Which drugs cannot be taken with Momelotinib at the same time and precautions

Momelotinib is an oral JAK1/JAK2 inhibitor mainly used in patients with myelofibrosis to improve anemia, splenomegaly and systemic symptoms. In clinical use, the metabolism of molotinib mainly relies on the liver CYP3A enzyme system. Therefore, special attention must be paid to possible drug interactions when using combined drugs to avoid abnormal increases or decreases in blood concentration, thereby affecting the efficacy or increasing the risk of adverse reactions.

First of all, strong CYP3A inhibitors such as ketoconazole, itraconazole, clarithromycin, etc. should avoid simultaneous use with molotinib. Because these drugs can significantly inhibit the metabolism of molotinib, leading to increased blood concentrations and an increased risk of serious adverse reactions, such as bone marrow suppression, abnormal liver function and prolongation of the electrocardiogram QT interval. If combined use is necessary, the dose of molotinib usually needs to be appropriately reduced and monitoring strengthened under the guidance of a physician.

Secondly, strong CYP3A inducers such as rifampicin, carbamazepine, phenytoin, etc. should also be taken with caution. Such drugs will accelerate the metabolism of molotinib and reduce the blood concentration of the drug, which may lead to weakened or even ineffective efficacy. In clinical practice, if a patient needs to use CYP3A inducers for a long time, doctors may choose to adjust the dose of molotinib or switch to other non-interacting drugs to ensure the therapeutic effect.

In addition, while taking molotinib, patients should be aware of the risks of combined use of other myelosuppressive drugs, drugs that affect liver and kidney function, or drugs that prolong QT intervals. For example, when used together with potent myelosuppressive chemotherapy drugs and anti-arrhythmic drugs, it is necessary to regularly monitor blood routine, liver and kidney function and electrocardiogram to detect abnormalities in time. In general, molotinib should be used strictly in compliance with medical advice and avoid simultaneous use with potentially interacting drugs. Through dose adjustment and regular monitoring, the efficacy can be maximized and the risk of adverse reactions can be reduced.

Reference materials:https://www.ema.europa.eu/en/homepage