APHON Pediatric Chemotherapy-Biotherapy Renewal

recommended during therapy with small molecule inhibitors, in order to minimize the risks of interactions that could affect the drug’s effectiveness. A searchable list of potential CYP-related drug interactions can be found at drug-interactions.medicine.iu.edu/MainTable.aspx.

Table 2. Drugs That Can Alter Blood Levels of Small Molecule Inhibitors Drugs that may decrease blood levels of small molecule inhibitors (resulting in decreased efficacy of the small molecule inhibitor)

Drugs that may increase blood levels of small molecule inhibitors (resulting in increased toxicity of the small molecule inhibitor)

Barbiturates Echinacea Dexamethasone Green tea

Aprepitant Grapefruit juice Ketoconazole Posaconazole Voriconazole

H2 antagonists Phenobarbital Proton pump inhibitors Rifampin St. John’s wort Topiramate

Lexicomp provides information for extemporaneous preparations of some small molecule inhibitors listed in Table 2. These are additional recommendations for extemporaneous preparations: ! Extemporaneous preparations should be made one dose at a time by adding an intact (not crushed or broken) capsule or tablet to the recommended liquid and allowing it to dissolve over a recommended time period. ! Extemporaneous solutions should be administered as soon as possible after preparation. They develop a bitter taste the longer they stand. ! To ensure that the entire dose is given, add 30 mL of diluent (water or juice) to the container used to dissolve the tablet, rinse the container, and then give the rinse to the patient.