Table 7 summarizes the effect of other drugs on TUKYSA.
| Strong CYP3A Inducers or Moderate CYP2C8 Inducers | |
| Clinical Impact | Concomitant use of TUKYSA with a strong CYP3A or moderate CYP2C8 inducer decreased tucatinib plasma concentrations [see Clinical Pharmacology (12.3)] which may reduce TUKYSA activity. |
| Management | Avoid concomitant use of TUKYSA with a strong CYP3A inducer or a moderate CYP2C8 inducer. |
| Strong or Moderate CYP2C8 Inhibitors | |
| Clinical Impact | Concomitant use of TUKYSA with a strong CYP2C8 inhibitor increased tucatinib plasma concentrations [see Clinical Pharmacology (12.3)], which may increase the risk of TUKYSA toxicity. |
| Management | Avoid concomitant use of TUKYSA with a strong CYP2C8 inhibitor. Increase monitoring for TUKYSA toxicity with moderate CYP2C8 inhibitors. |
Table 8 summarizes the effect of TUKYSA on other drugs.
| CYP3A Substrates | |
| Clinical Impact | Concomitant use of TUKYSA with a CYP3A substrate increased the plasma concentrations of CYP3A substrate [see Clinical Pharmacology (12.3)], which may increase the toxicity associated with a CYP3A substrate. |
| Management | Avoid concomitant use of TUKYSA with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. If concomitant use is unavoidable, decrease the CYP3A substrate dosage in accordance with approved product labeling. |
| P-glycoprotein (P-gp) Substrates | |
| Clinical Impact | Concomitant use of TUKYSA with a P-gp substrate increased the plasma concentrations of P-gp substrate [see Clinical Pharmacology (12.3)], which may increase the toxicity associated with a P-gp substrate. |
| Management | Consider reducing the dosage of P-gp substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. |
Table 7 summarizes the effect of other drugs on TUKYSA.
| Strong CYP3A Inducers or Moderate CYP2C8 Inducers | |
| Clinical Impact | Concomitant use of TUKYSA with a strong CYP3A or moderate CYP2C8 inducer decreased tucatinib plasma concentrations [see Clinical Pharmacology (12.3)] which may reduce TUKYSA activity. |
| Management | Avoid concomitant use of TUKYSA with a strong CYP3A inducer or a moderate CYP2C8 inducer. |
| Strong or Moderate CYP2C8 Inhibitors | |
| Clinical Impact | Concomitant use of TUKYSA with a strong CYP2C8 inhibitor increased tucatinib plasma concentrations [see Clinical Pharmacology (12.3)], which may increase the risk of TUKYSA toxicity. |
| Management | Avoid concomitant use of TUKYSA with a strong CYP2C8 inhibitor. Increase monitoring for TUKYSA toxicity with moderate CYP2C8 inhibitors. |
Table 8 summarizes the effect of TUKYSA on other drugs.
| CYP3A Substrates | |
| Clinical Impact | Concomitant use of TUKYSA with a CYP3A substrate increased the plasma concentrations of CYP3A substrate [see Clinical Pharmacology (12.3)], which may increase the toxicity associated with a CYP3A substrate. |
| Management | Avoid concomitant use of TUKYSA with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. If concomitant use is unavoidable, decrease the CYP3A substrate dosage in accordance with approved product labeling. |
| P-glycoprotein (P-gp) Substrates | |
| Clinical Impact | Concomitant use of TUKYSA with a P-gp substrate increased the plasma concentrations of P-gp substrate [see Clinical Pharmacology (12.3)], which may increase the toxicity associated with a P-gp substrate. |
| Management | Consider reducing the dosage of P-gp substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. |
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