Back to Search Start Over

Inadequate response to imatinib treatment in chronic myeloid leukemia due to a drug interaction with phenytoin.

Authors :
Osorio, S.
Escudero-Vilaplana, V.
Gómez-Centurión, I.
González-Arias, E.
García-González, X.
Díez, J. L.
Source :
Journal of Oncology Pharmacy Practice; Apr2019, Vol. 25 Issue 3, p694-698, 5p, 1 Chart
Publication Year :
2019

Abstract

Imatinib mesylate and the newer BCR-ABL tyrosine kinase inhibitors are the standard therapy for chronic myeloid leukemia. Although these are remarkably effective drugs, some mechanisms of resistance have been identified including drug-to-drug interactions. Here we present the case of a chronic myeloid leukemia patient with an inadequate response to imatinib due to concurrent phenytoin administration. Conspicuously low imatinib plasma trough levels were documented. Imatinib dose was increased from 400 to 800 mg with good response. In conclusion, drug-to-drug interactions should be ruled out in cases of resistance to tyrosine kinase inhibitor treatment. Potent inducers of cytochrome P450 isoenzyme CYP3A4, as phenytoin, could induce inadequate responses due to increased imatinib clearance and low imatinib trough plasma levels. Thus, this interaction should be avoided. When this is not possible, dose escalation of imatinib and measurement of plasma levels, if available, is recommended. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
10781552
Volume :
25
Issue :
3
Database :
Complementary Index
Journal :
Journal of Oncology Pharmacy Practice
Publication Type :
Academic Journal
Accession number :
135207518
Full Text :
https://doi.org/10.1177/1078155217743565