizotinib and lithium both increase QTc interval. Avoid or Use Alternate Drug.
- lofexidine
crizotinib and lofexidine both increase QTc interval. Avoid or Use Alternate Drug.
- loperamide
crizotinib and loperamide both increase QTc interval. Avoid or Use Alternate Drug.
- lopinavir
crizotinib and lopinavir both increase QTc interval. Avoid or Use Alternate Drug.
- lurbinectedin
crizotinib will increase the level or effect of lurbinectedin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- macimorelin
macimorelin and crizotinib both increase QTc interval. Avoid or Use Alternate Drug. Macimorelin causes an increase of ~11 msec in the corrected QT interval. Avoid coadministration with drugs that prolong QT interval, which could increase risk for developing torsade de pointes-type ventricular tachycardia. Allow sufficient washout time of drugs that are known to prolong the QT interval before administering macimorelin.
- mefloquine
crizotinib and mefloquine both increase QTc interval. Avoid or Use Alternate Drug.
- methadone
crizotinib and methadone both increase QTc interval. Avoid or Use Alternate Drug.
- midazolam intranasal
crizotinib will increase the level or effect of midazolam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of moderate CYP3A4 inhibitors with midazolam intranasal causes higher midazolam systemic exposure, which may prolong sedation.
- midostaurin
crizotinib and midostaurin both increase QTc interval. Avoid or Use Alternate Drug.
- mifepristone
mifepristone will increase the level or effect of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Increase in crizotinib levels may result in QT prolongation
- mirtazapine
crizotinib and mirtazapine both increase QTc interval. Avoid or Use Alternate Drug.
- mobocertinib
crizotinib will increase the level or effect of mobocertinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If use of moderate CYP3A4 inhibitor unavoidable, reduce mobocertinib dose by ~50% (eg, 160 to 80 mg); closely monitor QTc interval.
mobocertinib and crizotinib both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, reduce mobocertinib dose and monitor QTc interval more frequently. - naloxegol
crizotinib will increase the level or effect of naloxegol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministation of naloxegol with moderate CYP3A4 inhibitors is unavoidable, reduce naloxegol dose to 12.5 mg qDay
- neratinib
crizotinib will increase the level or effect of neratinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of neratinib with strong/moderate CYP3A4 inhibitors
- nilotinib
crizotinib and nilotinib both increase QTc interval. Avoid or Use Alternate Drug.
- olanzapine
crizotinib and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances
- olaparib
crizotinib will increase the level or effect of olaparib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration with moderate CYP3A inhibitors cannot be avoided, reduce olaparib dose to 200 mg (capsule) or 150 mg (tablet) PO BID. Do not substitute tablets with capsules.
- omaveloxolone
crizotinib will increase the level or effect of omaveloxolone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If unavoidable, reduce omaveloxolone dose to 100 mg/day. Closely monitor for adverse effects. If adverse effects emerge, further reduce to 50 mg/day.
- ondansetron
crizotinib and ondansetron both decrease QTc interval. Avoid or Use Alternate Drug. Avoid with congenital long QT syndrome; ECG monitoring recommended with concomitant medications that prolong QT interval, electrolyte abnormalities, CHF, or bradyarrhythmias.
- oxaliplatin
crizotinib and oxaliplatin both increase QTc interval. Avoid or Use Alternate Drug.
- pacritinib
crizotinib will increase the level or effect of pacritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- palifermin
palifermin increases toxicity of crizotinib by Other (see comment). Avoid or Use Alternate Drug. Comment: Palifermin should not be administered within 24 hr before, during infusion of, or within 24 hr after administration of antineoplastic agents. Coadministration of palifermin within 24 hr of chemotherapy resulted in increased severity and duration of oral mucositis.
- panobinostat
crizotinib and panobinostat both increase QTc interval. Avoid or Use Alternate Drug. Panobinostat is known to significantly prolong QT interval. Panobinostat prescribing information states use with drugs known to prolong QTc is not recommended.
- pazopanib
crizotinib and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.
- pemigatinib
crizotinib will increase the level or effect of pemigatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration with strong or moderate CYP3A4 inhibitors is unavoidable, reduce pemigatinib dose (refer to drug monograph dosage modifications). After discontinuing the CYP3A4 inhibitor for 3 elimination half-lives, may resume previous pemigatinib dose.
- pexidartinib
crizotinib will increase the level or effect of pexidartinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration with strong or moderate CYP3A4 inhibitors is unavoidable, reduce pexidartinib dose (refer to drug monograph dosage modifications). After discontinuing the CYP3A4 inhibitor for 3 elimination half-lives, may resume previous pexidartinib dose.
- pimavanserin
crizotinib and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.
- pitolisant
crizotinib and pitolisant both increase QTc interval. Avoid or Use Alternate Drug.
- ponesimod
ponesimod, crizotinib. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Consult cardiologist if considering treatment. Coadministration of ponesimod with drugs that decrease HR may have additive effects on decreasing HR and should generally not be initiated in these patients.
crizotinib and ponesimod both increase QTc interval. Avoid or Use Alternate Drug. - primaquine
crizotinib and primaquine both increase QTc interval. Avoid or Use Alternate Drug.
- primidone
primidone will decrease the level or effect of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- quetiapine
crizotinib and quetiapine both increase QTc interval. Avoid or Use Alternate Drug.
- quinidine
crizotinib increases levels of quinidine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of crizotinib with CYP3A substrates with narrow therapeutic indices should be avoided. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
crizotinib and quinidine both increase QTc interval. Avoid or Use Alternate Drug. - ranolazine
crizotinib and ranolazine both increase QTc interval. Avoid or Use Alternate Drug.
- repotrectinib
crizotinib will increase the level or effect of repotrectinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Discontinue strong or moderate CYP3A inhibitors and wait 3-5 elimination half-lives before initiating repotrectinib.
- ribociclib
ribociclib will increase the level or effect of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Increase in crizotinib levels may result in QT prolongation
ribociclib increases toxicity of crizotinib by QTc interval. Avoid or Use Alternate Drug. - selumetinib
crizotinib will increase the level or effect of selumetinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration with strong or moderate CYP3A4 inhibitors cannot be avoided, reduce selumetinib dosage (refer to selumetinib monograph for further information). After discontinuation of the strong or moderate CYP3A4 inhibitor for 3 elimination half-lives, resume selumetinib dose that was taken before initiating the inhibitor.
- sertraline
crizotinib and sertraline both increase QTc interval. Avoid or Use Alternate Drug.
- sevoflurane
crizotinib and sevoflurane both increase QTc interval. Avoid or Use Alternate Drug.
- sildenafil
crizotinib increases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid use of strong CYP3A4 inhibitors. If concomitant use of strong CYP3A inhibitors is unavoidable, reduce crizotnib to 250 mg PO qDay. After discontinuation of a strong CYP3A inhibitor, resume crizotinib dose used prior to initiating the strong CYP3A4 inhibitor.
- siponimod
crizotinib will increase the level or effect of siponimod by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of siponimod with a moderate or strong CYP3A4 inhibitor PLUS a moderate or strong CYP2C9 inhibitor is not recommended.
crizotinib and siponimod both increase QTc interval. Avoid or Use Alternate Drug. - solifenacin
crizotinib and solifenacin both increase QTc interval. Avoid or Use Alternate Drug.
- sotorasib
sotorasib will decrease the level or effect of crizotinib by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. If use is unavoidable, refer to the prescribing information of the P-gp substrate for dosage modifications.
- sunitinib
crizotinib and sunitinib both increase QTc interval. Avoid or Use Alternate Drug.
- tacrolimus
crizotinib increases levels of tacrolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of crizotinib with CYP3A substrates with narrow therapeutic indices should be avoided. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
crizotinib and tacrolimus both increase QTc interval. Avoid or Use Alternate Drug. - tazemetostat
crizotinib will increase the level or effect of tazemetostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of tazemetostat with moderate CYP3A4 inhibitors. If coadministration is unavoidable, reduce tazemetostat current dose (see drug monograph Dosage Modifications).
- tepotinib
tepotinib will increase the level or effect of crizotinib by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. If concomitant use unavoidable, reduce the P-gp substrate dosage if recommended in its approved product labeling.
- tetrabenazine
crizotinib and tetrabenazine both increase QTc interval. Avoid or Use Alternate Drug.
- topotecan
crizotinib will increase the level or effect of topotecan by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. Product labeling for PO topotecan recommends avoiding concomitant use of P-gp inhibitors; the interaction with IV topotecan may be less severe but is still likely of clinical significance
- trazodone
crizotinib and trazodone both increase QTc interval. Avoid or Use Alternate Drug.
- triclabendazole
crizotinib and triclabendazole both increase QTc interval. Avoid or Use Alternate Drug.
- tucatinib
tucatinib will increase the level or effect of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. If unavoidable, reduce CYP3A substrate dose according to product labeling.
- umeclidinium bromide/vilanterol inhaled
crizotinib increases toxicity of umeclidinium bromide/vilanterol inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.
- vardenafil
crizotinib and vardenafil both increase QTc interval. Avoid or Use Alternate Drug.
- venetoclax
crizotinib will increase the level or effect of venetoclax by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If a moderate CYP3A inhibitor must be used, reduce the venetoclax dose by at least 50%. Monitor more closely for signs of venetoclax toxicities.
crizotinib will increase the level or effect of venetoclax by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. If a P-gp inhibitor must be used, reduce the venetoclax dose by at least 50%. Monitor more closely for signs of venetoclax toxicities. - vilanterol/fluticasone furoate inhaled
crizotinib increases toxicity of vilanterol/fluticasone furoate inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.
- voriconazole
crizotinib and voriconazole both increase QTc interval. Avoid or Use Alternate Drug.
- voxelotor
voxelotor will increase the level or effect of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. Consider dose reduction of the sensitive CYP3A4 substrate(s) if unable to avoid.
Monitor Closely (319)
- abiraterone
abiraterone increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Caution should be exercised with concomitant use of moderate CYP3A inhibitors. .
- acalabrutinib
crizotinib will increase the level or effect of acalabrutinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Decrease acalabrutinib dose to 100 mg once daily if coadministered with a moderate CYP3A inhibitor.
- acetazolamide
acetazolamide will increase the level or effect of crizotinib by aldehyde dehydrogenase inhibition. Use Caution/Monitor.
- albuterol
albuterol and crizotinib both increase QTc interval. Use Caution/Monitor.
- alfentanil
crizotinib increases levels of alfentanil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of crizotinib with CYP3A substrates with narrow therapeutic indices should be avoided.
- alfuzosin
crizotinib increases levels of alfuzosin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
crizotinib and alfuzosin both increase QTc interval. Use Caution/Monitor. - aliskiren
crizotinib increases levels of aliskiren by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- alprazolam
crizotinib increases levels of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- aluminum hydroxide
aluminum hydroxide decreases levels of crizotinib by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor. Drugs that elevate the gastric pH may decrease the solubility of crizotinib and subsequently reduce its bioavailability. However, no formal studies have been conducted. .
- amiodarone
crizotinib increases levels of amiodarone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
amiodarone increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Caution should be exercised with concomitant use of moderate CYP3A inhibitors. . - amitriptyline
crizotinib and amitriptyline both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- amlodipine
crizotinib increases levels of amlodipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- amoxapine
crizotinib and amoxapine both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- anastrozole
anastrozole will increase the level or effect of crizotinib by aldehyde dehydrogenase inhibition. Use Caution/Monitor.
- apomorphine
crizotinib and apomorphine both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- aprepitant
aprepitant increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Caution should be exercised with concomitant use of moderate CYP3A inhibitors. .
crizotinib increases levels of aprepitant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Caution should be exercised with concomitant use of moderate CYP3A inhibitors. . - arformoterol
arformoterol and crizotinib both increase QTc interval. Use Caution/Monitor.
- aripiprazole
crizotinib increases levels of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- armodafinil
crizotinib increases levels of armodafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- arsenic trioxide
crizotinib and arsenic trioxide both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- artemether/lumefantrine
crizotinib and artemether/lumefantrine both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- asenapine
crizotinib and asenapine both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- asenapine transdermal
asenapine transdermal and crizotinib both increase QTc interval. Use Caution/Monitor.
- atazanavir
atazanavir increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Concomitant use of strong CYP3A inducers should be avoided. .
crizotinib increases levels of atazanavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A. - atogepant
crizotinib will increase the level or effect of atogepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- atorvastatin
crizotinib increases levels of atorvastatin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
crizotinib increases levels of atorvastatin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. - avanafil
crizotinib increases levels of avanafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- azithromycin
crizotinib and azithromycin both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
azithromycin increases toxicity of crizotinib by QTc interval. Use Caution/Monitor. - bedaquiline
crizotinib and bedaquiline both increase QTc interval. Modify Therapy/Monitor Closely. ECG should be monitored closely
- belzutifan
belzutifan will decrease the level or effect of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. If unable to avoid coadministration of belzutifan with sensitive CYP3A4 substrates, consider increasing the sensitive CYP3A4 substrate dose in accordance with its prescribing information.
- berotralstat
berotralstat will increase the level or effect of crizotinib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Monitor or titrate P-gp substrate dose if coadministered.
- betrixaban
crizotinib increases levels of betrixaban by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Decrease betrixaban dose to 80 mg PO once, then 40 mg PO qDay if coadministered with a P-gp inhibitor.
- bicalutamide
bicalutamide increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Caution should be exercised with concomitant use of moderate CYP3A inhibitors. .
- bortezomib
crizotinib increases levels of bortezomib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- bosentan
crizotinib increases levels of bosentan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- brexpiprazole
crizotinib will increase the level or effect of brexpiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Administer a quarter of brexpiprazole dose if coadministered with a moderate CYP3A4 inhibitor PLUS a strong/moderate CYP2D6 inhibitor.
- bromocriptine
crizotinib increases levels of bromocriptine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- budesonide
crizotinib increases levels of budesonide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- buprenorphine
crizotinib increases levels of buprenorphine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- buprenorphine buccal
crizotinib increases levels of buprenorphine buccal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- buprenorphine subdermal implant
crizotinib will increase the level or effect of buprenorphine subdermal implant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor patients already on buprenorphine subdermal implant who require newly-initiated treatment with CYP3A4 inhibitors for signs and symptoms of overmedication. If the dose of the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, implant removal may be necessary and the patient should then be treated with a buprenorphine dosage form that permits dose adjustments. If a CYP3A4 inhibitor is discontinued in a patient who has been stabilized on buprenorphine, monitor the patient for withdrawal.
- buprenorphine, long-acting injection
crizotinib will increase the level or effect of buprenorphine, long-acting injection by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Patients who transfer to buprenorphine long-acting injection from transmucosal buprenorphine coadministered with CYP3A4 inhibitors should be monitored to ensure buprenorphine plasma levels are adequate. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose occur and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, transition the patient back to a buprenorphine formulation that permits dose adjustments.
- buspirone
crizotinib increases levels of buspirone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- cabazitaxel
crizotinib increases levels of cabazitaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- cabozantinib
crizotinib will increase the level or effect of cabozantinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- calcium carbonate
calcium carbonate decreases levels of crizotinib by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor. Drugs that elevate the gastric pH may decrease the solubility of crizotinib and subsequently reduce its bioavailability. However, no formal studies have been conducted. .
- cannabidiol
crizotinib will increase the level or effect of cannabidiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Consider reducing the cannabidiol dose when coadministered with a moderate CYP3A4 inhibitor.
- carbamazepine
carbamazepine decreases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Concomitant use of strong CYP3A inducers should be avoided. .
crizotinib increases levels of carbamazepine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of crizotinib with CYP3A substrates with narrow therapeutic indices should be avoided. - carvedilol
crizotinib increases levels of carvedilol by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- cenobamate
cenobamate will decrease the level or effect of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Increase dose of CYP3A4 substrate, as needed, when coadministered with cenobamate.
- ceritinib
crizotinib increases levels of ceritinib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
ceritinib will increase the level or effect of crizotinib by aldehyde dehydrogenase inhibition. Use Caution/Monitor. - cetirizine
crizotinib increases levels of cetirizine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- chloroquine
crizotinib increases levels of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
chloroquine increases toxicity of crizotinib by QTc interval. Use Caution/Monitor. - chlorpromazine
crizotinib and chlorpromazine both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- ciclesonide inhaled
crizotinib increases levels of ciclesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- cilostazol
crizotinib increases levels of cilostazol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- cimetidine
cimetidine decreases levels of crizotinib by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor. Drugs that elevate the gastric pH may decrease the solubility of crizotinib and subsequently reduce its bioavailability. However, no formal studies have been conducted. .
- cinacalcet
crizotinib increases levels of cinacalcet by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- ciprofloxacin
crizotinib and ciprofloxacin both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- citalopram
crizotinib increases levels of citalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- clarithromycin
clarithromycin increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Concomitant use of strong CYP3A inhibitors should be avoided. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- clofazimine
crizotinib and clofazimine both increase QTc interval. Use Caution/Monitor.
- clomipramine
crizotinib and clomipramine both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- clonazepam
crizotinib increases levels of clonazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- conivaptan
crizotinib increases levels of conivaptan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- crofelemer
crofelemer increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Crofelemer has the potential to inhibit CYP3A4 at concentrations expected in the gut; unlikely to inhibit systemically because minimally absorbed.
- cyclobenzaprine
crizotinib and cyclobenzaprine both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- cyclophosphamide
cyclophosphamide will increase the level or effect of crizotinib by aldehyde dehydrogenase inhibition. Use Caution/Monitor.
- cyclosporine
crizotinib increases levels of cyclosporine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of crizotinib with CYP3A substrates with narrow therapeutic indices should be avoided.
cyclosporine increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Caution should be exercised with concomitant use of moderate CYP3A inhibitors. . - dabigatran
crizotinib will increase the level or effect of dabigatran by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Atrial fibrillation: Avoid coadministering dabigatran with P-gp inhibitors if CrCl <30 mL/min. DVT/PE treatment: Avoid coadministering dabigatran with P-gp inhibitors if CrCl <50 mL/min
- dabrafenib
dabrafenib will increase the level or effect of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.
- dapsone
crizotinib increases levels of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- daridorexant
crizotinib will increase the level or effect of daridorexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Daridorexant dose should not exceed 25 mg per night when coadministered with moderate CYP3A4 inhibitors.
- darifenacin
crizotinib increases levels of darifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- darunavir
darunavir increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Concomitant use of strong CYP3A inhibitors should be avoided. .
crizotinib increases levels of darunavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A. - dasatinib
crizotinib increases levels of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- daunorubicin
crizotinib increases levels of daunorubicin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- deflazacort
crizotinib will increase the level or effect of deflazacort by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Decrease deflazacort dose to one-third of the recommended dose if coadministered with moderate or strong CYP3A4 inhibitors.
- degarelix
crizotinib and degarelix both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- desipramine
crizotinib and desipramine both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- desloratadine
crizotinib increases levels of desloratadine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- deutetrabenazine
crizotinib and deutetrabenazine both increase QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation).
- dexamethasone
dexamethasone decreases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Concomitant use of strong CYP3A inducers should be avoided. .
crizotinib increases levels of dexamethasone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
crizotinib increases levels of dexamethasone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. - dexlansoprazole
dexlansoprazole decreases levels of crizotinib by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor. Drugs that elevate the gastric pH may decrease the solubility of crizotinib and subsequently reduce its bioavailability. However, no formal studies have been conducted. .
- diazepam
crizotinib increases levels of diazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- diazepam intranasal
crizotinib will increase the level or effect of diazepam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Strong or moderate CYP3A4 inhibitors may decrease rate of diazepam elimination, thereby increasing adverse reactions to diazepam.
- dichlorphenamide
dichlorphenamide and crizotinib both decrease serum potassium. Use Caution/Monitor.
- digoxin
crizotinib increases levels of digoxin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of crizotinib with CYP3A substrates with narrow therapeutic indices should be avoided.
crizotinib increases levels of digoxin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. - dihydroergotamine
crizotinib increases levels of dihydroergotamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of crizotinib with CYP3A substrates with narrow therapeutic indices should be avoided.
- dihydroergotamine intranasal
crizotinib increases levels of dihydroergotamine intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of crizotinib with CYP3A substrates with narrow therapeutic indices should be avoided.
- diltiazem
crizotinib increases levels of diltiazem by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
diltiazem increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Caution should be exercised with concomitant use of moderate CYP3A inhibitors. . - docetaxel
crizotinib increases levels of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
crizotinib increases levels of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. - dofetilide
crizotinib and dofetilide both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
dofetilide increases toxicity of crizotinib by QTc interval. Use Caution/Monitor. - dolasetron
crizotinib and dolasetron both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- doxepin
doxepin and crizotinib both increase QTc interval. Use Caution/Monitor.
- doxorubicin
crizotinib increases levels of doxorubicin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
crizotinib increases levels of doxorubicin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. - doxorubicin liposomal
crizotinib increases levels of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- droperidol
crizotinib and droperidol both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- duvelisib
duvelisib will increase the level or effect of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. will increase the level or effect of
- efavirenz
efavirenz increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Caution should be exercised with concomitant use of moderate CYP3A inhibitors. .
- elagolix
elagolix will increase the level or effect of crizotinib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
elagolix will decrease the level or effect of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Elagolix is a weak-to-moderate CYP3A4 inducer. Monitor CYP3A substrates if coadministered. Consider increasing CYP3A substrate dose if needed. - eletriptan
crizotinib increases levels of eletriptan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- elvitegravir/cobicistat/emtricitabine/tenofovir DF
elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Cobicistat is a CYP3A4 inhibitor; contraindicated with CYP3A4 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events.
- encorafenib
encorafenib, crizotinib. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma concentrations. Coadministration of encorafenib with sensitive CYP3A4 substrates may result in increased toxicity or decreased efficacy of these agents.
- ergotamine
crizotinib increases levels of ergotamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of crizotinib with CYP3A substrates with narrow therapeutic indices should be avoided.
- erlotinib
crizotinib increases levels of erlotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- erythromycin base
crizotinib increases levels of erythromycin base by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
crizotinib increases levels of erythromycin base by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
erythromycin base increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Caution should be exercised with concomitant use of moderate CYP3A inhibitors. . - erythromycin ethylsuccinate
erythromycin ethylsuccinate increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Caution should be exercised with concomitant use of moderate CYP3A inhibitors. .
crizotinib increases levels of erythromycin ethylsuccinate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
crizotinib increases levels of erythromycin ethylsuccinate by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval. - erythromycin lactobionate
erythromycin lactobionate increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Caution should be exercised with concomitant use of moderate CYP3A inhibitors. .
crizotinib increases levels of erythromycin lactobionate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
crizotinib increases levels of erythromycin lactobionate by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval. - erythromycin stearate
erythromycin stearate increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Caution should be exercised with concomitant use of moderate CYP3A inhibitors. .
crizotinib increases levels of erythromycin stearate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
crizotinib increases levels of erythromycin stearate by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval. - escitalopram
crizotinib increases levels of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
crizotinib and escitalopram both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval. - esomeprazole
esomeprazole decreases levels of crizotinib by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor. Drugs that elevate the gastric pH may decrease the solubility of crizotinib and subsequently reduce its bioavailability. However, no formal studies have been conducted. .
- eszopiclone
crizotinib increases levels of eszopiclone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce eszopiclone starting dose to 1 mg/day.
- ethosuximide
crizotinib increases levels of ethosuximide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- etoposide
crizotinib increases levels of etoposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
crizotinib increases levels of etoposide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. - etravirine
etravirine will decrease the level or effect of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- everolimus
crizotinib increases levels of everolimus by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- famotidine
famotidine decreases levels of crizotinib by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor. Drugs that elevate the gastric pH may decrease the solubility of crizotinib and subsequently reduce its bioavailability. However, no formal studies have been conducted. .
- fedratinib
fedratinib will increase the level or effect of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP3A4 substrates as necessary.
- felodipine
crizotinib increases levels of felodipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- fesoterodine
crizotinib increases levels of fesoterodine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- fexofenadine
crizotinib increases levels of fexofenadine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- finerenone
crizotinib will increase the level or effect of finerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor serum potassium during initiation and dosage adjustment of either finererone or moderate CYP3A4 inhibitors. Adjust finererone dosage as needed.
- flecainide
crizotinib and flecainide both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- fluconazole
crizotinib and fluconazole both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
fluconazole increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Caution should be exercised with concomitant use of moderate CYP3A inhibitors. . - fluoxetine
crizotinib and fluoxetine both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- fluphenazine
crizotinib and fluphenazine both increase QTc interval. Use Caution/Monitor.
- flurazepam
crizotinib increases levels of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- fosamprenavir
fosamprenavir increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Concomitant use of strong CYP3A inhibitors should be avoided. .
crizotinib increases levels of fosamprenavir by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. - fosaprepitant
fosaprepitant increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Caution should be exercised with concomitant use of moderate CYP3A inhibitors. .
crizotinib increases levels of fosaprepitant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Caution should be exercised with concomitant use of moderate CYP3A inhibitors. . - foscarnet
crizotinib and foscarnet both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- fosphenytoin
fosphenytoin decreases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Concomitant use of strong CYP3A inducers should be avoided. .
crizotinib increases levels of fosphenytoin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of crizotinib with CYP3A substrates with narrow therapeutic indices should be avoided. - fostemsavir
crizotinib and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.
- gadobenate
crizotinib and gadobenate both increase QTc interval. Use Caution/Monitor.
- gemifloxacin
crizotinib and gemifloxacin both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- gemtuzumab
crizotinib and gemtuzumab both increase QTc interval. Use Caution/Monitor.
- gepirone
crizotinib will increase the level or effect of gepirone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce gepirone dose by 50% when used concomitantly with a moderate CYP3A4 inhibitor.
gepirone and crizotinib both increase QTc interval. Modify Therapy/Monitor Closely. - glecaprevir/pibrentasvir
crizotinib will increase the level or effect of glecaprevir/pibrentasvir by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- goserelin
goserelin increases toxicity of crizotinib by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- grapefruit
grapefruit increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Concomitant use of strong CYP3A inhibitors should be avoided. .
- guanfacine
crizotinib will increase the level or effect of guanfacine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Strong or moderate CYP3A4 inhibitors significantly increase guanfacine plasma concentrations. FDA-approved labeling for extended-release (ER) guanfacine recommends that, if coadministered, the guanfacine dosage should be decreased to half of the recommended dose. Specific recommendations for immediate-release (IR) guanfacine are not available.
- haloperidol
crizotinib increases levels of haloperidol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- hawthorn
crizotinib and hawthorn both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- histrelin
histrelin increases toxicity of crizotinib by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- hydroxyprogesterone caproate (DSC)
crizotinib increases levels of hydroxyprogesterone caproate (DSC) by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- ibrutinib
crizotinib increases levels of ibrutinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Coadministration with moderate CYP3A4 inhibitors, reduce ibrutinib dose to 280 mg qDay (B-cell malignancies) or 420 mg qDay (graft versus host disease). After CYP3A inhibitor discontinuation, resume previous dose of ibrutinib.
- ibuprofen/famotidine
ibuprofen/famotidine decreases levels of crizotinib by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor. Drugs that elevate the gastric pH may decrease the solubility of crizotinib and subsequently reduce its bioavailability. However, no formal studies have been conducted. .
- ibutilide
crizotinib and ibutilide both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- ifosfamide
crizotinib will decrease the level or effect of ifosfamide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Use of a CYP3A4 inhibitor may decrease metabolism of ifosfamide, potentially reducing ifosfamide therapeutic effects.
- iloperidone
crizotinib and iloperidone both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
iloperidone increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Iloperidone is a time-dependent CYP3A inhibitor and may lead to increased plasma levels of drugs predominantly eliminated by CYP3A4. - imatinib
imatinib increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Concomitant use of strong CYP3A inhibitors should be avoided. .
crizotinib increases levels of imatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
crizotinib increases levels of imatinib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. - indapamide
crizotinib and indapamide both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- indinavir
indinavir increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Concomitant use of strong CYP3A inhibitors should be avoided. .
crizotinib increases levels of indinavir by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. - irinotecan
crizotinib increases levels of irinotecan by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- irinotecan liposomal
crizotinib increases levels of irinotecan liposomal by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- isavuconazonium sulfate
crizotinib will increase the level or effect of isavuconazonium sulfate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- isoniazid
isoniazid increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Concomitant use of strong CYP3A inhibitors should be avoided. .
- isradipine
crizotinib and isradipine both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
crizotinib increases levels of isradipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A. - istradefylline
istradefylline will increase the level or effect of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. This effect was not observed with istradefylline 20 mg/day. Consider dose reduction of sensitive CYP3A4 substrates.
istradefylline will increase the level or effect of crizotinib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Istradefylline 40 mg/day increased peak levels and AUC of P-gp substrates in clinical trials. Consider dose reduction of sensitive P-gp substrates. - ivacaftor
crizotinib will increase the level or effect of ivacaftor by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce ivacaftor dose if coadministered with moderate CYP3A4 inhibitors. See specific ivacaftor-containing product for precise dosage modification.
- ivosidenib
crizotinib will increase the level or effect of ivosidenib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with moderate CYP3A4 inhibitors may increase ivosidenib plasma concentrations, thus increasing the risk of QTc prolongation. Monitor for increased risk of QTc interval prolongation.
- ixabepilone
crizotinib increases levels of ixabepilone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- lansoprazole
lansoprazole decreases levels of crizotinib by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor. Drugs that elevate the gastric pH may decrease the solubility of crizotinib and subsequently reduce its bioavailability. However, no formal studies have been conducted. .
- lapatinib
crizotinib increases levels of lapatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
crizotinib increases levels of lapatinib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
lapatinib increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Caution should be exercised with concomitant use of moderate CYP3A inhibitors. . - larotrectinib
larotrectinib will increase the level or effect of crizotinib by aldehyde dehydrogenase inhibition. Use Caution/Monitor.
- lefamulin
crizotinib will increase the level or effect of lefamulin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor for adverse effects if lefamulin is coadministered with moderate CYP3A inhibitors.
- lenacapavir
lenacapavir will increase the level or effect of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lencapavir (a moderate CYP3A4 inhibitor) may increase CYP3A4 substrates initiated within 9 months after last SC dose of lenacapavir, which may increase potential risk of adverse reactions of CYP3A4 substrates.
- lenvatinib
crizotinib and lenvatinib both increase QTc interval. Use Caution/Monitor. Lenvatinib prescribing information recommends monitoring ECG closely when coadministered with QT prolonging drugs.
- leuprolide
leuprolide increases toxicity of crizotinib by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- levalbuterol
crizotinib and levalbuterol both increase QTc interval. Use Caution/Monitor.
- levamlodipine
crizotinib will increase the level or effect of levamlodipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Coadministration with moderate and strong CYP3A inhibitors results in increased systemic exposure to amlodipine and may require dose reduction. Monitor for symptoms of hypotension and edema when amlodipine is coadministered with CYP3A inhibitors to determine the need for dose adjustment.
- levofloxacin
crizotinib and levofloxacin both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- loperamide
crizotinib increases levels of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- lopinavir
lopinavir increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Concomitant use of strong CYP3A inhibitors should be avoided. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- loratadine
crizotinib increases levels of loratadine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- lorlatinib
lorlatinib will decrease the level or effect of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- lovastatin
crizotinib increases levels of lovastatin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
crizotinib increases levels of lovastatin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. - lumateperone
crizotinib will increase the level or effect of lumateperone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce lumateperone dose to 21 mg/day if coadministered with moderate CYP3A4 inhibitors.
- lumefantrine
crizotinib and lumefantrine both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- magnesium hydroxide
magnesium hydroxide decreases levels of crizotinib by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor. Drugs that elevate the gastric pH may decrease the solubility of crizotinib and subsequently reduce its bioavailability. However, no formal studies have been conducted. .
- magnesium oxide
magnesium oxide decreases levels of crizotinib by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor. Drugs that elevate the gastric pH may decrease the solubility of crizotinib and subsequently reduce its bioavailability. However, no formal studies have been conducted. .
- maprotiline
crizotinib and maprotiline both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- maraviroc
crizotinib increases levels of maraviroc by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- mavacamten
crizotinib will increase the level or effect of mavacamten by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Inititiation of moderate CYP3A4 inhibitors may require decreased mavacamten dose.
- mefloquine
crizotinib will increase the level or effect of mefloquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- methadone
crizotinib increases levels of methadone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- methylergonovine
crizotinib increases levels of methylergonovine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- midazolam
crizotinib increases levels of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of crizotinib with CYP3A substrates with narrow therapeutic indices should be avoided.
- mifepristone
mifepristone, crizotinib. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available.
- mirtazapine
crizotinib increases levels of mirtazapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- mitomycin
crizotinib increases levels of mitomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- mitotane
mitotane decreases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments.
- modafinil
crizotinib increases levels of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- moxifloxacin
crizotinib and moxifloxacin both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- nafcillin
nafcillin will decrease the level or effect of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- naldemedine
crizotinib increases levels of naldemedine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor naldemedine for potential adverse effects if coadministered with strong or moderate CYP3A4 inhibitors.
crizotinib increases levels of naldemedine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Monitor naldemedine for potential adverse effects if coadministered with P-gp inhibitors. - nefazodone
nefazodone increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Concomitant use of strong CYP3A inhibitors should be avoided. .
- nelfinavir
nelfinavir increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Concomitant use of strong CYP3A inhibitors should be avoided. .
crizotinib increases levels of nelfinavir by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. - nicardipine
nicardipine increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Concomitant use of strong CYP3A inhibitors should be avoided. .
crizotinib increases levels of nicardipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A. - nifedipine
crizotinib increases levels of nifedipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- nilotinib
crizotinib increases levels of nilotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- nimodipine
crizotinib increases levels of nimodipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- nintedanib
crizotinib increases levels of nintedanib by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. If nintedanib adverse effects occur, management may require interruption, dose reduction, or discontinuation of therapy.
- nisoldipine
crizotinib increases levels of nisoldipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- nizatidine
nizatidine decreases levels of crizotinib by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor. Drugs that elevate the gastric pH may decrease the solubility of crizotinib and subsequently reduce its bioavailability. However, no formal studies have been conducted. .
- norgestrel
crizotinib will increase the level or effect of norgestrel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Strong or moderate CYP3A4 inhibitors may increase systemic concentration of norgestrel, which may increase risk for adverse effects
- nortriptyline
crizotinib and nortriptyline both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- octreotide
crizotinib and octreotide both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- ofloxacin
crizotinib and ofloxacin both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- oliceridine
crizotinib will increase the level or effect of oliceridine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. If concomitant use is necessary, may require less frequent oliceridine dosing. Closely monitor for respiratory depression and sedation and titrate subsequent doses accordingly. If inhibitor is discontinued, consider increase oliceridine dosage until stable drug effects are achieved. Monitor for signs of opioid withdrawal.
- olodaterol inhaled
crizotinib and olodaterol inhaled both increase QTc interval. Use Caution/Monitor.
- omeprazole
omeprazole will decrease the level or effect of crizotinib by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor. Drugs that elevate the gastric pH may decrease the solubility of crizotinib and subsequently reduce its bioavailability. However, no formal studies have been conducted.
- ondansetron
crizotinib increases levels of ondansetron by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- osilodrostat
osilodrostat and crizotinib both increase QTc interval. Use Caution/Monitor.
- osimertinib
osimertinib and crizotinib both increase QTc interval. Use Caution/Monitor. Conduct periodic monitoring with ECGs and electrolytes in patients taking drugs known to prolong the QTc interval.
- oxaliplatin
oxaliplatin will increase the level or effect of crizotinib by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- oxcarbazepine
oxcarbazepine decreases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Concomitant use of strong CYP3A inducers should be avoided. .
- oxycodone
crizotinib increases levels of oxycodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- ozanimod
ozanimod and crizotinib both increase QTc interval. Modify Therapy/Monitor Closely. The potential additive effects on heart rate, treatment with ozanimod should generally not be initiated in patients who are concurrently treated with QT prolonging drugs with known arrhythmogenic properties.
- paclitaxel
crizotinib increases levels of paclitaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
crizotinib increases levels of paclitaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. - paclitaxel protein bound
crizotinib increases levels of paclitaxel protein bound by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
crizotinib increases levels of paclitaxel protein bound by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. - palbociclib
crizotinib will increase the level or effect of palbociclib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- paliperidone
crizotinib and paliperidone both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- palovarotene
crizotinib will increase the level or effect of palovarotene by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Avoid coadministration of palovarotene, a CYP3A substrate, with moderate CYP3A inhibitors. If unavoidable, reduce palovarotene dose by 50%.
- pantoprazole
pantoprazole decreases levels of crizotinib by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor. Drugs that elevate the gastric pH may decrease the solubility of crizotinib and subsequently reduce its bioavailability. However, no formal studies have been conducted. .
- pasireotide
crizotinib and pasireotide both increase QTc interval. Modify Therapy/Monitor Closely.
- pazopanib
crizotinib increases levels of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
crizotinib increases levels of pazopanib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval. - pentamidine
crizotinib and pentamidine both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- perphenazine
crizotinib and perphenazine both increase QTc interval. Use Caution/Monitor.
- phenobarbital
phenobarbital decreases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Concomitant use of strong CYP3A inducers should be avoided. .
- phenytoin
phenytoin decreases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Concomitant use of strong CYP3A inducers should be avoided. .
crizotinib increases levels of phenytoin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of crizotinib with CYP3A substrates with narrow therapeutic indices should be avoided. - posaconazole
posaconazole increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Concomitant use of strong CYP3A inhibitors should be avoided. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- pravastatin
crizotinib increases levels of pravastatin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- praziquantel
crizotinib increases levels of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- procainamide
crizotinib and procainamide both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- propafenone
crizotinib and propafenone both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- protriptyline
crizotinib and protriptyline both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- quetiapine
crizotinib increases levels of quetiapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- quinine
crizotinib increases levels of quinine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
crizotinib and quinine both increase QTc interval. Use Caution/Monitor. - quizartinib
quizartinib, crizotinib. Either increases effects of the other by QTc interval. Modify Therapy/Monitor Closely. Monitor patients more frequently with ECG if coadministered with QT prolonging drugs.
- rabeprazole
rabeprazole decreases levels of crizotinib by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor. Drugs that elevate the gastric pH may decrease the solubility of crizotinib and subsequently reduce its bioavailability. However, no formal studies have been conducted. .
- ranolazine
crizotinib increases levels of ranolazine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- repaglinide
crizotinib increases levels of repaglinide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- rifabutin
rifabutin decreases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Concomitant use of strong CYP3A inducers should be avoided. .
- rifampin
rifampin decreases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Concomitant use of strong CYP3A inducers should be avoided. .
crizotinib increases levels of rifampin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. - rifapentine
rifapentine decreases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Concomitant use of strong CYP3A inducers should be avoided. .
- rifaximin
crizotinib increases levels of rifaximin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- rilpivirine
crizotinib increases levels of rilpivirine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- rimegepant
crizotinib will increase the level or effect of rimegepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Avoid repeating rimegepant dose within 48 hr if coadministered with a moderate CYP3A4 inhibitor.
- risperidone
crizotinib and risperidone both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- ritonavir
ritonavir increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Concomitant use of strong CYP3A inhibitors should be avoided. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
crizotinib increases levels of ritonavir by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. - rivaroxaban
crizotinib increases levels of rivaroxaban by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- romidepsin
crizotinib increases levels of romidepsin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
crizotinib increases levels of romidepsin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
crizotinib and romidepsin both increase QTc interval. Use Caution/Monitor. - rucaparib
rucaparib will increase the level or effect of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP3A4 substrates, if clinically indicated.
- salmeterol
crizotinib and salmeterol both increase QTc interval. Use Caution/Monitor.
- saquinavir
saquinavir increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Concomitant use of strong CYP3A inhibitors should be avoided. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
crizotinib increases levels of saquinavir by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval. - sarecycline
sarecycline will increase the level or effect of crizotinib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Monitor for toxicities of P-gp substrates that may require dosage reduction when coadministered with P-gp inhibitors.
- saxagliptin
crizotinib increases levels of saxagliptin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- selpercatinib
selpercatinib increases toxicity of crizotinib by QTc interval. Use Caution/Monitor.
- silodosin
crizotinib increases levels of silodosin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
crizotinib increases levels of silodosin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. - simvastatin
crizotinib increases levels of simvastatin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- siponimod
siponimod and crizotinib both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Caution if coadministered because of additive immunosuppressive effects during such therapy and in the weeks following administration. When switching from drugs with prolonged immune effects, consider the half-life and mode of action of these drugs to avoid unintended additive immunosuppressive effects.
- sirolimus
crizotinib increases levels of sirolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of crizotinib with CYP3A substrates with narrow therapeutic indices should be avoided.
crizotinib increases levels of sirolimus by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. - sitagliptin
crizotinib increases levels of sitagliptin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- sodium bicarbonate
sodium bicarbonate decreases levels of crizotinib by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor. Drugs that elevate the gastric pH may decrease the solubility of crizotinib and subsequently reduce its bioavailability. However, no formal studies have been conducted. .
- sodium zirconium cyclosilicate
sodium zirconium cyclosilicate will decrease the level or effect of crizotinib by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Check specific recommendations for drugs that exhibit pH-dependent solubility that may affect their systemic exposure and efficacy. In general, administer drugs at least 2 hr before or after sodium zirconium cyclosilicate.
- solifenacin
crizotinib increases levels of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- sonidegib
crizotinib will increase the level or effect of sonidegib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Avoid coadministration of sonidegib with moderate CYP3A4 inhibitors. If a moderate CYP3A inhibitor must be used, administer the moderate CYP3A inhibitor for <14 days and monitor closely for adverse reactions, particularly musculoskeletal adverse reactions.
- sorafenib
sorafenib and crizotinib both increase QTc interval. Use Caution/Monitor.
- sotalol
crizotinib and sotalol both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- sparsentan
crizotinib will increase the level or effect of sparsentan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. No dosage adjustment needed. Monitor blood pressure, serum potassium, edema, and kidney function regularly if sparsentan is coadministered with moderate CYP3A4 inhibitors.
- St John's Wort
St John's Wort decreases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Concomitant use of strong CYP3A inducers should be avoided. .
- stiripentol
stiripentol, crizotinib. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP3A4 inhibitor and inducer. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. CYP3A4 substrates may require dosage adjustment.
stiripentol will increase the level or effect of crizotinib by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Consider reducing the dose of P-glycoprotein (P-gp) substrates, if adverse reactions are experienced when administered concomitantly with stiripentol. - sufentanil
crizotinib increases levels of sufentanil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- sufentanil SL
crizotinib will increase the level or effect of sufentanil SL by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of sufentanil SL with any CYP3A4 inhibitor may increase sufentanil plasma concentration, and, thereby increase or prolonged adverse effects, including potentially fatal respiratory depression.
- sunitinib
crizotinib increases effects of sunitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- suvorexant
crizotinib will increase the level or effect of suvorexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Decrease suvorexant starting dose to 5 mg HS if coadministered with moderate CYP3A4 inhibitors
- tacrolimus
crizotinib increases levels of tacrolimus by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- tadalafil
crizotinib increases levels of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- tamoxifen
crizotinib, tamoxifen. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. CYP3A4 inhibition decreases metabolism of tamoxifen to N-desmethyl tamoxifen (active metabolite with similar biologic activity).
- tamsulosin
crizotinib increases levels of tamsulosin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- tazemetostat
tazemetostat will decrease the level or effect of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- tecovirimat
tecovirimat will decrease the level or effect of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Tecovirimat is a weak CYP3A4 inducer. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered.
- telavancin
crizotinib and telavancin both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- temsirolimus
crizotinib increases levels of temsirolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- teniposide
crizotinib increases levels of teniposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
crizotinib increases levels of teniposide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. - tezacaftor
crizotinib will increase the level or effect of tezacaftor by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adjust tezacaftor dosage regimen if coadministered with a moderate CYP3A inhibitor.
- theophylline
crizotinib increases levels of theophylline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of crizotinib with CYP3A substrates with narrow therapeutic indices should be avoided.
- thiothixene
crizotinib and thiothixene both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- tiagabine
crizotinib increases levels of tiagabine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- tinidazole
crizotinib will increase the level or effect of tinidazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- tipranavir
tipranavir increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Concomitant use of strong CYP3A inhibitors should be avoided. .
- tofacitinib
crizotinib increases levels of tofacitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. No specific dose adjustment recommended when tofacitinib coadministered with moderate CYP3A4 inhibitors; decrease tofacitinib dose if coadministered with both moderate CYP3A4 and potent CYP2C19 inhibitors.
- tolterodine
crizotinib increases levels of tolterodine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- tolvaptan
crizotinib increases levels of tolvaptan by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- toremifene
crizotinib and toremifene both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- trabectedin
crizotinib will increase the level or effect of trabectedin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- tramadol
crizotinib increases levels of tramadol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- trazodone
crizotinib increases levels of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- triazolam
crizotinib increases levels of triazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- trimipramine
crizotinib and trimipramine both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
crizotinib increases levels of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A. - triptorelin
triptorelin increases toxicity of crizotinib by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- tucatinib
tucatinib will increase the level or effect of crizotinib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Consider reducing the dosage of P-gp substrates, where minimal concentration changes may lead to serious or life-threatening toxicities.
- valbenazine
valbenazine and crizotinib both increase QTc interval. Use Caution/Monitor.
- vandetanib
crizotinib and vandetanib both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- vardenafil
crizotinib will increase the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- vemurafenib
crizotinib and vemurafenib both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- verapamil
crizotinib increases levels of verapamil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
crizotinib increases levels of verapamil by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
verapamil increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Caution should be exercised with concomitant use of moderate CYP3A inhibitors. . - vinblastine
crizotinib increases levels of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
crizotinib increases levels of vinblastine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. - vincristine
crizotinib increases levels of vincristine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
crizotinib increases levels of vincristine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. - vincristine liposomal
crizotinib increases levels of vincristine liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
crizotinib increases levels of vincristine liposomal by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. - vinorelbine
crizotinib increases levels of vinorelbine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- voclosporin
crizotinib will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
voclosporin, crizotinib. Either increases effects of the other by QTc interval. Use Caution/Monitor. - voriconazole
voriconazole increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Concomitant use of strong CYP3A inhibitors should be avoided. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- vorinostat
crizotinib and vorinostat both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- zanubrutinib
crizotinib will increase the level or effect of zanubrutinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce zanubrutinib (a CYP3A4 substrate) to 80 mg PO BID to when coadministered with a moderate CYP3A4 inhibitor. Interrupt dose as recommended for adverse reactions. After discontinuing the CYP3A4 inhibitor, resume previous dose of zanubrutinib.
- ziprasidone
crizotinib and ziprasidone both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- zolpidem
crizotinib increases levels of zolpidem by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- zonisamide
crizotinib increases levels of zonisamide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
Minor (4)
- entecavir
crizotinib, entecavir. Either increases effects of the other by decreasing renal clearance. Minor/Significance Unknown. Coadministration with drugs that reduce renal function or compete for active tubular secretion may increase serum concentrations of either entecavir or the coadministered drug.
- estradiol vaginal
crizotinib will increase the level or effect of estradiol vaginal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- lapatinib
crizotinib and lapatinib both increase QTc interval. Minor/Significance Unknown.
- rilpivirine
crizotinib and rilpivirine both increase QTc interval. Minor/Significance Unknown.
Adverse Effects
>10%
ALK- or ROS1-positive metastatic NSCLC
- Vision disorders (≥25%)
- Nausea (≥25%)
- Diarrhea (≥25%)
- Vomiting (≥25%)
- Edema (≥25%)
- Constipation (≥25%)
- Elevated transaminases (≥25%)
- Fatigue (≥25%)
- Decreased appetite (≥25%)
- Upper respiratory infection (≥25%)
- Dizziness (≥25%)
- Neuropathy (≥25%)
ALK-positive metastatic NSCLC
-
All grades
- Increased ALT (76-79%)
- Vision disorder (60-71%)
- Increased AST (61-66%)
- Diarrhea (60-61%)
- Nausea (55-56%)
- Neutropenia (49-52%)
- Lymphopenia (48-51%)
- Edema (31-49%)
- Vomiting (46-47%)
- Constipation (42-43%)
- Upper respiratory tract infection (26-32%)
- Hypophosphatemia (28-32%)
- Decreased appetite (27-30%)
- Fatigue (27-29%)
- Abdominal pain (26%)
- Dysgeusia (26%)
- Headache (22%)
- Dizziness (18-22%)
- Neuropathy (19-21%)
- Pyrexia (19%)
- Hypokalemia (18%)
- Pain in extremity (16%)
- Bradycardia (5-14%)
- Dyspepsia (8-14%)
- Rash (9-11%)
-
Grade 3-4
- Increased ALT (15-17%)
- Neutropenia (11-12%)
ALCL
-
All grades
- Neutropenia (100%)
- Blood creatinine increased (100%)
- Diarrhea (92%)
- Vomiting (92%)
- ALT increased (81%)
- Nausea (77%)
- AST increased (65%)
- Vision disorders (65%)
- Hypocalcemia (62%)
- Lymphopenia (58%)
- Headache (58%)
- Musculoskeletal pain (58%)
- Hypoalbuminemia (54%)
- Anemia (54%)
- Abdominal pain (50%)
- Stomatitis (46%)
- Hyperglycemia (46%)
- Hypomagnesemia (46%)
- Fatigue (46%)
- Decreased appetite (42%)
- Thrombocytopenia (38%)
- Pyrexia (38%)
- Hypoglycemia (35%)
- Pruritus (35%)
- Cough (35%)
- Hypokalemia (31%)
- Constipation (31%)
- Upper respiratory tract infection (31%)
- Hypertension (31%)
- Hypermagnesemia (27%)
- Edema (27%)
- Chills (27%)
- Hyperkalemia (23%)
- Dysgeusia (23%)
- Dizziness (23%)
- Rash (23%)
- Rhinitis allergic (23%)
- Bradycardia (19%)
- Hypotension (19%)
- Alkaline phosphatase increase (19%)
- Hypernatremia (19%)
- Hyponatremia (12%)
- Hyperuricemia (12%)
- Hypophosphatemia (12%)
- Peripheral neuropathy (12%)
-
Grade 3-4
- Neutropenia (77%)
- Lymphopenia (38%)
- Thrombocytopenia (19%)
- Diarrhea (12%)
- Musculoskeletal pain (12%)
1-10%
ALK-positive metastatic NSCLC
-
All grades
- Dysphagia (10%)
- Decreased weight (10%)
- Increased weight (8%)
- Esophagitis (2-6%)
- Pulmonary embolism (6%)
- QT prolonged (5-6%)
- Renal cyst (4-5%)
- ILD/pneumonitis (1-4%)
- Syncope (1-3%)
- Decreased blood testosterone (1%)
- Hepatic failure (1%)
-
Grade 3-4
- Hypophosphatemia (5-10%)
- Increased AST (8-9%)
- Lymphopenia (7-9%)
- Pulmonary embolism (5%)
- Hypokalemia (4%)
- Syncope (3%)
- QT prolonged (2-3%)
- Diarrhea (2%)
- Vomiting (1-2%)
- Constipation (2%)
- Esophagitis (2%)
- Bradycardia (1%)
- Vision disorder (1%)
- Dysphagia (1%)
- Edema (1%)
- Increased weight (1%)
- Headache (1%)
- Dizziness (1%)
- Decreased weight (1%)
- Nausea (1%)
ALCL
-
Grade 3-4
- Stomatitis (8%)
- QT prolonged (8%)
- GGT increase (8%)
- Esophagitis (8%)
- Muscular weakness (8%)
- Acute renal injury (8%)
- Febrile neutropenia (3.8%)
- Vomiting (3.8%)
- Nausea (3.8%)
- Anemia (3.8%)
- ALT increased (3.8%)
- AST increased (3.8%)
- Hypocalcemia (3.8%)
- Hypokalemia (3.8%)
Postmarketing Reports
Increased blood creatine phosphokinase
Warnings
Contraindications
None
Cautions
Severe, including fatal, treatment-related ILD/pneumonitis reported; monitor for pulmonary symptoms indicative of pneumonitis; generally occurred within 3 months after initiation
Drug-induced hepatoxicity reported; monitor liver function tests every 2 weeks during the first 2 months of treatment, then monthly, and as clinically needed; more frequently in patients who develop increased transaminases; withhold, reduce dose, or permanently discontinue for hepatotoxicity as recommended
Symptomatic bradycardia reported, including syncope; monitor HR and blood pressure regularly
Caution when driving or operating machinery because of vision disorder, dizziness, or fatigue associated with treatment
May cause fetal harm when administered to pregnant females
Interstitial lung disease (ILD)/Pneumonitis reported; permanently discontinue in patients with ILD/pneumonitis
Visual loss
- Visual field defect with vision loss reported; optic atrophy and optic nerve disorder have been reported as potential causes of vision loss; most common visual symptoms were blurred vision and visual impairment in ALCL patients
- There is insufficient information to characterize risks of resumption of drug in patients who develop visual symptoms or visual loss; a decision to resume therapy should consider potential benefits versus risks to patient
- For pediatric and young adult patients with ALCL or pediatric patients with IMT, obtain baseline and follow-up ophthalmologic examinations including retinal examination within 1 month of initiating therapy and every 3 months thereafter
- Perform an ophthalmological evaluation consisting of best corrected visual acuity, retinal photographs, visual fields, optical coherence tomography (OCT), and other evaluations as appropriate for new onset of visual loss and for other visual symptoms as clinically warranted
- Permanently discontinue therapy for Grade 3 or 4 ocular disorders or severe visual loss (best-corrected vision less than 20/200 in one or both eyes) unless another cause is identified
Gastrointestinal toxicity
- Severe gastrointestinal toxicities (eg, diarrhea, nausea, vomiting, stomatitis) can occur in ALCL patients; provide standard antiemetic and antidiarrheal agents for gastrointestinal toxicities in patients with ALCL; antiemetics are recommended prior to and during treatment with drug to prevent nausea and vomiting; if patients develop Grade 3 nausea lasting 3 days or Grade 3 or 4 diarrhea or vomiting despite maximum medical therapy, withhold therapy until resolved, and then resume at next lower dose level; consider supportive care such as hydration, electrolyte supplementation, and nutritional support as clinically indicated
QT interval prolongation
- QTc prolongation reported
- Avoid use with congenital long QT syndrome
- Consider periodic ECG and electrolyte monitoring in patients with congestive heart failure, bradyarrhythmias, electrolyte abnormalities, or taking medications known to prolong QT interval
Drug interaction overview
- CYP3A4/5 and P-gp substrate; CYP3A4 inhibitor
-
Strong or moderate CYP3A inhibitors
- Avoid coadministration
- Strong CYP3A inhibitors increases crizotinib plasma concentration and risk of adverse reactions of crizotinib
- If unavoidable, reduce crizotinib dosage
- Avoid grapefruit or grapefruit
- Use caution with concomitant use of moderate CYP3A4 inhibitors
-
Strong CYP3A inducers
- Avoid coadministration
- Strong CYP3A inducers decreases crizotinib plasma concentrations and efficacy of crizotinib
-
CYP3A substrates
- Avoid coadministration
- Crizotinib may increases plasma concentrations and rise of adverse effects of CYP3A substrates
- If unavoidable, decrease CYP3A substrate dosage according to prescribing information
-
Drugs that prolong the QT interval
- Avoid coadministration
-
Drugs that cause bradycardia
- Avoid coadministration
- Drugs include beta-blockers, nondihydropyridine calcium channel blockers, clonidine, and digoxin
Pregnancy & Lactation
Pregnancy
Based on its mechanism of action, can cause fetal harm when administered to a pregnant woman
Verify pregnancy status of females of reproductive potential before initiation
Animal data
- Oral administration in pregnant rats during organogenesis at exposures similar to those observed with maximum recommended human dose resulted in embryotoxicity and fetotoxicity
Contraception
- Females of reproductive potential: Use effective contraception during treatment and for at least 45 days following the final dose
- Males with female partners of reproductive potential: Use condoms during treatment and for at least 90 days after final dose
Infertility
- Based on reproductive organ findings in animals, reduced fertility in females and males of reproductive potential may occur
- Unknown whether these effects on fertility are reversible
Lactation
No information available on drug presence in human milk, effects on the breastfed infants, or effects on milk production
Do not breastfeed during treatment and for 45 days after final dose
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Inhibitor of receptor tyrosine kinases including ALK, Hepatocyte Growth Factor Receptor (HGFR, c-Met), and Recepteur d’Origine Nantais (RON)
ALK gene expression and signaling that contribute to increased cell proliferation and survival of the tumors become activated following formation of ALK oncogenic fusion proteins
Inhibits signaling that promotes the expression of these oncogenic fusion proteins, thereby inhibiting tumor cell proliferation
Absorption
Adults
- Bioavailability: 43% (mean absolute bioavailability)
- Mean accumulation ratio: 4.8
- Peak plasma time: 4-6 hr
- Steady-state reached at 15 days (250 mg PO BID)
-
Effect of food
- High-fat meal reduced AUC and peak plasma concentration by ~14%
Children and young adults
- Peak plasma concentration: 621 ng/mL
- AUC: 6530 ng⋅hr/mL
Distribution
Protein Bound: 91% to human plasma proteins, independent of drug concentration
Vd (steady-state): 1772 L (50-mg IV dose)
Blood-to-plasma ratio: 1
P-glycoprotein (P-gp) substrate and inhibitor
Metabolism
Predominantly metabolized by CYP3A4/5
Time-dependent inhibitor of CYP3A
Primary metabolic pathways in humans were oxidation of the piperidine ring to crizotinib lactam and O-dealkylation, with subsequent Phase 2 conjugation of O-dealkylated metabolites
Elimination
Half-life: 42 hr
Total body clearance: 60 L/hr (250 mg PO q12hr at steady-state); 100 L/hr (250 mg PO qDay)
Excretion: Feces 63%; urine 22%
Pharmacogenomics
Patient selection for treatment is based on presence of ALK fusion gene
Verify presence of ALK fusion gene by using the diagnostic test, Abbott Molecular’s Vysis ALK Break Apart FISH Probe Kit
Administration
Oral Administration
Take with or without food
Swallow capsules whole
Oral pellets
- Pellets are supplied encapsulated in shells; do not chew or crush
- Do not swallow pellets encapsulated in shell
-
May administered by 2 options
- Open shell(s) and empty contents directly into patient’s mouth, OR
- Open shell(s) and empty contents into a consumer-supplied oral dosing aid (eg, spoon, medicine cup)
- Administer pellets via dosing aid directly into patient’s mouth
- Immediately after administration, give a sufficient amount of water to ensure that all medication is swallowed
ALCL
- Administer under adult supervision
- May combine different strengths capsules or pellets if necessary
-
Unable to swallow capsules
- Adults: 250 mg (oral pellets) PO TID with or without food until disease progression or unacceptable toxicity occurs
Before and during treatment
- Provide standard antiemetic and antidiarrheal agents before and during treatment
- Consider IV or oral hydration and replace electrolytes as clinically indicated
Missed dose
- Next dose >6 hr: Take as soon as possible
- Next dose <6 hr: Skip missed dose; do NOT double dose to make up for missed dose
- Vomited dose after administration: Do NOT take extra dose; take next dose at regularly scheduled time
Storage
Capsules: Store at room temperature (20-25ºC [68-77ºF]); excursions permitted to 15-30ºC (59-86ºF)
Images
BRAND | FORM. | UNIT PRICE | PILL IMAGE |
---|---|---|---|
Xalkori oral - | 250 mg capsule | ![]() |
Copyright © 2010 First DataBank, Inc.
Patient Handout
crizotinib oral
CRIZOTINIB - ORAL
(kriz-OH-ti-nib)
COMMON BRAND NAME(S): Xalkori
USES: Crizotinib is used to treat certain types of cancer (such as lung cancer, anaplastic large cell lymphoma-ALCL). It is also used to treat a certain type of tumor (inflammatory myofibroblastic tumor-IMT). Crizotinib works by slowing or stopping the growth of cancer or tumor cells. It belongs to a class of drugs known as kinase inhibitors.
HOW TO USE: Read the Medication Guide provided by your pharmacist before you start taking crizotinib and each time you get a refill. If you have any questions, ask your doctor or pharmacist.Take this medication by mouth with or without food as directed by your doctor, usually once or twice daily. Swallow whole with a glass of water. Do not crush or chew this medication. If you vomit after taking your dose of the medication, do not take an extra dose. Take the next dose of your medication at the regular time.The dosage is based on your medical condition, lab tests, response to treatment, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). For children, the dosage is also based on body size.To decrease the risk of side effects, your doctor may prescribe other medications to take along with this medication. Carefully follow your doctor's directions for all your medications.Avoid eating grapefruit or drinking grapefruit juice while using this medication unless your doctor or pharmacist says you may do so safely. Grapefruit can increase the chance of side effects with this medicine. Ask your doctor or pharmacist for more details.Do not increase your dose or use this drug more often or for longer than prescribed. Your condition will not improve any faster, and your risk of side effects will increase.Use this medication regularly to get the most benefit from it. To help you remember, use it at the same times each day.Since this drug can be absorbed through the skin and lungs and may harm an unborn baby, women who are pregnant or who may become pregnant should not handle this medication or breathe the dust from the capsules.
SIDE EFFECTS: Nausea, diarrhea, vomiting, dizziness, tiredness, headache, heartburn, change in taste, loss of appetite, mouth sores, joint pain, trouble sleeping, or constipation may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.This medication may lower your ability to fight infections. This may make you more likely to get a serious (rarely fatal) infection or make any infection you have worse. Tell your doctor right away if you have any signs of infection (such as cough, sore throat, fever, chills).Tell your doctor right away if you have any serious side effects, including: vision changes (such as blurred/decreased vision, flashes of light, sensitivity to light, floaters), swelling of the legs/feet/hands.Get medical help right away if you have any very serious side effects, including: symptoms of lung problems (such as trouble breathing, cough), eye pain/swelling/redness, fast/slow/irregular heartbeat, severe dizziness, fainting, easy bleeding/bruising, symptoms of liver problems (such as nausea/vomiting that doesn't stop, dark urine, stomach/abdominal pain, yellowing eyes/skin).A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.Crizotinib can commonly cause a rash that is usually not serious. However, you may not be able to tell it apart from a rare rash that could be a sign of a severe reaction. Tell your doctor right away if you develop any rash.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before taking this medication, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney problems, liver problems.Crizotinib may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using crizotinib, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/"water pills") or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using crizotinib safely.Crizotinib can make you more likely to get infections or may make current infections worse. Stay away from anyone who has an infection that may easily spread (such as chickenpox, COVID-19, measles, flu). Talk to your doctor if you have been exposed to an infection or for more details.Tell your health care professional that you are using crizotinib before having any immunizations/vaccinations. Avoid contact with people who have recently received live vaccines (such as flu vaccine inhaled through the nose).This drug may make you dizzy or cause vision changes. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be more sensitive to the side effects of this drug, especially QT prolongation (see above).This medication can affect fertility in both males and females. Ask your doctor for more details.Since this drug can be absorbed through the skin and lungs and may harm an unborn baby, women who are pregnant or who may become pregnant should not handle this medication or breathe the dust from the capsules.Tell your doctor if you are pregnant or plan to become pregnant. You should not become pregnant while using crizotinib. Crizotinib may harm an unborn baby. Your doctor should order a pregnancy test before you start this medication. Women using this medication should ask about reliable forms of birth control during treatment and for some time after the last dose. Men using this medication should ask about reliable forms of birth control during treatment and for 90 days after the last dose. If you or your partner becomes pregnant, talk to your doctor right away about the risks and benefits of this medication.It is unknown if this drug passes into breast milk. Because of possible harm to a nursing infant, breast-feeding is not recommended while using this medication and for 45 days after stopping this medication. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: See also How to Use section.Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: drugs that may slow the heartbeat (including digoxin, clonidine, beta-blockers such as atenolol/metoprolol, calcium channel blockers such as diltiazem/verapamil).Other medications can affect the removal of crizotinib from your body, which may affect how crizotinib works. Examples include azole antifungals (such as itraconazole), macrolide antibiotics (such as erythromycin), rifamycins (such as rifabutin), drugs for seizures (such as carbamazepine, phenytoin), St. John's wort, among others.This medication can slow down the removal of other medications from your body, which may affect how they work. Examples of affected drugs include alfentanil, elacestrant, ergots (such as ergotamine), fentanyl, flibanserin, lomitapide, tacrolimus, among others.Many drugs besides crizotinib may affect the heart rhythm (QT prolongation), including amiodarone, dofetilide, quinidine, procainamide, sotalol, and certain antipsychotic medications (such as pimozide, thioridazine, ziprasidone), among others.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
NOTES: Do not share this medication with others.Lab and/or medical tests (such as liver/kidney function, EKG, complete blood counts, eye exams, blood pressure, heart rate) will be done before you start taking this medication and while you are taking it. Keep all medical and lab appointments. Consult your doctor for more details.
MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is less than 6 hours before the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
STORAGE: Store at room temperature. Keep this medication in the original container away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Information last revised August 2023. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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