Which antibiotics can decarvatinib be used safely with?

Deucravacitinib is a selective TYK2 inhibitor mainly used to treat moderate to severe plaque psoriasis. Its metabolic pathway is mainly through the non-main metabolism of CYP2B6, CYP1A2, CYP2D6 and CYP2C19 , and does not significantly inhibit or induce CYP pathway and therefore has a low risk of interaction with most antibiotics. Although generally safe, antibiotics still need to be paired according to their metabolic characteristics to reduce potential drug interactions.

In clinical practice, decavatinib can be used safely in combination with commonly used antibiotics such as penicillins, cephalosporins, most fluoroquinolones, and azithromycin . The metabolic pathways of these drugs do not significantly overlap with TYK2 inhibitors and will not interfere with each other's plasma concentrations. For example, amoxicillin, cefuroxime, levofloxacin, azithromycin, etc. are all safer combination drug options. For patients with psoriasis who require anti-infective therapy, such combinations generally do not increase the risk of adverse effects.

It should be noted that some antibiotics have the characteristics of greater burden on the liver and kidneys, such as clarithromycin and erythromycin Strong CYP3A4 inhibitors. Although their metabolic pathways do not overlap much with those of decavatinib, they may still theoretically increase the metabolic pressure on the liver. Therefore, it is recommended to closely monitor liver function when used together. In addition, aminoglycoside antibiotics (such as gentamicin) are nephrotoxic. If the patient has renal function problems, he/she needs to be cautious, because patients with psoriasis may experience fluctuations in liver and kidney indicators after long-term medication, and enhanced monitoring is required when used together.

In general, the risk of interaction between decavatinib and most antibiotics is not high, and it can be used as a clinically relatively safe combination therapy. However, before starting antibiotic treatment, doctors should be informed of the use of TYK2 inhibitors so that they can choose the safest antibiotic regimen based on the type of infection, organ function indicators, and available drug combinations. If nausea, fatigue, rash, or elevated liver enzymes occur during combined medication, blood, liver and kidney function must be reviewed in a timely manner, and the medication must be adjusted or treatment suspended according to the situation.

Reference materials:https://www.drugs.com/