Duvelisib – Uses, Dosage, Side Effects, Interaction Duvelisib is an orally bioavailable, highly selective, and potent small molecule inhibitor of the delta and gamma isoforms of phosphoinositide-3 kinase (PI3K) with potential immunomodulating and antineoplastic activities. Upon administration, duvelisib prevents the activation of the PI3K delta/gamma-mediated signaling pathways which may lead to a reduction in cellular proliferation in PI3K delta/gamma-expressing tumor cells. Unlike other isoforms of PI3K, the delta and gamma isoforms are overexpressed primarily in hematologic malignancies and inflammatory and autoimmune diseases. By selectively targeting these PI3K isoforms, PI3K signaling in normal, non-neoplastic cells is minimally or not affected which would result in a more favorable side effect profile. Duvelisib is an oral inhibitor of phosphatidylinositol 3-kinase (PI3K) that is approved for use in relapsed or refractory chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL). Duvelisib is associated with a high rate of serum enzyme elevations during therapy and with an occasional concurrent rise in serum bilirubin and is a suspected but not proven cause of clinically apparent acute liver injury. Duvelisib, also known as IPI-145 and INK-1197, is a small-molecule inhibitor of phosphoinositide-3 kinases that was designed initially to prove that simultaneous inhibition of the isoforms delta and gamma can produce a broad adaptative and innate immune cell inhibitory activity. All the work around duvelisib showed that this agent is a potent inhibitor of both forms. Duvelisib was developed by Verastem, Inc, and FDA-approved on September 24, 2018. Mechanism of Action Duvelisib acts as a strong reversible inhibitor of the isoform gamma and delta of the phosphoinositide3-kinase (PI3K). PI3K plays a very important role in innate and adaptative immunity and the inhibition of the form delta and gamma has been very important for the suppression of immunity. The activity of PI3K gamma and delta is restricted to hematopoietic cells and it is necessary for normal B cell development. In lymphomas, the activation of PI3K is enlarged to promote unlimited growth and survival. Hence, inhibition of PI3K can provide inhibition of the signaling from BCR, inhibition of a cytokine signaling from the microenvironment, and enhancement of anti-tumor immunity. The specific mechanism of these PI3K inhibitors is further described as follows: -BCR activates signaling pathways after antigen engagement and it is also critical for the physiologic life of the lymphocytes and neoplastic lymphomas. In CLL, BCR reacts to auto- and exo-antigens to promote clonal expansion. This sustained presence of BCR activates delta PI3K producing a pro-survival pathway of the neoplastic cells which already present a higher activity of PI3K. Thus, the blockade of PI3K will limit the activity of BCR and the driven physiology of the lymphoma. -The inhibition of PI3K can also inhibit paracrine and autocrine pro-survival signals mediated by adhesion molecules, chemokines, and soluble factors. This activity is attained due to the fact that several downstream signals convey on PI3K. -It has been reported that the inactivation of PI3K produces a significant resistance to tumorigenesis. This data suggests that inhibition of PI3K can facilitate the recognition and elimination of tumor cells. In summary, duvelisib inhibits the isoform delta of PI3K which is necessary for cell proliferation and survival, and the isoform gamma which is critical for cytokine signaling and the pro-inflammatory response. Preclinical data showed that duvelisib presents cytotoxic actions at micromolar doses and antagonizes the activation of downstream signaling even in the presence of the mutation BTK C481S, which allows for the treatment of patients resistant to ibrutinib. In clinical trials, duvelisib was compared to ofatumumab in patients with chronic lymphocytic leukemia or small lymphocytic leukemia. These trials reported a median progression-free survival of 16.4 months and an overall response rate of 78% which were almost 2-fold what was reported for ofatumumab. In clinical trials of follicular lymphoma, duvelisib presented an overall response rate of 42% from which almost all the patients observed a partial response. Of the responding patients, 43% maintained the response for at least 6 months and 17% for at least 12 months. Indications Duvelisib is indicated for the treatment of adult patients with relapsed or refractory chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) after at least two prior therapies. CLL is a cancer of the blood stem cells which are the blood cells that can develop into different types of cells. In leukemia, there is an overproduction of cells that are abnormal and do not mature into blood cells thus, they just crowd out normal cells and impair their normal function. In lymphocyte leukemia, abnormal cell growth is observed in the lymphoid cells which are the type of blood cells that mature into lymphocytes. CLL is a type of lymphocytic leukemia that develops slowly over months or years. The SLL is a very similar disease to the CLL and these terms are usually referred to interchangeably. The only difference between these two diseases is that in CLL the cells are found mostly in the blood and bone marrow while in SLL, the cells are mainly found in the lymph nodes. As well, duvelisib obtained accelerated approval for the treatment of adult patients with relapsed or refractory follicular lymphoma after at least two prior systemic therapies. This approval is still under the status of continued approval and it is restrained to confirmatory trials. The follicular lymphoma is a B-cell lymphoma that clusters in the lymph nodes or other tissues. Treatment of mature B cell malignancies Copiktra monotherapy is indicated for the treatment of adult patients with Relapsed or refractory chronic lymphocytic leukemia (CLL) after at least two prior therapies, Follicular lymphoma (FL) that is refractory to at least two prior systemic therapies. Duvelisib is indicated for the treatment of relapsed or refractory chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) in adult patients who have trialed at least two prior therapies. Duvelisib is an inhibitor of phosphatidylinositol 3-kinase delta and gamma used to treat relapsed or refractory chronic lymphocytic leukemia or small lymphocytic lymphoma. Refractory Small Lymphocytic Lymphoma Relapsed Chronic Lymphocytic Leukemia Refractory Chronic Lymphocytic Leukemia (CLL) Relapsed Small Lymphocytic Lymphoma Contraindications a bad infection low levels of a type of white blood cell called neutrophils a type of inflammation of the lung called interstitial pneumonitis inflammation of the large intestine abnormal liver function tests pregnancy a patient who is producing milk and breastfeeding Dosage Strengths: 15 mg; 25 mg Chronic Lymphocytic Leukemia 25 mg orally 2 times a day in 28-day cycles until unacceptable toxicity or progressive disease If a dose is missed by fewer than 6 hours, take the missed dose right away and take the next dose as usual. If a dose is missed by more than 6 hours, wait and take the next dose at the usual time. Provide prophylaxis for Pneumocystis jirovecii (PJP) during therapy with this drug. Withhold therapy in patients with suspected PJP of any Grade and discontinue if PJP is confirmed. Consider prophylactic antivirals during therapy to prevent cytomegalovirus (CMV) infection/reactivation. Dose Adjustments DOSE MODIFICATION LEVELS: Initial dose: 25 mg orally 2 times a day Dose reduction: 15 mg orally 2 times a day Subsequent dose modification: Discontinue therapy if the patient is unable to tolerate 15 mg orally 2 times a day. Nonhematologic Adverse Reactions: INFECTION: Grade 3 or greater infection: Withhold therapy until resolved; resume at the same or reduced dose. CMV infection or viremia (positive PCR or antigen test): Withhold therapy until resolved; resume at the same or reduced dose; if therapy is resumed, monitor for CMV reactivation (by PCR or antigen test) monthly. Pneumocystis jiroveci pneumonia (PJP): For suspected PJP, withhold therapy until evaluated; for confirmed PJP, discontinue therapy. NON-INFECTIOUS DIARRHEA OR COLITIS: Mild/moderate diarrhea (Grade 1 or 2, up to 6 stools per day over baseline) and responsive to antidiarrheal agents, OR asymptomatic (Grade 1) colitis: Maintain current dose; initiate antidiarrheals if needed; monitor weekly until resolved. Mild/moderate diarrhea (Grade 1 or 2, up to 6 stools per day over baseline) and unresponsive to antidiarrheals: Withhold therapy until resolved; initiate enteric-acting steroids (e.g., budesonide); monitor weekly until resolved; resume at a reduced dose. Abdominal pain, stool with mucus or blood, change in bowel habits, peritoneal signs, OR severe diarrhea (Grade 3, greater than 6 stools per day over baseline): Withhold therapy until resolved; initiate enteric acting steroids (e.g., budesonide) or systemic steroids; monitor weekly until resolved; resume at a reduced dose. For life-threatening recurrent Grade 3 diarrhea or recurrent colitis of any Grade, discontinue therapy. CUTANEOUS REACTIONS: Grade 1 to 2: Maintain dose; initiate emollients, antihistamines, or topical steroids; monitor closely. Grade 3: Withhold therapy until resolved; initiate emollients, antihistamines, or topical steroids; monitor weekly until resolved; resume at a reduced dose. If a severe cutaneous reaction does not improve, worsens, recurs, or becomes life-threatening, discontinue therapy. SJS, TEN, DRESS (any Grade): Discontinue therapy. PNEUMONITIS WITHOUT SUSPECTED INFECTIOUS CAUSE: Moderate (Grade 2) symptomatic pneumonitis: Withhold therapy; initiate systemic steroids; if pneumonitis recovers to Grade 0 or 1, resume therapy at a reduced dose; if non-infectious pneumonitis recurs or the patient does not respond to steroid therapy, discontinue this drug. Severe (Grade 3) or life-threatening pneumonitis: Discontinue therapy; initiate systemic steroids. ALT/AST ELEVATION: Grade 2 (3 to 5 x upper limit of normal [ULN]): Maintain dose; monitor weekly until recovery to less than 3 x ULN. Grade 3 (greater than 5 to 20 x ULN: Withhold therapy and monitor weekly until recovery to less than 3 x ULN; resume at the same dose (first occurrence) or reduce dose for subsequent occurrences. Grade 4 (greater than 20 x ULN: Discontinue therapy. Hematologic Adverse Reactions: NEUTROPENIA: Absolute neutrophil count (ANC) 0.5 to 1 Gi/L: Maintain dose; monitor ANC weekly. ANC less than 0.5 Gi/L: Withhold therapy; monitor ANC until greater than 0.5 Gi/L; resume at the same dose (first occurrence) or reduce dose for subsequent occurrences. THROMBOCYTOPENIA: Grade 3 (platelet count 25 to less than 50 Gi/L with Grade 1 bleeding: Maintain dose; monitor platelet counts weekly. Grade 3 (platelet count 25 to less than 50 Gi/L with Grade 2 bleeding or Grade 4 (platelet count less than 25 Gi/L): Withhold therapy; monitor platelet count until 25 Gi/L or greater and resolution of bleeding; resume at the same dose (first occurrence) or reduce dose for subsequent occurrences. Dose Modification for Concomitant Use with CYP450 3A4 Inhibitors: When given with strong CYP450 3A4 inhibitors (e.g., ketoconazole), reduce the dose of this drug to 15 mg orally 2 times a day. Administration advice: This drug may be taken with or without food. Capsules should be swallowed whole, not opened, broken, or chewed. Side Effects The Most Common nausea vomiting constipation tiredness headache muscle or joint pain yellow eyes or skin; abdominal pain; unexplained bruising or bleeding; loss of appetite; yellow or brown-colored urine; pale stools; pain in the upper right part of the stomach low blood cell counts; bone pain, muscle pain; fever, cough, tiredness; or cold symptoms such as stuffy nose, sneezing, and sore throat. More Common abdominal pain appetite change back pain blurred vision constipation diarrhea dizziness dry mouth excessive sweating headache heartburn joint pain muscle aches and pain nausea pain in the arms and legs skin redness tiredness vomiting weight changes chest pain fainting fever high blood pressure Rare mouth sores numbness, tingling, muscle weakness, and pain rash ringing, buzzing, hissing, or clicking sounds in the ears shortness of breath signs of anemia (low red blood cells; e.g., dizziness, pale skin, unusual tiredness or weakness, shortness of breath) signs of clotting problems (e.g., unusual nosebleeds, bruising, blood in urine, coughing blood, bleeding gums, cuts that don’t stop bleeding) signs of depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide) signs of infection (symptoms may include fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness) swollen hands, feet, or joints symptoms of fluid around the lungs (e.g., chest pain, difficult or painful breathing, cough) symptoms of irregular heartbeat (e.g., chest pain, dizziness, rapid, pounding heartbeat, shortness of breath) symptoms of a lung infection (LRTI) (e.g., shortness of breath, cough, chest pain) symptoms of skin cancer (e.g., skin sore, wart, or bump that does not heal) symptoms of a urinary tract infection (e.g., pain when urinating, urinating more often than usual, low back or flank pain) symptoms of fluid around the lungs (e.g., chest pain, painful breathing, cough) waking up in the night to urinate signs of bleeding in the stomach (e.g., bloody, black, or tarry stools; spitting up of blood; vomiting blood or material that looks like coffee grounds) signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat) Drug Interaction DRUG INTERACTION Abametapir The serum concentration of Duvelisib can be increased when it is combined with Abametapir. Abatacept The metabolism of Duvelisib can be increased when combined with Abatacept. Abemaciclib The metabolism of Abemaciclib can be decreased when combined with Duvelisib. Abrocitinib The serum concentration of Duvelisib can be increased when it is combined with Abrocitinib. Acalabrutinib The metabolism of Acalabrutinib can be decreased when combined with Duvelisib. Acenocoumarol The metabolism of Acenocoumarol can be decreased when combined with Duvelisib. Acetaminophen The metabolism of Duvelisib can be increased when combined with Acetaminophen. Acetazolamide The metabolism of Duvelisib can be decreased when combined with Acetazolamide. Adalimumab The metabolism of Duvelisib can be increased when combined with Adalimumab. Afatinib Afatinib may decrease the excretion rate of Duvelisib which could result in a higher serum level. Albendazole The metabolism of Duvelisib can be decreased when combined with Albendazole. Aldesleukin The metabolism of Duvelisib can be decreased when combined with Aldesleukin. Alectinib The metabolism of Alectinib can be decreased when combined with Duvelisib. Alpelisib The metabolism of Alpelisib can be decreased when combined with Duvelisib. Ambrisentan The serum concentration of Duvelisib can be increased when it is combined with Ambrisentan. Aminoglutethimide The metabolism of Duvelisib can be increased when combined with Aminoglutethimide. Aminophylline The metabolism of Aminophylline can be decreased when combined with Duvelisib. Amiodarone The metabolism of Duvelisib can be decreased when combined with Amiodarone. Amobarbital The metabolism of Duvelisib can be increased when combined with Amobarbital. Amprenavir The metabolism of Duvelisib can be decreased when combined with Amprenavir. Anakinra The metabolism of Duvelisib can be increased when combined with Anakinra. Apalutamide The serum concentration of Duvelisib can be decreased when it is combined with Apalutamide. Apixaban The serum concentration of Duvelisib can be increased when it is combined with Apixaban. Apremilast The metabolism of Duvelisib can be increased when combined with Apremilast. Aprepitant The metabolism of Duvelisib can be decreased when combined with Aprepitant. Armodafinil The metabolism of Duvelisib can be increased when combined with Armodafinil. Arsenic trioxide The serum concentration of Duvelisib can be increased when it is combined with Arsenic trioxide. Articaine The risk or severity of methemoglobinemia can be increased when Duvelisib is combined with Articaine. Asciminib The serum concentration of Duvelisib can be increased when it is combined with Asciminib. Astemizole The metabolism of Astemizole can be decreased when combined with Duvelisib. Asunaprevir The serum concentration of Duvelisib can be increased when it is combined with Asunaprevir. Atazanavir The metabolism of Duvelisib can be decreased when combined with Atazanavir. Avacopan The metabolism of Duvelisib can be decreased when combined with Avacopan. Avanafil The serum concentration of Avanafil can be increased when it is combined with Duvelisib. Avatrombopag Avatrombopag may decrease the excretion rate of Duvelisib which could result in a higher serum level. Axitinib The metabolism of Axitinib can be decreased when combined with Duvelisib. Azithromycin The metabolism of Duvelisib can be decreased when combined with Azithromycin. Beclomethasone Beclomethasone dipropionate may decrease the excretion rate of Duvelisib which could result in a higher serum level. Belantamab The serum concentration of Belantamab mafodotin can be increased when it is combined with Duvelisib. Belinostat The serum concentration of Duvelisib can be increased when it is combined with Belinostat. Belumosudil Belumosudil may decrease the excretion rate of Duvelisib which could result in a higher serum level. Bendamustine The serum concentration of Bendamustine can be increased when it is combined with Duvelisib. Benzocaine The risk or severity of methemoglobinemia can be increased when Duvelisib is combined with Benzocaine. Benzyl alcohol The risk or severity of methemoglobinemia can be increased when Duvelisib is combined with Benzyl alcohol. Berotralstat The metabolism of Duvelisib can be decreased when combined with Berotralstat. Betamethasone The metabolism of Duvelisib can be increased when combined with Betamethasone. Betamethasone The metabolism of Duvelisib can be increased when combined with Betamethasone phosphate. Betrixaban The serum concentration of Betrixaban can be increased when it is combined with Duvelisib. Bexarotene The metabolism of Duvelisib can be increased when combined with Bexarotene. Bicalutamide The metabolism of Bicalutamide can be decreased when combined with Duvelisib. Bifonazole The metabolism of Duvelisib can be decreased when combined with Bifonazole. Bimekizumab The metabolism of Duvelisib can be increased when combined with Bimekizumab. Binimetinib The serum concentration of Binimetinib can be increased when it is combined with Duvelisib. Bisoprolol The serum concentration of Duvelisib can be increased when it is combined with Bisoprolol. Boceprevir The metabolism of Duvelisib can be decreased when combined with Boceprevir. Bortezomib The metabolism of Bortezomib can be decreased when combined with Duvelisib. Bosentan The metabolism of Duvelisib can be increased when combined with Bosentan. Bosutinib The metabolism of Bosutinib can be decreased when combined with Duvelisib. Brentuximab vedotin The metabolism of Brentuximab vedotin can be decreased when combined with Duvelisib. Brigatinib The metabolism of Brigatinib can be decreased when combined with Duvelisib. Budesonide The metabolism of Duvelisib can be increased when combined with Budesonide. Bupivacaine The risk or severity of methemoglobinemia can be increased when Duvelisib is combined with Bupivacaine. Buprenorphine Buprenorphine may decrease the excretion rate of Duvelisib which could result in a higher serum level. Busulfan The metabolism of Busulfan can be decreased when combined with Duvelisib. Butacaine The risk or severity of methemoglobinemia can be increased when Duvelisib is combined with Butacaine. Butalbital The metabolism of Duvelisib can be increased when combined with Butalbital. Butamben The risk or severity of methemoglobinemia can be increased when Duvelisib is combined with Butamben. Cabazitaxel The metabolism of Cabazitaxel can be decreased when combined with Duvelisib. Cabergoline The metabolism of Cabergoline can be decreased when combined with Duvelisib. Caffeine Caffeine may decrease the excretion rate of Duvelisib which could result in a higher serum level. Calcitriol The metabolism of Duvelisib can be increased when combined with Calcitriol. Canagliflozin The serum concentration of Duvelisib can be increased when it is combined with Canagliflozin. Canakinumab The metabolism of Duvelisib can be increased when combined with Canakinumab. Candicidin The metabolism of Duvelisib can be decreased when combined with Candicidin. Cannabidiol Cannabidiol may decrease the excretion rate of Duvelisib which could result in a higher serum level. Capmatinib The serum concentration of Duvelisib can be increased when it is combined with Capmatinib. Capsaicin The risk or severity of methemoglobinemia can be increased when Duvelisib is combined with Capsaicin. Carbamazepine The metabolism of Duvelisib can be increased when combined with Carbamazepine. Carfilzomib The serum concentration of Duvelisib can be increased when it is combined with Carfilzomib. Carvedilol The serum concentration of Duvelisib can be increased when it is combined with Carvedilol. Cefradine The metabolism of Duvelisib can be increased when combined with Cefradine. Cenobamate The serum concentration of Duvelisib can be decreased when it is combined with Cenobamate. Cephalexin The metabolism of Duvelisib can be decreased when combined with Cephalexin. Ceritinib The metabolism of Ceritinib can be decreased when combined with Duvelisib. Cerivastatin The metabolism of Duvelisib can be increased when combined with Cerivastatin. Certolizumab pegol The metabolism of Duvelisib can be increased when combined with Certolizumab pegol. Chloramphenicol The metabolism of Duvelisib can be decreased when combined with Chloramphenicol. Chloroprocaine The risk or severity of methemoglobinemia can be increased when Duvelisib is combined with Chloroprocaine. Chlorpromazine The metabolism of Duvelisib can be increased when combined with Chlorpromazine. Cholesterol Cholesterol may increase the excretion rate of Duvelisib which could result in a lower serum level and potentially a reduction in efficacy. Cimetidine The metabolism of Duvelisib can be decreased when combined with Cimetidine. Cinchocaine The risk or severity of methemoglobinemia can be increased when Duvelisib is combined with Cinchocaine. Ciprofloxacin The metabolism of Duvelisib can be decreased when combined with Ciprofloxacin. Cisapride The metabolism of Duvelisib can be decreased when combined with Cisapride. Citalopram The metabolism of Duvelisib can be decreased when combined with Citalopram. Clarithromycin The metabolism of Duvelisib can be decreased when combined with Clarithromycin. Clevidipine The metabolism of Duvelisib can be increased when combined with Clevidipine. Clobazam The metabolism of Duvelisib can be increased when combined with Clobazam. Clobetasol The metabolism of Duvelisib can be increased when combined with Clobetasol propionate. Clofazimine Clofazimine may decrease the excretion rate of Duvelisib which could result in a higher serum level. You Might Also Read Flutamide - Uses, Dosage, Side Effects, Interaction Clofibrate The metabolism of Duvelisib can be increased when combined with Clofibrate. Clomifene The serum concentration of Duvelisib can be increased when it is combined with Clomifene. Clomipramine The metabolism of Clomipramine can be decreased when combined with Duvelisib. Clonidine The metabolism of Clonidine can be decreased when combined with Duvelisib. Clozapine The metabolism of Duvelisib can be decreased when combined with Clozapine. Cobicistat The metabolism of Duvelisib can be decreased when combined with Cobicistat. Cobimetinib The metabolism of Cobimetinib can be decreased when combined with Duvelisib. Cocaine The risk or severity of methemoglobinemia can be increased when Duvelisib is combined with Cocaine. Colchicine The serum concentration of Duvelisib can be increased when it is combined with Colchicine. Conivaptan The metabolism of Duvelisib can be decreased when combined with Conivaptan. Copanlisib The metabolism of Copanlisib can be decreased when combined with Duvelisib. Corticotropin The metabolism of Duvelisib can be increased when combined with Corticotropin. Cortisone acetate The metabolism of Duvelisib can be increased when combined with Cortisone acetate. Crizotinib The metabolism of Crizotinib can be decreased when combined with Duvelisib. Curcumin The metabolism of Duvelisib can be decreased when combined with Curcumin. Cyclophosphamide The metabolism of Cyclophosphamide can be decreased when combined with Duvelisib. Cyclosporine The metabolism of Cyclosporine can be decreased when combined with Duvelisib. Cyproterone acetate The metabolism of Duvelisib can be decreased when combined with Cyproterone acetate. Dabigatran etexilate The serum concentration of Duvelisib can be increased when it is combined with Dabigatran etexilate. Dabrafenib The serum concentration of Duvelisib can be decreased when it is combined with Dabrafenib. Daclatasvir Daclatasvir may decrease the excretion rate of Duvelisib which could result in a higher serum level. Dacomitinib The metabolism of Dacomitinib can be decreased when combined with Duvelisib. Dactinomycin The serum concentration of Dactinomycin can be increased when it is combined with Duvelisib. Dalfopristin The metabolism of Duvelisib can be decreased when combined with Dalfopristin. Danazol The metabolism of Duvelisib can be decreased when combined with Danazol. Daptomycin The serum concentration of Duvelisib can be increased when it is combined with Daptomycin. Darbepoetin alfa The risk or severity of Thrombosis can be increased when Darbepoetin alfa is combined with Duvelisib. Darolutamide The serum concentration of Duvelisib can be increased when it is combined with Darolutamide. Darunavir The metabolism of Duvelisib can be decreased when combined with Darunavir. Dasabuvir Dasabuvir may decrease the excretion rate of Duvelisib which could result in a higher serum level. Dasatinib The metabolism of Dasatinib can be decreased when combined with Duvelisib. Daunorubicin The metabolism of Duvelisib can be decreased when combined with Daunorubicin. Deferasirox The metabolism of Duvelisib can be increased when combined with Deferasirox. Deflazacort The metabolism of Duvelisib can be increased when combined with Deflazacort. Delavirdine The metabolism of Duvelisib can be decreased when combined with Delavirdine. Desipramine The metabolism of Duvelisib can be decreased when combined with Desipramine. Desvenlafaxine The metabolism of Duvelisib can be decreased when combined with Desvenlafaxine. Dexamethasone The metabolism of Duvelisib can be increased when combined with Dexamethasone. Dexamethasone acetate The metabolism of Duvelisib can be increased when combined with Dexamethasone acetate. Dextropropoxyphene The metabolism of Duvelisib can be decreased when combined with Dextropropoxyphene. Dicloxacillin The metabolism of Duvelisib can be increased when combined with Dicloxacillin. Diethylstilbestrol Diethylstilbestrol may decrease the excretion rate of Duvelisib which could result in a higher serum level. Difluocortolone The metabolism of Duvelisib can be increased when combined with Difluocortolone. Digitoxin The metabolism of Digitoxin can be decreased when combined with Duvelisib. Digoxin The serum concentration of Digoxin can be increased when it is combined with Duvelisib. Dihydroergocornine The metabolism of Duvelisib can be decreased when combined with Dihydroergocornine. Dihydroergocristine The metabolism of Dihydroergocristine can be decreased when combined with Duvelisib. Dihydroergotamine The metabolism of Dihydroergotamine can be decreased when combined with Duvelisib. Diltiazem The metabolism of Duvelisib can be decreased when combined with Diltiazem. Dimethyl sulfoxide The metabolism of Duvelisib can be decreased when combined with Dimethyl sulfoxide. Diosmin The serum concentration of Duvelisib can be increased when it is combined with Diosmin. Diphenhydramine The risk or severity of methemoglobinemia can be increased when Duvelisib is combined with Diphenhydramine. Docetaxel The metabolism of Docetaxel can be decreased when combined with Duvelisib. Dofetilide The metabolism of Dofetilide can be decreased when combined with Duvelisib. Dolutegravir The serum concentration of Duvelisib can be increased when it is combined with Dolutegravir. Doxazosin The metabolism of Duvelisib can be decreased when combined with Doxazosin. Doxorubicin The metabolism of Doxorubicin can be decreased when combined with Duvelisib. Dronedarone The metabolism of Dronedarone can be decreased when combined with Duvelisib. Drospirenone The metabolism of Duvelisib can be decreased when combined with Drospirenone. Dyclonine The risk or severity of methemoglobinemia can be increased when Duvelisib is combined with Dyclonine. Ebastine The metabolism of Duvelisib can be decreased when combined with Ebastine. Echinacea The metabolism of Duvelisib can be increased when combined with Echinacea. Edoxaban The serum concentration of Duvelisib can be increased when it is combined with Edoxaban. Efavirenz The metabolism of Duvelisib can be decreased when combined with Efavirenz. Elagolix The serum concentration of Duvelisib can be increased when it is combined with Elagolix. Elbasvir Elbasvir may decrease the excretion rate of Duvelisib which could result in a higher serum level. Elexacaftor The metabolism of Elexacaftor can be decreased when combined with Duvelisib. Eliglustat The serum concentration of Duvelisib can be increased when it is combined with Eliglustat. Eltrombopag Eltrombopag may decrease the excretion rate of Duvelisib which could result in a higher serum level. Elvitegravir The metabolism of Duvelisib can be decreased when combined with Elvitegravir. Emapalumab The metabolism of Duvelisib can be increased when combined with Emapalumab. Enasidenib The metabolism of Enasidenib can be decreased when combined with Duvelisib. Enfortumab vedotin The serum concentration of Enfortumab vedotin can be increased when it is combined with Duvelisib. Entrectinib The metabolism of Entrectinib can be decreased when combined with Duvelisib. Enzalutamide The serum concentration of Duvelisib can be decreased when it is combined with Enzalutamide. Epinephrine The metabolism of Duvelisib can be decreased when combined with Epinephrine. Erdafitinib The serum concentration of Duvelisib can be increased when it is combined with Erdafitinib. Ergotamine The metabolism of Duvelisib can be decreased when combined with Ergotamine. Erlotinib The metabolism of Erlotinib can be decreased when combined with Duvelisib. Ertugliflozin The serum concentration of Duvelisib can be increased when it is combined with Ertugliflozin. Erythromycin The metabolism of Duvelisib can be decreased when combined with Erythromycin. Erythropoietin The risk or severity of Thrombosis can be increased when Erythropoietin is combined with Duvelisib. Esketamine The metabolism of Duvelisib can be increased when combined with Esketamine. Eslicarbazepine The metabolism of Duvelisib can be increased when combined with Eslicarbazepine. Eslicarbazepine acetate The metabolism of Duvelisib can be increased when combined with Eslicarbazepine acetate. Estetrol The metabolism of Estetrol can be decreased when combined with Duvelisib. Estradiol Estradiol may decrease the excretion rate of Duvelisib which could result in a higher serum level. Estradiol acetate Estradiol acetate may decrease the excretion rate of Duvelisib which could result in a higher serum level. Estradiol benzoate Estradiol benzoate may decrease the excretion rate of Duvelisib which could result in a higher serum level. Estradiol cypionate Estradiol cypionate may decrease the excretion rate of Duvelisib which could result in a higher serum level. Estradiol dienanthate Estradiol dienanthate may decrease the excretion rate of Duvelisib which could result in a higher serum level. Estradiol valerate Estradiol valerate may decrease the excretion rate of Duvelisib which could result in a higher serum level. Etanercept The metabolism of Duvelisib can be increased when combined with Etanercept. Ethambutol The metabolism of Duvelisib can be decreased when combined with Ethambutol. Ethanol The metabolism of Duvelisib can be increased when combined with Ethanol. Ethyl chloride The risk or severity of methemoglobinemia can be increased when Duvelisib is combined with Ethyl chloride. Etidocaine The risk or severity of methemoglobinemia can be increased when Duvelisib is combined with Etidocaine. Etoposide The metabolism of Etoposide can be decreased when combined with Duvelisib. Etoricoxib The metabolism of Duvelisib can be decreased when combined with Etoricoxib. Etravirine The metabolism of Duvelisib can be increased when combined with Etravirine. Everolimus The metabolism of Everolimus can be decreased when combined with Duvelisib. Favipiravir The serum concentration of Duvelisib can be increased when it is combined with Favipiravir. Febuxostat The excretion of Duvelisib can be decreased when combined with Febuxostat. Fedratinib Fedratinib may decrease the excretion rate of Duvelisib which could result in a higher serum level. Felbamate The metabolism of Duvelisib can be increased when combined with Felbamate. Fenofibrate The metabolism of Duvelisib can be decreased when combined with Fenofibrate. Fexinidazole The metabolism of Duvelisib can be decreased when combined with Fexinidazole. Fexofenadine The serum concentration of Duvelisib can be increased when it is combined with Fexofenadine. Flibanserin The serum concentration of Duvelisib can be increased when it is combined with Flibanserin. Flucloxacillin The metabolism of Duvelisib can be increased when combined with Flucloxacillin. Fluconazole The metabolism of Duvelisib can be decreased when combined with Fluconazole. Flunisolide The metabolism of Duvelisib can be increased when combined with Flunisolide. Fluocinolone acetonide The metabolism of Duvelisib can be increased when combined with Fluocinolone acetonide. Fluocinonide The metabolism of Duvelisib can be increased when combined with Fluocinonide. Fluocortolone The metabolism of Duvelisib can be increased when combined with Fluocortolone. Fluoxetine The metabolism of Duvelisib can be decreased when combined with Fluoxetine. Fluticasone The metabolism of Duvelisib can be increased when combined with Fluticasone. Fluticasone furoate The metabolism of Duvelisib can be increased when combined with Fluticasone furoate. Fluticasone propionate The metabolism of Duvelisib can be decreased when combined with Fluticasone propionate. Fluvoxamine The metabolism of Duvelisib can be decreased when combined with Fluvoxamine. Formestane The metabolism of Duvelisib can be increased when combined with Formestane. Fosamprenavir The metabolism of Duvelisib can be decreased when combined with Fosamprenavir. Fosaprepitant The metabolism of Duvelisib can be increased when combined with Fosaprepitant. Fosnetupitant The metabolism of Duvelisib can be decreased when combined with Fosnetupitant. Fosphenytoin The metabolism of Duvelisib can be increased when combined with Fosphenytoin. Fostamatinib Fostamatinib may decrease the excretion rate of Duvelisib which could result in a higher serum level. Fostemsavir Fostemsavir may decrease the excretion rate of Duvelisib which could result in a higher serum level. Fusidic acid The metabolism of Duvelisib can be decreased when combined with Fusidic acid. Futibatinib The serum concentration of Futibatinib can be increased when it is combined with Duvelisib. Gefitinib Gefitinib may decrease the excretion rate of Duvelisib which could result in a higher serum level. Gemcitabine The serum concentration of Gemcitabine can be increased when it is combined with Duvelisib. Gilteritinib Gilteritinib may decrease the excretion rate of Duvelisib which could result in a higher serum level. Ginkgo biloba The metabolism of Duvelisib can be decreased when combined with Ginkgo biloba. Glasdegib Glasdegib may decrease the excretion rate of Duvelisib which could result in a higher serum level. Glecaprevir Glecaprevir may decrease the excretion rate of Duvelisib which could result in a higher serum level. Glyburide The metabolism of Duvelisib can be decreased when combined with Glyburide. Glycerol The metabolism of Duvelisib can be increased when combined with Glycerol phenylbutyrate. Golimumab The metabolism of Duvelisib can be increased when combined with Golimumab. Grazoprevir Grazoprevir may decrease the excretion rate of Duvelisib which could result in a higher serum level. Griseofulvin The metabolism of Duvelisib can be increased when combined with Griseofulvin. Haloperidol The serum concentration of Haloperidol can be increased when it is combined with Duvelisib. Hydralazine The metabolism of Duvelisib can be decreased when combined with Hydralazine. Hydrocortamate The metabolism of Duvelisib can be increased when combined with Hydrocortamate. Hydrocortisone The metabolism of Duvelisib can be increased when combined with Hydrocortisone. Hydrocortisone The metabolism of Duvelisib can be increased when combined with Hydrocortisone acetate. Hydrocortisone The metabolism of Duvelisib can be increased when combined with Hydrocortisone butyrate. Hydrocortisone The metabolism of Duvelisib can be increased when combined with Hydrocortisone succinate. Idelalisib The metabolism of Idelalisib can be decreased when combined with Duvelisib. Ifosfamide The metabolism of Ifosfamide can be decreased when combined with Duvelisib. Imatinib Imatinib may decrease the excretion rate of Duvelisib which could result in a higher serum level. Imipramine The serum concentration of Imipramine can be increased when it is combined with Duvelisib. Indacaterol The serum concentration of Duvelisib can be increased when it is combined with Indacaterol. Indinavir The metabolism of Duvelisib can be decreased when combined with Indinavir. Infigratinib The metabolism of Duvelisib can be decreased when combined with Infigratinib. Infliximab The metabolism of Duvelisib can be increased when combined with Infliximab. Inotuzumab The serum concentration of Inotuzumab ozogamicin can be increased when it is combined with Duvelisib. Irbesartan The metabolism of Duvelisib can be decreased when combined with Irbesartan. Irinotecan The metabolism of Irinotecan can be decreased when combined with Duvelisib. Isavuconazole The serum concentration of Duvelisib can be increased when it is combined with Isavuconazole. Isavuconazonium The serum concentration of Duvelisib can be increased when it is combined with Isavuconazonium. Isoniazid The metabolism of Duvelisib can be decreased when combined with Isoniazid. Isradipine The metabolism of Duvelisib can be decreased when combined with Isradipine. Istradefylline Istradefylline may decrease the excretion rate of Duvelisib which could result in a higher serum level. Itraconazole The metabolism of Duvelisib can be decreased when combined with Itraconazole. Ivacaftor The serum concentration of Duvelisib can be increased when it is combined with Ivacaftor. Ivosidenib The metabolism of Duvelisib can be increased when combined with Ivosidenib. Ixabepilone The metabolism of Ixabepilone can be decreased when combined with Duvelisib. Ixazomib The metabolism of Ixazomib can be decreased when combined with Duvelisib. Ketazolam The metabolism of Duvelisib can be decreased when combined with Ketazolam. Ketoconazole The metabolism of Duvelisib can be decreased when combined with Ketoconazole. Lacosamide The metabolism of Duvelisib can be decreased when combined with Lacosamide. Lanreotide The metabolism of Duvelisib can be decreased when combined with Lanreotide. Lansoprazole Lansoprazole may decrease the excretion rate of Duvelisib which could result in a higher serum level. Lapatinib The serum concentration of Duvelisib can be increased when it is combined with Lapatinib. Larotrectinib The serum concentration of Larotrectinib can be increased when it is combined with Duvelisib. Lasmiditan The serum concentration of Duvelisib can be increased when it is combined with Lasmiditan. Ledipasvir Ledipasvir may decrease the excretion rate of Duvelisib which could result in a higher serum level. Lefamulin The metabolism of Lefamulin can be decreased when combined with Duvelisib. Lemborexant The serum concentration of Duvelisib can be increased when it is combined with Lemborexant. Lenvatinib The serum concentration of Duvelisib can be increased when it is combined with Lenvatinib. Lesinurad The metabolism of Duvelisib can be increased when combined with Lesinurad. Letermovir Letermovir may decrease the excretion rate of Duvelisib which could result in a higher serum level. Levacetylmethadol The metabolism of Levacetylmethadol can be decreased when combined with Duvelisib. Levobupivacaine The risk or severity of methemoglobinemia can be increased when Duvelisib is combined with Levobupivacaine. Levoketoconazole The metabolism of Duvelisib can be decreased when combined with Levoketoconazole. Lidocaine The risk or severity of methemoglobinemia can be increased when Duvelisib is combined with Lidocaine. Linagliptin The metabolism of Duvelisib can be decreased when combined with Linagliptin. Lomitapide The metabolism of Lomitapide can be decreased when combined with Duvelisib. Lonafarnib The metabolism of Duvelisib can be decreased when combined with Lonafarnib. Loncastuximab The serum concentration of Loncastuximab tesirine can be increased when it is combined with Duvelisib. Loperamide The serum concentration of Duvelisib can be increased when it is combined with Loperamide. Lopinavir The metabolism of Duvelisib can be decreased when combined with Lopinavir. Lorlatinib The metabolism of Duvelisib can be increased when combined with Lorlatinib. Losartan The metabolism of Duvelisib can be decreased when combined with Losartan. Lovastatin The metabolism of Duvelisib can be decreased when combined with Lovastatin. Loxapine The serum concentration of Duvelisib can be increased when it is combined with Loxapine. Lumacaftor The serum concentration of Duvelisib can be decreased when it is combined with Lumacaftor. Lusutrombopag The serum concentration of Lusutrombopag can be increased when it is combined with Duvelisib. Manidipine The metabolism of Duvelisib can be decreased when combined with Manidipine. Mannitol The serum concentration of Duvelisib can be increased when it is combined with Mannitol. You Might Also Read Cefdaloxime Antibiotic; Mechanism, Uses, Dosage, Side effects, Interaction Mavacamten The serum concentration of Duvelisib can be decreased when it is combined with Mavacamten. Medroxyprogesterone The metabolism of Duvelisib can be increased when combined with Medroxyprogesterone acetate. Mefloquine The serum concentration of Duvelisib can be increased when it is combined with Mefloquine. Meloxicam The risk or severity of methemoglobinemia can be increased when Duvelisib is combined with Meloxicam. Meperidine The metabolism of Duvelisib can be decreased when combined with Meperidine. Mepivacaine The risk or severity of methemoglobinemia can be increased when Duvelisib is combined with Mepivacaine. Meprednisone The metabolism of Duvelisib can be increased when combined with Meprednisone. Methadone The metabolism of Duvelisib can be decreased when combined with Methadone. Methimazole The metabolism of Duvelisib can be decreased when combined with Methimazole. Methotrexate The metabolism of Methotrexate can be decreased when combined with Duvelisib. Methoxy polyethylene The risk or severity of Thrombosis can be increased when Methoxy polyethylene glycol-epoetin beta is combined with Duvelisib. Methylene blue The serum concentration of Duvelisib can be increased when it is combined with Methylene blue. Methylergometrine The metabolism of Duvelisib can be decreased when combined with Methylergometrine. Methylphenobarbital The metabolism of Duvelisib can be increased when combined with Methylphenobarbital. Methylprednisolone The metabolism of Duvelisib can be increased when combined with Methylprednisolone. Methylprednisone The metabolism of Methylprednisone can be decreased when combined with Duvelisib. Methysergide The metabolism of Duvelisib can be decreased when combined with Methysergide. Metreleptin The metabolism of Duvelisib can be increased when combined with Metreleptin. Metronidazole The metabolism of Duvelisib can be decreased when combined with Metronidazole. Metyrapone The metabolism of Duvelisib can be increased when combined with Metyrapone. Miconazole The metabolism of Duvelisib can be decreased when combined with Miconazole. Midazolam The metabolism of Duvelisib can be decreased when combined with Midazolam. Midostaurin The metabolism of Duvelisib can be decreased when combined with Midostaurin. Mifepristone The serum concentration of Duvelisib can be increased when it is combined with Mifepristone. Milnacipran The metabolism of Duvelisib can be decreased when combined with Milnacipran. Miocamycin The metabolism of Duvelisib can be decreased when combined with Miocamycin. Mirabegron The serum concentration of Duvelisib can be increased when it is combined with Mirabegron. Mirtazapine The metabolism of Duvelisib can be decreased when combined with Mirtazapine. Mitapivat The serum concentration of Duvelisib can be increased when it is combined with Mitapivat. Mitotane The metabolism of Duvelisib can be increased when combined with Mitotane. Modafinil The metabolism of Duvelisib can be increased when combined with Modafinil. Mometasone The metabolism of Duvelisib can be increased when combined with Mometasone furoate. Morphine The serum concentration of Duvelisib can be increased when it is combined with Morphine. Nafcillin The metabolism of Duvelisib can be increased when combined with Nafcillin. Naloxone The metabolism of Duvelisib can be decreased when combined with Naloxone. Nefazodone The metabolism of Duvelisib can be decreased when combined with Nefazodone. Nelfinavir The metabolism of Duvelisib can be decreased when combined with Nelfinavir. Neratinib The metabolism of Neratinib can be decreased when combined with Duvelisib. Netupitant The metabolism of Duvelisib can be decreased when combined with Netupitant. Niacin The metabolism of Duvelisib can be decreased when combined with Niacin. Nicardipine The metabolism of Duvelisib can be decreased when combined with Nicardipine. Nilotinib The metabolism of Duvelisib can be decreased when combined with Nilotinib. Nilvadipine The metabolism of Duvelisib can be decreased when combined with Nilvadipine. Nintedanib The metabolism of Duvelisib can be decreased when combined with Nintedanib. Norethisterone The metabolism of Duvelisib can be decreased when combined with Norethisterone. Norgestimate The serum concentration of Duvelisib can be increased when it is combined with Norgestimate. Nortriptyline The metabolism of Nortriptyline can be decreased when combined with Duvelisib. Noscapine The metabolism of Duvelisib can be decreased when combined with Noscapine. Novobiocin Novobiocin may decrease the excretion rate of Duvelisib which could result in a higher serum level. Octreotide The metabolism of Duvelisib can be decreased when combined with Octreotide. Olaparib The metabolism of Olaparib can be decreased when combined with Duvelisib. Omadacycline The serum concentration of Omadacycline can be increased when it is combined with Duvelisib. Ombitasvir The serum concentration of Duvelisib can be increased when it is combined with Ombitasvir. Omeprazole Omeprazole may decrease the excretion rate of Duvelisib which could result in a higher serum level. Oritavancin The metabolism of Duvelisib can be increased when combined with Oritavancin. Orphenadrine The metabolism of Duvelisib can be decreased when combined with Orphenadrine. Osilodrostat The metabolism of Duvelisib can be decreased when combined with Osilodrostat. Osimertinib The metabolism of Osimertinib can be decreased when combined with Duvelisib. Oteseconazole The serum concentration of Duvelisib can be increased when it is combined with Oteseconazole. Oxcarbazepine The metabolism of Duvelisib can be increased when combined with Oxcarbazepine. Oxetacaine The risk or severity of methemoglobinemia can be increased when Duvelisib is combined with Oxetacaine. Oxybuprocaine The risk or severity of methemoglobinemia can be increased when Duvelisib is combined with Oxybuprocaine. Oxybutynin The metabolism of Duvelisib can be decreased when combined with Oxybutynin. Paclitaxel The metabolism of Paclitaxel can be decreased when combined with Duvelisib. Pacritinib The serum concentration of Duvelisib can be increased when it is combined with Pacritinib. Palbociclib The metabolism of Palbociclib can be decreased when combined with Duvelisib. Paliperidone The serum concentration of Duvelisib can be increased when it is combined with Paliperidone. Panobinostat The metabolism of Panobinostat can be decreased when combined with Duvelisib. Pantoprazole Pantoprazole may decrease the excretion rate of Duvelisib which could result in a higher serum level. Paritaprevir Paritaprevir may decrease the excretion rate of Duvelisib which could result in a higher serum level. Pasireotide The metabolism of Duvelisib can be decreased when combined with Pasireotide. Pazopanib The metabolism of Pazopanib can be decreased when combined with Duvelisib. Peginesatide The risk or severity of Thrombosis can be increased when Peginesatide is combined with Duvelisib. Pentobarbital The metabolism of Duvelisib can be increased when combined with Pentobarbital. Perampanel The metabolism of Duvelisib can be increased when combined with Perampanel. Pexidartinib The metabolism of Pexidartinib can be decreased when combined with Duvelisib. Phenobarbital The metabolism of Duvelisib can be increased when combined with Phenobarbital. Phenol The risk or severity of methemoglobinemia can be increased when Duvelisib is combined with Phenol. Phenprocoumon The metabolism of Phenprocoumon can be decreased when combined with Duvelisib. Phenylbutazone The metabolism of Duvelisib can be increased when combined with Phenylbutazone. Phenytoin The metabolism of Duvelisib can be increased when combined with Phenytoin. Pibrentasvir Pibrentasvir may decrease the excretion rate of Duvelisib which could result in a higher serum level. Pimavanserin The metabolism of Duvelisib can be decreased when combined with Pimavanserin. Pimozide The metabolism of Pimozide can be decreased when combined with Duvelisib. Piperaquine The metabolism of Duvelisib can be decreased when combined with Piperaquine. Pitolisant The serum concentration of Duvelisib can be decreased when it is combined with Pitolisant. Pomalidomide The metabolism of Pomalidomide can be decreased when combined with Duvelisib. Ponatinib The metabolism of Ponatinib can be decreased when combined with Duvelisib. Posaconazole The metabolism of Duvelisib can be decreased when combined with Posaconazole. Pralsetinib Pralsetinib may decrease the excretion rate of Duvelisib which could result in a higher serum level. Pramocaine The risk or severity of methemoglobinemia can be increased when Duvelisib is combined with Pramocaine. Pravastatin Pravastatin may decrease the excretion rate of Duvelisib which could result in a higher serum level. Prednisolone The metabolism of Duvelisib can be increased when combined with Prednisolone. Prednisolone acetate The metabolism of Duvelisib can be increased when combined with Prednisolone acetate. Prednisolone phosphate The metabolism of Duvelisib can be increased when combined with Prednisolone phosphate. Prednisone acetate The metabolism of Duvelisib can be increased when combined with Prednisone acetate. Pretomanid The metabolism of Duvelisib can be decreased when combined with Pretomanid. Prilocaine The risk or severity of methemoglobinemia can be increased when Duvelisib is combined with Prilocaine. Primaquine The metabolism of Duvelisib can be decreased when combined with Primaquine. Procaine The risk or severity of methemoglobinemia can be increased when Duvelisib is combined with Procaine. Progesterone Progesterone may decrease the excretion rate of Duvelisib which could result in a higher serum level. Propafenone The serum concentration of Duvelisib can be increased when it is combined with Propafenone. Proparacaine The risk or severity of methemoglobinemia can be increased when Duvelisib is combined with Proparacaine. Propofol The metabolism of Duvelisib can be decreased when combined with Propofol. Propoxycaine The risk or severity of methemoglobinemia can be increased when Duvelisib is combined with Propoxycaine. Quinidine The metabolism of Quinidine can be decreased when combined with Duvelisib. Quinine The serum concentration of Duvelisib can be increased when it is combined with Quinine. Quinupristin The metabolism of Duvelisib can be decreased when combined with Quinupristin. Rabeprazole Rabeprazole may decrease the excretion rate of Duvelisib which could result in a higher serum level. Raloxifene The metabolism of Duvelisib can be decreased when combined with Raloxifene. Ranolazine The serum concentration of Duvelisib can be increased when it is combined with Ranolazine. Regorafenib The metabolism of Regorafenib can be decreased when combined with Duvelisib. Relugolix The serum concentration of Duvelisib can be increased when it is combined with Relugolix. Remdesivir The metabolism of Duvelisib can be decreased when combined with Remdesivir. Reserpine The serum concentration of Duvelisib can be increased when it is combined with Reserpine. Revefenacin The serum concentration of Duvelisib can be increased when it is combined with Revefenacin. Ribociclib The metabolism of Duvelisib can be decreased when combined with Ribociclib. Rifabutin The metabolism of Duvelisib can be increased when combined with Rifabutin. Rifampicin The metabolism of Duvelisib can be increased when combined with Rifampicin. Rifamycin The metabolism of Duvelisib can be increased when combined with Rifamycin. Rifapentine The metabolism of Duvelisib can be increased when combined with Rifapentine. Rilonacept The metabolism of Duvelisib can be increased when combined with Rilonacept. Rilpivirine Rilpivirine may decrease the excretion rate of Duvelisib which could result in a higher serum level. Rimegepant The serum concentration of Rimegepant can be increased when it is combined with Duvelisib. Riociguat The serum concentration of Duvelisib can be increased when it is combined with Riociguat. Ripretinib Ripretinib may decrease the excretion rate of Duvelisib which could result in a higher serum level. Ritonavir The metabolism of Duvelisib can be decreased when combined with Ritonavir. Rivaroxaban The serum concentration of Duvelisib can be increased when it is combined with Rivaroxaban. Rofecoxib The metabolism of Duvelisib can be increased when combined with Rofecoxib. Roflumilast The metabolism of Duvelisib can be decreased when combined with Roflumilast. Rolapitant Rolapitant may decrease the excretion rate of Duvelisib which could result in a higher serum level. Romidepsin The metabolism of Romidepsin can be decreased when combined with Duvelisib. Ropivacaine The risk or severity of methemoglobinemia can be increased when Duvelisib is combined with Ropivacaine. Rosuvastatin The metabolism of Duvelisib can be decreased when combined with Rosuvastatin. Roxadustat The serum concentration of Duvelisib can be increased when it is combined with Roxadustat. Roxithromycin The metabolism of Duvelisib can be decreased when combined with Roxithromycin. Rucaparib Rucaparib may decrease the excretion rate of Duvelisib which could result in a higher serum level. Rufinamide The metabolism of Duvelisib can be increased when combined with Rufinamide. Ruxolitinib The metabolism of Ruxolitinib can be decreased when combined with Duvelisib. Safinamide Safinamide may decrease the excretion rate of Duvelisib which could result in a higher serum level. Sapropterin The serum concentration of Duvelisib can be increased when it is combined with Sapropterin. Saquinavir The metabolism of Duvelisib can be decreased when combined with Saquinavir. Sarecycline The serum concentration of Duvelisib can be increased when it is combined with Sarecycline. Sarilumab The metabolism of Duvelisib can be increased when combined with Sarilumab. Satralizumab The serum concentration of Duvelisib can be decreased when it is combined with Satralizumab. Secobarbital The metabolism of Duvelisib can be increased when combined with Secobarbital. Secukinumab The metabolism of Duvelisib can be increased when combined with Secukinumab. Selexipag The serum concentration of Duvelisib can be increased when it is combined with Selexipag. Selumetinib The serum concentration of Duvelisib can be increased when it is combined with Selumetinib. Sildenafil The serum concentration of Duvelisib can be increased when it is combined with Sildenafil. Silodosin The serum concentration of Duvelisib can be increased when it is combined with Silodosin. Siltuximab The metabolism of Duvelisib can be increased when combined with Siltuximab. Simeprevir The metabolism of Duvelisib can be decreased when combined with Simeprevir. Simvastatin The serum concentration of Duvelisib can be increased when it is combined with Simvastatin. Siponimod The metabolism of Siponimod can be decreased when combined with Duvelisib. Sirolimus The metabolism of Sirolimus can be decreased when combined with Duvelisib. Sitagliptin The serum concentration of Duvelisib can be increased when it is combined with Sitagliptin. Sitaxentan The metabolism of Duvelisib can be decreased when combined with Sitaxentan. Sofosbuvir The serum concentration of Duvelisib can be increased when it is combined with Sofosbuvir. Somatostatin The metabolism of Duvelisib can be decreased when combined with Somatostatin. Somatrogon The metabolism of Duvelisib can be increased when combined with Somatrogon. Sonidegib The metabolism of Sonidegib can be decreased when combined with Duvelisib. Sorafenib The metabolism of Sorafenib can be decreased when combined with Duvelisib. Sotagliflozin Sotagliflozin may decrease the excretion rate of Duvelisib which could result in a higher serum level. Sotorasib The serum concentration of Duvelisib can be decreased when it is combined with Sotorasib. St. John’s Wort The metabolism of Duvelisib can be increased when combined with St. John’s Wort. Stiripentol The metabolism of Duvelisib can be decreased when combined with Stiripentol. Sulfamethoxazole The metabolism of Duvelisib can be decreased when combined with Sulfamethoxazole. Sulfasalazine Sulfasalazine may decrease the excretion rate of Duvelisib which could result in a higher serum level. Sulfinpyrazone The metabolism of Duvelisib can be increased when combined with Sulfinpyrazone. Sunitinib The metabolism of Sunitinib can be decreased when combined with Duvelisib. Suvorexant The serum concentration of Duvelisib can be increased when it is combined with Suvorexant. Tacrolimus The metabolism of Tacrolimus can be decreased when combined with Duvelisib. Tafamidis The serum concentration of Duvelisib can be increased when it is combined with Tafamidis. Talazoparib The serum concentration of Talazoparib can be increased when it is combined with Duvelisib. Tamoxifen The metabolism of Tamoxifen can be decreased when combined with Duvelisib. Tasimelteon The metabolism of Duvelisib can be decreased when combined with Tasimelteon. Taurocholic acid Taurocholic acid may decrease the excretion rate of Duvelisib which could result in a higher serum level. Tazemetostat The metabolism of Tazemetostat can be decreased when combined with Duvelisib. Technetium The serum concentration of Duvelisib can be increased when it is combined with Technetium Tc-99m sestamibi. Tecovirimat The metabolism of Duvelisib can be increased when combined with Tecovirimat. Tegaserod The serum concentration of Duvelisib can be increased when it is combined with Tegaserod. Telaprevir The metabolism of Duvelisib can be decreased when combined with Telaprevir. Telithromycin The metabolism of Duvelisib can be decreased when combined with Telithromycin. Telmisartan Telmisartan may decrease the excretion rate of Duvelisib which could result in a higher serum level. Telotristat ethyl The serum concentration of Duvelisib can be decreased when it is combined with Telotristat ethyl. Temsirolimus The metabolism of Temsirolimus can be decreased when combined with Duvelisib. Teniposide The metabolism of Teniposide can be decreased when combined with Duvelisib. Tenofovir alafenamide The metabolism of Duvelisib can be decreased when combined with Tenofovir alafenamide. Tenofovir disoproxil The serum concentration of Duvelisib can be increased when it is combined with Tenofovir disoproxil. Tepotinib The serum concentration of Duvelisib can be increased when it is combined with Tepotinib. Terbinafine The metabolism of Duvelisib can be increased when combined with Terbinafine. Terfenadine The metabolism of Duvelisib can be decreased when combined with Terfenadine. Teriflunomide Teriflunomide may decrease the excretion rate of Duvelisib which could result in a higher serum level. Testosterone The metabolism of Duvelisib can be increased when combined with Testosterone. Tetracaine The risk or severity of methemoglobinemia can be increased when Duvelisib is combined with Tetracaine. Tetracycline The metabolism of Duvelisib can be decreased when combined with Tetracycline. You Might Also Read Dutasteride Contraindications, Pregnancy Category Theophylline The metabolism of Theophylline can be decreased when combined with Duvelisib. Thiamylal The metabolism of Duvelisib can be increased when combined with Thiamylal. Thiotepa The metabolism of Thiotepa can be decreased when combined with Duvelisib. Ticagrelor The serum concentration of Duvelisib can be increased when it is combined with Ticagrelor. Tipranavir The metabolism of Duvelisib can be decreased when combined with Tipranavir. Tivozanib Tivozanib may decrease the excretion rate of Duvelisib which could result in a higher serum level. Tocilizumab The metabolism of Duvelisib can be increased when combined with Tocilizumab. Tolvaptan The metabolism of Tolvaptan can be decreased when combined with Duvelisib. Topiramate The metabolism of Duvelisib can be increased when combined with Topiramate. Topotecan The serum concentration of Topotecan can be increased when it is combined with Duvelisib. Toremifene The serum concentration of Duvelisib can be increased when it is combined with Toremifene. Trabectedin The metabolism of Trabectedin can be decreased when combined with Duvelisib. Trastuzumab emtansine The metabolism of Trastuzumab emtansine can be decreased when combined with Duvelisib. Triamcinolone The metabolism of Duvelisib can be increased when combined with Triamcinolone. Triclabendazole The metabolism of Duvelisib can be decreased when combined with Triclabendazole. Trilaciclib The serum concentration of Trilaciclib can be increased when it is combined with Duvelisib. Trimipramine The serum concentration of Trimipramine can be increased when it is combined with Duvelisib. Troglitazone The metabolism of Duvelisib can be increased when combined with Troglitazone. Troleandomycin The metabolism of Duvelisib can be decreased when combined with Troleandomycin. Tucatinib Tucatinib may decrease the excretion rate of Duvelisib which could result in a higher serum level. Ubrogepant The serum concentration of Ubrogepant can be increased when it is combined with Duvelisib. Umbralisib The serum concentration of Duvelisib can be increased when it is combined with Umbralisib. Umeclidinium The serum concentration of Duvelisib can be increased when it is combined with Umeclidinium. Valproic acid The metabolism of Duvelisib can be decreased when combined with Valproic acid. Vandetanib The metabolism of Vandetanib can be decreased when combined with Duvelisib. Vardenafil The serum concentration of Duvelisib can be increased when it is combined with Vardenafil. Velpatasvir Velpatasvir may decrease the excretion rate of Duvelisib which could result in a higher serum level. Vemurafenib The serum concentration of Duvelisib can be increased when it is combined with Vemurafenib. Venetoclax The metabolism of Venetoclax can be decreased when combined with Duvelisib. Venlafaxine Venlafaxine may increase the excretion rate of Duvelisib which could result in a lower serum level and potentially a reduction in efficacy. Verapamil The metabolism of Duvelisib can be decreased when combined with Verapamil. Viloxazine The metabolism of Duvelisib can be decreased when combined with Viloxazine. Vinblastine The metabolism of Vinblastine can be decreased when combined with Duvelisib. Vincristine The metabolism of Vincristine can be decreased when combined with Duvelisib. Vindesine The metabolism of Vindesine can be decreased when combined with Duvelisib. Vinflunine The metabolism of Vinflunine can be decreased when combined with Duvelisib. Vinorelbine The metabolism of Vinorelbine can be decreased when combined with Duvelisib. Vismodegib Vismodegib may decrease the excretion rate of Duvelisib which could result in a higher serum level. Vitamin E The metabolism of Duvelisib can be increased when combined with Vitamin E. Voclosporin The serum concentration of Duvelisib can be increased when it is combined with Voclosporin. Vorapaxar The serum concentration of Duvelisib can be increased when it is combined with Vorapaxar. Voriconazole The metabolism of Duvelisib can be decreased when combined with Voriconazole. Voxilaprevir Voxilaprevir may decrease the excretion rate of Duvelisib which could result in a higher serum level. Warfarin The metabolism of Warfarin can be decreased when combined with Duvelisib. Zafirlukast The metabolism of Duvelisib can be decreased when combined with Zafirlukast. Zanubrutinib The metabolism of Zanubrutinib can be decreased when combined with Duvelisib. Zimelidine The metabolism of Duvelisib can be decreased when combined with Zimelidine. Ziprasidone The metabolism of Duvelisib can be decreased when combined with Ziprasidone. Zonisamide The serum concentration of Duvelisib can be increased when it is combined with Zonisamide. Zuclopenthixol The metabolism of Duvelisib can be decreased when combined with Zuclopenthixol. Pregnancy and Lactation US FDA pregnancy category: Not assigned. Pregnancy If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential harm to the fetus. Verify negative pregnancy status in females of reproductive potential prior to initiating therapy. Advise females of reproductive potential and males with female partners of reproductive potential to use effective contraception during therapy and for at least one month after the last dose. Lactation This drug may harm a nursing child. Women should not breastfeed while taking this drug and for at least one month after. No information is available on the use of this drug during breastfeeding. Because it is 98% bound to plasma proteins, the amount in milk is likely to be low; however, because of its potential toxicity in the breastfed infant, the manufacturer recommends that breastfeeding be discontinued. How should this medicine be used? Duvelisib comes as a capsule to take by mouth. It is usually taken twice daily with or without food. Take duvelisib at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take duvelisib exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Swallow the capsule whole; do not open, chew, or break them. Your doctor may decrease your dose of duvelisib or tell you to stop taking the medication for a time or permanently if you experience serious side effects during your treatment. This depends on how well the medication works for you and the side effects you experience. Talk to your doctor about how you are feeling during your treatment. Continue to take duvelisib even if you feel well. Do not stop taking duvelisib without talking to your doctor. What special precautions should I follow? Before taking duvelisib, tell your doctor and pharmacist if you are allergic to duvelisib, any other medications, or any of the ingredients in duvelisib capsules. Ask your pharmacist or check the Medication Guide for a list of the ingredients. tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take while taking duvelisib. Your doctor may need to change the doses of your medications or monitor you carefully for side effects. The following nonprescription or herbal products may interact with duvelisib: St. John’s wort. Be sure to let your doctor and pharmacist know that you are taking these medications before you start taking duvelisib. Do not start any of these medications while taking duvelisib without discussing it with your healthcare provider. tell your doctor if you have or have ever had liver disease. tell your doctor if you are pregnant or plan to become pregnant. You must have a pregnancy test before you start taking duvelisib. You should not become pregnant during your treatment with duvelisib. If you are female, you should use birth control to prevent pregnancy during your treatment with duvelisib and at least 1 month after your final dose. If you are a male and your partner can become pregnant, you should use effective birth control during your treatment and for 1 month after your final dose. If you or your partner become pregnant while taking duvelisib, call your doctor immediately. Duvelisib may harm the fetus. tell your doctor if you are breastfeeding. You should not breastfeed while you are taking duvelisib and for at least 1 month after your final dose. References https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/211155s000lbl.pdf https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211155s001lbl.pdf https://pubchem.ncbi.nlm.nih.gov/compound/Duvelisib https://www.cancer.gov/about-cancer/treatment/drugs/duvelisib https://www.webmd.com/drugs/2/drug-176153/duvelisib-oral/details/list-contraindications https://en.wikipedia.org/wiki/Duvelisib https://go.drugbank.com/drugs/DB11952 https://medlineplus.gov/druginfo/meds/a618056.html https://www.drugs.com/mtm/duvelisib.html ChemIDplus LICENSE https://www.nlm.nih.gov/copyright.html Duvelisib [USAN:INN] https://chem.nlm.nih.gov/chemidplus/sid/1201438563 ChemIDplus Chemical Information Classification https://chem.nlm.nih.gov/chemidplus/ DrugBank https://www.drugbank.ca/legal/terms_of_use Duvelisib https://www.drugbank.ca/drugs/DB11952 EPA DSSTox LICENSE https://www.epa.gov/privacy/privacy-act-laws-policies-and-resources Duvelisib https://comptox.epa.gov/dashboard/DTXSID80152697 CompTox Chemicals Dashboard Chemical Lists https://comptox.epa.gov/dashboard/chemical-lists/ European Chemicals Agency (ECHA) https://echa.europa.eu/web/guest/legal-notice 8-chloro-2-phenyl-3-[(1S)-1-(7H-purin-6-ylamino)ethyl]isoquinolin-1(2H)-one https://echa.europa.eu/information-on-chemicals 8-chloro-2-phenyl-3-[(1S)-1-(7H-purin-6-ylamino)ethyl]isoquinolin-1(2H)-one https://echa.europa.eu/information-on-chemicals/cl-inventory-database/-/discli/details/253383 FDA Global Substance Registration System (GSRS) https://www.fda.gov/about-fda/about-website/website-policies#linking DUVELISIB https://gsrs.ncats.nih.gov/ginas/app/beta/substances/610V23S0JI ChEBI 8-chloro-2-phenyl-3-[(1S)-1-(7H-purin-6-ylamino)ethyl]-1-isoquinolinone http://www.ebi.ac.uk/chebi/searchId.do?chebiId=CHEBI:131169 ChEBI Ontology http://www.ebi.ac.uk/chebi/userManualForward.do#ChEBI%20Ontology LiverTox LICENSE https://www.nlm.nih.gov/copyright.html Duvelisib https://www.ncbi.nlm.nih.gov/books/n/livertox/Duvelisib/ NCI Thesaurus (NCIt) https://www.cancer.gov/policies/copyright-reuse https://ncithesaurus.nci.nih.gov/ncitbrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&ns=ncit&code=C99225 NCI Thesaurus Tree https://ncit.nci.nih.gov ChEMBL http://www.ebi.ac.uk/Information/termsofuse.html https://www.ebi.ac.uk/chembl/compound_report_card/CHEMBL3039502/ ChEMBL Protein Target Tree https://www.ebi.ac.uk/chembl/g/#browse/targets Comparative Toxicogenomics Database (CTD) http://ctdbase.org/about/legal.jsp https://ctdbase.org/detail.go?type=chem&acc=C586691 Drug Gene Interaction database (DGIdb) http://www.dgidb.org/downloads https://www.dgidb.org/drugs/DUVELISIB IUPHAR/BPS Guide to PHARMACOLOGY https://www.guidetopharmacology.org/about.jsp#license https://www.guidetopharmacology.org/GRAC/LigandDisplayForward?ligandId=7795 Guide to Pharmacology Target Classification https://www.guidetopharmacology.org/targets.jsp Therapeutic Target Database (TTD) IPI-145 http://idrblab.net/ttd/data/drug/details/D0RU0O ClinicalTrials.gov https://clinicaltrials.gov/ct2/about-site/terms-conditions#Use https://clinicaltrials.gov/ DailyMed LICENSE https://www.nlm.nih.gov/copyright.html DUVELISIB https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=DUVELISIB European Medicines Agency (EMA) https://www.ema.europa.eu/en/about-us/legal-notice duvelisib (P/0428/2019) https://www.ema.europa.eu/en/medicines/human/paediatric-investigation-plans/emea-002587-pip01-19 Copiktra (EMEA/H/C/005381) https://www.ema.europa.eu/en/medicines/human/EPAR/copiktra EU Clinical Trials Register https://www.clinicaltrialsregister.eu/ FDA Orange Book https://www.fda.gov/about-fda/about-website/website-policies#linking https://www.fda.gov/drugs/drug-approvals-and-databases/approved-drug-products-therapeutic-equivalence-evaluations-orange-book WHO Anatomical Therapeutic Chemical (ATC) Classification https://www.whocc.no/copyright_disclaimer/ https://www.whocc.no/atc/ ATC Code https://www.whocc.no/atc_ddd_index/ FDA Medication Guides https://www.fda.gov/about-fda/about-website/website-policies#linking Copiktra https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=medguide.page National Drug Code (NDC) Directory https://www.fda.gov/about-fda/about-website/website-policies#linking DUVELISIB https://www.fda.gov/drugs/drug-approvals-and-databases/national-drug-code-directory NCI Cancer Drugs LICENSE https://www.cancer.gov/policies/copyright-reuse Copiktra (Duvelisib) https://www.cancer.gov/about-cancer/treatment/drugs/duvelisib NIPH Clinical Trials Search of Japan https://rctportal.niph.go.jp/en/ NLM RxNorm Terminology https://www.nlm.nih.gov/research/umls/rxnorm/docs/termsofservice.html duvelisib https://rxnav.nlm.nih.gov/id/rxnorm/2058509 PubChem https://pubchem.ncbi.nlm.nih.gov Springer Nature https://pubchem.ncbi.nlm.nih.gov/substance/?source=15745&sourceid=30052051-301991071 https://pubchem.ncbi.nlm.nih.gov/substance/?source=15745&sourceid=30052051-609414931 Thieme Chemistry LICENSE The Thieme Chemistry contribution within PubChem is provided under a CC-BY-NC-ND 4.0 license, unless otherwise stated. https://creativecommons.org/licenses/by-nc-nd/4.0/ https://pubchem.ncbi.nlm.nih.gov/substance/?source=22163&sourceid=30052051-301991376 Wikidata LICENSE CCZero https://creativecommons.org/publicdomain/zero/1.0/ Duvelisib https://www.wikidata.org/wiki/Q27077129 Medical Subject Headings (MeSH) https://www.nlm.nih.gov/copyright.html duvelisib https://www.ncbi.nlm.nih.gov/mesh/67586691 MeSH Tree http://www.nlm.nih.gov/mesh/meshhome.html KEGG https://www.kegg.jp/kegg/legal.html USP drug classification http://www.genome.jp/kegg-bin/get_htext?br08302.keg Anatomical Therapeutic Chemical (ATC) classification http://www.genome.jp/kegg-bin/get_htext?br08303.keg Target-based classification of drugs http://www.genome.jp/kegg-bin/get_htext?br08310.keg Drug Groups http://www.genome.jp/kegg-bin/get_htext?br08330.keg UN Globally Harmonized System of Classification and Labelling of Chemicals (GHS) GHS Classification Tree http://www.unece.org/trans/danger/publi/ghs/ghs_welcome_e.html NORMAN Suspect List Exchange LICENSE Data: CC-BY 4.0; Code (hosted by ECI, LCSB): Artistic-2.0 https://creativecommons.org/licenses/by/4.0/ NORMAN Suspect List Exchange Classification https://www.norman-network.com/nds/SLE/ PATENTSCOPE (WIPO) SID 391972934 https://pubchem.ncbi.nlm.nih.gov/substance/391972934 Show More