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Drug Interactions between efavirenz and Lyfgenia

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Major

efavirenz lovotibeglogene autotemcel

Applies to: efavirenz and Lyfgenia (lovotibeglogene autotemcel)

ADJUST DOSING INTERVAL: Antiretroviral medications may interfere with the manufacturing of apheresed cells used for autologous gene therapy that undergo transduction by a lentiviral vector (LVV) (e.g., atidarsagene autotemcel, betibeglogene autotemcel, elivaldogene autotemcel, lovotibeglogene autotemcel). Following hematopoietic stem cell (HSC) mobilization and apheresis, CD34+ cells are genetically modified with a replication-incompetent, self-inactivating LVV carrying functional copies of deoxyribonucleic acid (DNA). Lentiviruses are retroviruses which possess short spans of genetic information identical to that of the human immunodeficiency virus (HIV) and may therefore be susceptible to inactivation by antiretroviral medications. Clinical data examining the use of antiretroviral medication(s) during the mobilization and apheresis process are not available.

MANAGEMENT: Antiretroviral medications should be avoided for at least one month, or the expected duration of elimination of the antiretroviral medication, prior to HSC mobilization and until all cycles of apheresis have been completed. Some manufacturers of atidarsagene autotemcel suggest continuing to avoid antiretroviral medications for at least 7 days after its infusion. If antiretroviral therapy is being considered for HIV or human T-lymphotropic virus (HTLV) prophylaxis, serology testing should be conducted to rule out infection before initiating mobilization and apheresis. Delaying gene therapy treatment until an HIV/HTLV western blot and viral load assay have been performed at 6-months postexposure may be appropriate. In addition, after the administration of autologous gene therapies that undergo the LVV transduction process, use of non-polymerase chain reaction (PCR)-based assays are recommended when screening for HIV, due to the risk of a false positive result with PCR-based assays.

References (4)
  1. (2022) "Product Information. Zynteglo (betibeglogene autotemcel)." bluebird bio
  2. (2022) "Product Information. Skysona (elivaldogene autotemcel)." bluebird bio
  3. (2023) "Product Information. Lyfgenia (lovotibeglogene autotemcel)." bluebird bio
  4. (2024) "Product Information. Lenmeldy (atidarsagene autotemcel)." Orchard Therapeutics

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Drug and food interactions

Moderate

efavirenz food

Applies to: efavirenz

ADJUST DOSING INTERVAL: Administration with food increases the plasma concentrations of efavirenz and may increase the frequency of adverse reactions. According to the product labeling, administration of efavirenz capsules (600 mg single dose) with a high-fat/high-caloric meal (894 kcal, 54 g fat, 54% calories from fat) or a reduced-fat/normal-caloric meal (440 kcal, 2 g fat, 4% calories from fat) was associated with mean increases of 39% and 51% in efavirenz peak plasma concentration (Cmax) and 22% and 17% in systemic exposure (AUC), respectively, compared to administration under fasted conditions. For efavirenz tablets, administration of a single 600 mg dose with a high-fat/high-caloric meal (approximately 1000 kcal, 500-600 kcal from fat) resulted in a 79% increase in mean Cmax and a 28% increase in mean AUC of efavirenz relative to administration under fasted conditions.

GENERALLY AVOID: Alcohol may potentiate the central nervous system (CNS) depressant effects of efavirenz. Concomitant use may result in additive CNS depression and impairment of judgment, thinking, and psychomotor skills. In more severe cases, hypotension, respiratory depression, profound sedation, coma, or even death may occur.

MANAGEMENT: Efavirenz should be taken on an empty stomach, preferably at bedtime. Dosing at bedtime may improve the tolerability of nervous system symptoms such as dizziness, insomnia, impaired concentration, somnolence, abnormal dreams and hallucinations, although they often resolve on their own after the first 2 to 4 weeks of therapy . Patients should be advised of the potential for additive central nervous system effects when efavirenz is used concomitantly with alcohol or psychoactive drugs, and to avoid driving or operating hazardous machinery until they know how the medication affects them.

References (4)
  1. (2001) "Product Information. Sustiva (efavirenz)." DuPont Pharmaceuticals
  2. (2023) "Product Information. Sustiva (efavirenz)." Bristol-Myers Squibb, SUPPL-59/47
  3. (2024) "Product Information. Stocrin (efavirenz)." Merck Sharp & Dohme (Australia) Pty Ltd
  4. (2024) "Product Information. Efavirenz (efavirenz)." Viatris UK Healthcare Ltd

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.