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Clinical Effect: Concomitant use of acalabrutinib with a strong CYP3A inhibitor (e.g., itraconazole) increases the plasma concentration of acalabrutinib. Increased acalabrutinib concentration may lead to increased toxicity.
Prevention or Management: Avoid concomitant use of strong CYP3A inhibitors with acalabrutinib. Alternatively, if the inhibitor will be used short-term, interrupt acalabrutinib therapy.
Clinical Effect: Concomitant use of acalabrutinib with a moderate CYP3A inhibitor may increase the plasma concentration of acalabrutinib. Increased acalabrutinib concentration may lead to increased toxicity.
Prevention or Management: When acalabrutinib is used concomitantly with a moderate CYP3A inhibitor, reduce the dose of acalabrutinib to 100 mg once daily.
Clinical Effect: Concomitant use of acalabrutinib with a strong CYP3A inducer (e.g., rifampicin) decreases the plasma concentration of acalabrutinib. Decreased acalabrutinib concentration may reduce the activity of acalabrutinib.
Prevention or Management: Avoid concomitant use of strong CYP3A inducers with acalabrutinib. If use of a strong CYP3A inducer cannot be avoided, increase the dose of acalabrutinib to 200 mg approximately every 12 hours.
Clinical Effect: Concomitant use of acalabrutinib with proton pump inhibitors (PPIs), H2-receptor antagonists, or antacids may decrease the plasma concentration of acalabrutinib. Decreased acalabrutinib concentration may reduce the activity of acalabrutinib. If treatment with an acid-reducing agent is necessary, consider using an H2-receptor antagonist (e.g., ranitidine or famotidine) or an antacid (e.g., calcium carbonate).
Prevention or Management: Administer acalabrutinib and the acid-reducing agent at least 2 hours apart. Take acalabrutinib 2 hours before administering an H2-receptor antagonist.
Proton Pump Inhibitors (PPIs): Avoid concomitant use. Due to the long-lasting effect of PPIs, separating the administration times may not eliminate the interaction with acalabrutinib.
FDA，2025.01
