Brigatinib is an orally available inhibitor of receptor tyrosine kinases anaplastic lymphoma kinase (ALK) and the epidermal growth factor receptor (EGFR) with potential antineoplastic activity. Brigatinib binds to and inhibits ALK kinase and ALK fusion proteins as well as EGFR and mutant forms. This leads to the inhibition of ALK kinase and EGFR kinase, disrupts their signaling pathways and eventually inhibits tumor cell growth in susceptible tumor cells. In addition, AP26113 appears to overcome mutation-based resistance. ALK belongs to the insulin receptor superfamily and plays an important role in nervous system development; ALK dysregulation and gene rearrangements are associated with a series of tumors. EGFR is overexpressed in a variety of cancer cell types.
Brigatinib is a tyrosine kinase receptor inhibitor and antineoplastic agent used in the therapy of selected forms of advanced non-small cell lung cancer. Brigatinib is associated with a moderate rate of transient elevations in serum aminotransferase levels during therapy but has yet to be linked to instances of clinically apparent acute liver injury.
Brigatinib, originally named AP26113, is a reversible dual inhibitor of anaplastic lymphoma kinase (ALK) and epidermal growth factor receptor (EGFR). It presents selectivity against the mutant forms of EGFR compared to the wild-type. It also exhibits selectivity against 9 different Crizotinib-resistant mutants of the EML4-ALK fusion gene, which is a pivotal player in the transformation of susceptible lung parenchyma. Brigatinib was developed by Ariad Pharmaceuticals, a subsidiary of Takeda Pharmaceutical Company Limited, and FDA-approved on April 28, 2017.
Mechanism of Action
Brigitanib acts as a tyrosine kinase inhibitor with activity against multiple kinases including ALK, ROS1, insulin-like growth factor 1 receptor and against EGFR deletions and point mutations. It acts by inhibiting ALK phosphorylation and the activation of downstream signaling proteins.
Brigitanib inhibits proliferation and in vitro viability of cells expressing the fusion protein EML4-ALK as well as 17 crizotinib-resistant ALK mutants. Its action is expanded to cells expressing EGFR deletions, ROS1-L2026M, FLT3-F691L and FLT3-D835Y. Brigitanib presents a dose-dependent inhibition of tumor growth, tumor burden and prolonged survival in mice EML4-ALK xenograft models. Time course of Brigatinib and exposure-response studies are still unknown.
Indications
- The anaplastic lymphoma kinase positive, metastatic non-small cell lung cancer (ALK+ NSCLC), represents only 3-5% of the NSCLC cancer cases, but the ALK mutation, overexpression and presence in several oncogenic fusion proteins in solid and hematologic tumors have pointed out the importance as well as its potential as a cancer therapy target. The ALK-related cases of NSCLC are associated with the presence of the fusion gene EML4-ALK which fused the ALK protein with the echinoderm microtubule-associated protein like-4 whose original function is the correct formation of microtubules. The presence of the aberrant fusion protein results in abnormal signaling that provokes increased cell growth, proliferation and survival. Crizotinib is indicated for the treatment of such cases but the presence of ALK kinase domain mutations confer resistance to the treatment. Thus, brigatinib is indicated for the treatment of patients with ALK+ NSCLC with intolerance to Crizotinib.
- Alunbrig is indicated as monotherapy for the treatment of adult patients with anaplastic lymphoma kinase (ALK)‑positive advanced non‑small cell lung cancer (NSCLC) previously not treated with an ALK inhibitor.Alunbrig is indicated as monotherapy for the treatment of adult patients with anaplastic lymphoma kinase ALKpositive advanced NSCLC previously treated with crizotinib.
- Brigatinib is a tyrosine kinase receptor inhibitor and antineoplastic agent used in the therapy of selected forms of advanced non-small cell lung cancer. Brigatinib is associated with a moderate rate of transient elevations in serum aminotransferase levels during therapy but has yet to be linked to instances of clinically apparent acute liver injury.
Use in Cancer
Brigatinib is approved to treat:
- Non-small cell lung cancer is ALK-positive and has metastasized (spread to other body parts). It is used in adults.
Brigatinib is also being studied in the treatment of other types of cancer.
Contraindications
The following conditions are contraindicated with this drug. Check with your physician if you have any of the following:
- high blood pressure
- slow heartbeat
- high amount of bilirubin in the blood
- high blood sugar
- abnormal liver function tests
- pregnancy
- a patient who is producing milk and breastfeeding
- increased creatine kinase levels
- lung tissue problem
- high blood levels of the lipase enzyme
- high blood levels of the amylase enzyme
- chronic kidney disease stage 4 (severe)
- kidney disease with likely reduction in kidney function
- Child-Pugh class C liver impairment
Dosage
Strengths: 90 mg; 30 mg; 180 mg; 90 mg-180 mg
Non-Small Cell Lung Cancer
- Initial dose: 90 mg orally once a day for the first 7 days
- Maintenance dose: 180 mg orally once a day
Renal Dose Adjustments
- Mild to moderate renal dysfunction (CrCl 30 to 89 mL/min): No adjustment recommended.
Severe renal dysfunction (CrCl 15 to 29 mL/min): Reduce once daily dose by approximately 50% (i.e., from 180 mg to 90 mg OR 90 mg to 60 mg).
Liver Dose Adjustments
- Mild to moderate liver dysfunction (Child-Pugh A to B) : No adjustment recommended.
- Severe liver dysfunction (Child-Pugh C): Reduce once daily dose by approximately 40% (i.e., from 180 mg to 120 mg, OR 120 mg to 90 mg, OR 90 mg to 60 mg).
Dose Adjustments
DOSE REDUCTION FOR ADVERSE REACTIONS:
STARTING DOSE 90 MG ONCE A DAY:
- First reduction: 60 mg once a day
- Second reduction: Permanently discontinue therapy.
- Third reduction: N/A
STARTING DOSE 180 MG ONCE A DAY:
- First reduction: 120 mg once a day
- Second reduction: 90 mg once a day
- Third reduction: 60 mg once a day
STRONG OR MODERATE CYP450 3A INHIBITORS:
- Avoid concomitant use.
- If concomitant use of a strong CYP450 3A inhibitor cannot be avoided, reduce the once a day dose of this drug by approximately 50% (i.e., from 180 mg to 90 mg OR from 90 mg to 60 mg).
- If coadministration of a moderate CYP450 3A inhibitor cannot be avoided, reduce the once daily dose of this drug by approximately 40% (i.e., from 180 mg to 120 mg, OR 120 mg to 90 mg, OR from 90 mg to 60 mg).
- After discontinuation of a strong or moderate CYP450 3A inhibitor, resume the dose of this drug that was tolerated prior to initiating the CYP450 3A inhibitor.
MODERATE CYP450 3A INDUCERS:
- Avoid concomitant use.
- If coadministration of a moderate CYP450 3A inducer cannot be avoided, increase the once daily dose of this drug in 30 mg increments after 7 days of therapy with the current dose as tolerated, up to a maximum of twice the dose that was tolerated prior to initiating the moderate CYP450 3A inducer.
- After discontinuation of a moderate CYP450 3A inducer, resume the dose of this drug that was tolerated prior to initiating the moderate CYP450 3A inducer.
DOSE MODIFICATIONS FOR ADVERSE REACTIONS:
INTERSTITIAL LUNG DISEASE (ILD)/PNEUMONITIS:
*GRADE 1:
- If new pulmonary symptoms occur during the first 7 days of therapy, withhold this drug until recovery to baseline, then resume at the same dose and do not escalate to 180 mg if ILD/pneumonitis is suspected.
- If new pulmonary symptoms occur after the first 7 days of therapy, withhold this drug until recovery to baseline, then resume at same dose.
- If ILD/pneumonitis recurs, permanently discontinue this drug.
*GRADE 2:
- If new pulmonary symptoms occur during the first 7 days of therapy, withhold this drug until recovery to baseline; resume at next lower dose and do not dose escalate if ILD/pneumonitis is suspected.
- If new pulmonary symptoms occur after the first 7 days of therapy, withhold this drug until recovery to baseline.
- If ILD/pneumonitis is suspected, resume at next lower dose; otherwise, resume at same dose.
- If ILD/pneumonitis recurs, permanently discontinue this drug.
- Grade 3 or 4: Permanently discontinue this drug.
HYPERTENSION:
*GRADE 3 (SBP 160 mmHg or greater or DBP 100 mmHg or greater, medical intervention indicated, more than 1 antihypertensive drug, or more intensive therapy than previously used indicated):
- Withhold dosing until recovery to Grade 1 or less (SBP less than 140 mmHg and DBP less than 90 mmHg) then resume at the next lower dose.
- Recurrence: Withhold the drug until recovery to Grade 1 or less and resume at next lower dose or permanently discontinue this drug.
GRADE 4 (life-threatening consequences, urgent intervention indicated):
- Withhold this drug until recovery to Grade 1 or less and resume at the next lower dose OR permanently discontinue this drug.
- GRADE 4 RECURRENCE: Permanently discontinue this drug.
BRADYCARDIA (HR less than 60 bpm):
*SYMPTOMATIC BRADYCARDIA:
- Withhold this drug until recovery to asymptomatic bradycardia or to a resting heart rate of 60 bpm or above.
- If a concomitant medication known to cause bradycardia is identified and discontinued or dose-adjusted, resume this drug at same dose upon recovery to asymptomatic bradycardia or to resting heart rate of 60 bpm or above.
- If no concomitant medication known to cause bradycardia is identified, or if contributing concomitant medications are not discontinued or dose-adjusted, resume this drug at next lower dose upon recovery to asymptomatic bradycardia or to resting heart rate of 60 bpm or above.
*LIFE-THREATENING BRADYCARDIA (urgent intervention indicated):
- Permanently discontinue this drug if no contributing concomitant medication is identified.
- If contributing concomitant medication is identified and discontinued or dose-adjusted, resume this drug at next lower dose upon recovery to asymptomatic bradycardia or to a resting heart rate of 60 bpm or above, with frequent monitoring as clinically indicated.
- Recurrence: Permanently discontinue this drug.
VISUAL DISTURBANCE:
- GRADE 2 OR 3: Withhold this drug until recovery to Grade 1 or baseline, then resume at the next lower dose.
- GRADE 4: Permanently discontinue this drug.
CREATINE PHOSPHOKINASE (CPK) ELEVATION:
*GRADE 3 OR 4 CPK ELEVATION (greater than 5 times upper level of normal [ULN] with Grade 2 or higher muscle pain or weakness):
- Withhold this drug until recovery to Grade 1 or less ((less than or equal to 2.5 x ULN) or to baseline, then resume at the same dose.
- Recurrence: Withhold until recovery to Grade 1 or less (less than or equal to 2.5 x ULN) or to baseline, then resume at next lower dose
LIPASE/AMYLASE ELEVATION:
- GRADE 3 (greater than 2 x ULN): Withhold this drug until recovery to Grade 1 or less (1.5 x ULN or less) or to baseline, then resume at the same dose.
- RECURRENCE: Withhold until recovery to Grade 1 or less (less than or equal to 1.5 x ULN) or to baseline, then resume at next lower dose.
- GRADE 4 (greater than 5 x ULN): Withhold dosing until recovery to Grade 1 or less (1.5 x ULN or less) or to baseline, then resume at the next lower dose.
HYPERGLYCEMIA
*GRADE 3 (greater than 250 mg/dL OR 13.9 mmol/L) OR GRADE 4:
- Withhold this drug until adequate hyperglycemic control is achieved and resume at next lower dose OR permanently discontinue therapy.
OTHER ADVERSE REACTIONS:
*GRADE 3:
- Withhold this drug until recovery to baseline, then resume at the same dose.
- Recurrence: Withhold this drug until recovery to baseline, then resume at the next lower dose OR discontinue therapy.
*GRADE 4:
- Withhold dosing until recovery to baseline, then resume at the next lower dose.
- Recurrence: Permanently discontinue therapy.
Side Effects
The Most Common
- nausea
- diarrhea
- vomiting
- constipation
- tiredness
- rash
- headache
- numbness, pain, tingling, or burning feeling in the feet or hands
- back or joint pain
- loss of appetite
- difficulty falling asleep or staying asleep
- shortness of breath or difficulty breathing
- chest pain
- cough with or without mucus
- fever
- headache, dizziness, lightheadedness, or feeling faint
- blurred or double vision
- seeing flashes of light
- light hurting your eyes
- seeing ”floaters” or small specks
- extreme thirst, frequent urination, extreme hunger, blurred vision, or weakness
- upper stomach pain that may spread to the back or get worse with eating; weight loss; or nausea
- slow or irregular heartbeat
- muscle pain, spasms, tenderness, or weakness
More common
- Back pain
- blurred vision
- burning, crawling, itching, numbness, prickling, “pins and needles”, or tingling feelings
- chest pain or tightness
- chills
- clay colored stools
- confusion
- cough
- dark urine
- decreased appetite
- difficulty in moving
- dizziness
- dry mouth
- fever
- flushed, dry skin
- fruit-like breath odor
- headache
- hoarseness
- increased hunger
- increased thirst
- increased urination
- itching, skin rash
- joint pain
- loss of appetite
- lower back or side pain
- muscle pain, tenderness, or weakness
- nausea
- nervousness
- pain in the arms or legs
- painful or difficult urination
Rare
- muscle pain, tenderness, or weakness
- nausea
- nervousness
- pain in the arms or legs
- painful or difficult urination
- pale skin
- pounding in the ears
- skin rash or itching
- slow or fast heartbeat
- sneezing
- sore throat
- stomach pain or tenderness
- sweating
- swelling of the feet or lower legs
- swollen joints
- thickening of bronchial secretions
- trouble breathing
- unexplained weight loss
- unusual bleeding or bruising
- unusual tiredness or weakness
- vomiting
- weakness in the arms, hands, legs, or feet
- yellow eyes or skin
Drug Interaction
| DRUG | INTERACTION |
|---|---|
| Abaloparatide | The therapeutic efficacy of Abaloparatide can be decreased when used in combination with Brigatinib. |
| Abametapir | The serum concentration of Brigatinib can be increased when it is combined with Abametapir. |
| Abatacept | The metabolism of Brigatinib can be increased when combined with Abatacept. |
| Abemaciclib | The excretion of Abemaciclib can be decreased when combined with Brigatinib. |
| Abiraterone | The metabolism of Brigatinib can be decreased when combined with Abiraterone. |
| Acalabrutinib | The metabolism of Brigatinib can be decreased when combined with Acalabrutinib. |
| Acenocoumarol | The metabolism of Acenocoumarol can be increased when combined with Brigatinib. |
| Acetaminophen | The metabolism of Brigatinib can be increased when combined with Acetaminophen. |
| Acetazolamide | The metabolism of Brigatinib can be decreased when combined with Acetazolamide. |
| Acyclovir | The excretion of Acyclovir can be decreased when combined with Brigatinib. |
| Adalimumab | The metabolism of Brigatinib can be increased when combined with Adalimumab. |
| Afatinib | Afatinib may decrease the excretion rate of Brigatinib which could result in a higher serum level. |
| Albendazole | The metabolism of Brigatinib can be decreased when combined with Albendazole. |
| Aldesleukin | The metabolism of Brigatinib can be decreased when combined with Aldesleukin. |
| Alectinib | Alectinib may decrease the excretion rate of Brigatinib which could result in a higher serum level. |
| Allopurinol | Brigatinib may decrease the excretion rate of Allopurinol which could result in a higher serum level. |
| Almotriptan | The metabolism of Brigatinib can be decreased when combined with Almotriptan. |
| Alpelisib | The serum concentration of Alpelisib can be increased when it is combined with Brigatinib. |
| Aminoglutethimide | The metabolism of Brigatinib can be increased when combined with Aminoglutethimide. |
| Aminophenazone | The metabolism of Brigatinib can be decreased when combined with Aminophenazone. |
| Amiodarone | The metabolism of Brigatinib can be decreased when combined with Amiodarone. |
| Amitriptyline | The metabolism of Brigatinib can be decreased when combined with Amitriptyline. |
| Amobarbital | The metabolism of Brigatinib can be increased when combined with Amobarbital. |
| Amodiaquine | The metabolism of Brigatinib can be decreased when combined with Amodiaquine. |
| Amprenavir | The metabolism of Brigatinib can be decreased when combined with Amprenavir. |
| Anakinra | The metabolism of Brigatinib can be increased when combined with Anakinra. |
| Anastrozole | The metabolism of Brigatinib can be decreased when combined with Anastrozole. |
| Antipyrine | The metabolism of Brigatinib can be decreased when combined with Antipyrine. |
| Apalutamide | The metabolism of Brigatinib can be increased when combined with Apalutamide. |
| Apixaban | The metabolism of Brigatinib can be decreased when combined with Apixaban. |
| Apomorphine | The metabolism of Brigatinib can be decreased when combined with Apomorphine. |
| Apremilast | The metabolism of Brigatinib can be increased when combined with Apremilast. |
| Aprepitant | The metabolism of Brigatinib can be decreased when combined with Aprepitant. |
| Aripiprazole | The metabolism of Aripiprazole can be increased when combined with Brigatinib. |
| Aripiprazole lauroxil | The metabolism of Aripiprazole lauroxil can be increased when combined with Brigatinib. |
| Armodafinil | The metabolism of Brigatinib can be increased when combined with Armodafinil. |
| Articaine | The risk or severity of methemoglobinemia can be increased when Brigatinib is combined with Articaine. |
| Asciminib | The serum concentration of Brigatinib can be increased when it is combined with Asciminib. |
| Astemizole | The metabolism of Brigatinib can be decreased when combined with Astemizole. |
| Asunaprevir | The metabolism of Brigatinib can be increased when combined with Asunaprevir. |
| Atazanavir | The metabolism of Brigatinib can be decreased when combined with Atazanavir. |
| Atorvastatin | The metabolism of Brigatinib can be decreased when combined with Atorvastatin. |
| Avacopan | The metabolism of Brigatinib can be decreased when combined with Avacopan. |
| Avanafil | Avanafil may decrease the excretion rate of Brigatinib which could result in a higher serum level. |
| Avatrombopag | The metabolism of Brigatinib can be increased when combined with Avatrombopag. |
| Azelastine | The metabolism of Brigatinib can be decreased when combined with Azelastine. |
| Azithromycin | The metabolism of Brigatinib can be decreased when combined with Azithromycin. |
| Baricitinib | The excretion of Baricitinib can be decreased when combined with Brigatinib. |
| Beclomethasone dipropionate | The metabolism of Brigatinib can be increased when combined with Beclomethasone dipropionate. |
| Belumosudil | Belumosudil may decrease the excretion rate of Brigatinib which could result in a higher serum level. |
| Belzutifan | The serum concentration of Brigatinib can be decreased when it is combined with Belzutifan. |
| Benzocaine | The risk or severity of methemoglobinemia can be increased when Brigatinib is combined with Benzocaine. |
| Benzyl alcohol | The risk or severity of methemoglobinemia can be increased when Brigatinib is combined with Benzyl alcohol. |
| Berotralstat | The serum concentration of Berotralstat can be increased when it is combined with Brigatinib. |
| Betamethasone | The metabolism of Brigatinib can be increased when combined with Betamethasone. |
| Betamethasone phosphate | The metabolism of Brigatinib can be increased when combined with Betamethasone phosphate. |
| Bexarotene | The metabolism of Brigatinib can be increased when combined with Bexarotene. |
| Bezafibrate | The metabolism of Brigatinib can be decreased when combined with Bezafibrate. |
| Bicalutamide | The metabolism of Brigatinib can be decreased when combined with Bicalutamide. |
| Bifonazole | The metabolism of Brigatinib can be decreased when combined with Bifonazole. |
| Bimekizumab | The metabolism of Brigatinib can be increased when combined with Bimekizumab. |
| Boceprevir | The metabolism of Brigatinib can be decreased when combined with Boceprevir. |
| Bosentan | The metabolism of Brigatinib can be increased when combined with Bosentan. |
| Bosutinib | The metabolism of Brigatinib can be decreased when combined with Bosutinib. |
| Brentuximab vedotin | The metabolism of Brigatinib can be decreased when combined with Brentuximab vedotin. |
| Budesonide | The metabolism of Brigatinib can be increased when combined with Budesonide. |
| Bupivacaine | The risk or severity of methemoglobinemia can be increased when Brigatinib is combined with Bupivacaine. |
| Buprenorphine | The metabolism of Brigatinib can be decreased when combined with Buprenorphine. |
| Butacaine | The risk or severity of methemoglobinemia can be increased when Brigatinib is combined with Butacaine. |
| Butalbital | The metabolism of Brigatinib can be increased when combined with Butalbital. |
| Butamben | The risk or severity of methemoglobinemia can be increased when Brigatinib is combined with Butamben. |
| Cabazitaxel | The metabolism of Brigatinib can be decreased when combined with Cabazitaxel. |
| Cabozantinib | The metabolism of Brigatinib can be decreased when combined with Cabozantinib. |
| Caffeine | Caffeine may decrease the excretion rate of Brigatinib which could result in a higher serum level. |
| Calcitriol | The metabolism of Brigatinib can be increased when combined with Calcitriol. |
| Canakinumab | The metabolism of Brigatinib can be increased when combined with Canakinumab. |
| Candesartan cilexetil | The metabolism of Brigatinib can be decreased when combined with Candesartan cilexetil. |
| Candicidin | The metabolism of Brigatinib can be decreased when combined with Candicidin. |
| Cannabidiol | The metabolism of Brigatinib can be decreased when combined with Cannabidiol. |
| Capmatinib | The serum concentration of Capmatinib can be decreased when it is combined with Brigatinib. |
| Capsaicin | The risk or severity of methemoglobinemia can be increased when Brigatinib is combined with Capsaicin. |
| Carbamazepine | The metabolism of Brigatinib can be increased when combined with Carbamazepine. |
| Carbimazole | The therapeutic efficacy of Carbimazole can be decreased when used in combination with Brigatinib. |
| Cefradine | The metabolism of Brigatinib can be increased when combined with Cefradine. |
| Celecoxib | The metabolism of Brigatinib can be decreased when combined with Celecoxib. |
| Cenobamate | The serum concentration of Brigatinib can be decreased when it is combined with Cenobamate. |
| Cephalexin | The metabolism of Brigatinib can be decreased when combined with Cephalexin. |
| Ceritinib | The metabolism of Brigatinib can be decreased when combined with Ceritinib. |
| Cerivastatin | The metabolism of Brigatinib can be increased when combined with Cerivastatin. |
| Certolizumab pegol | The metabolism of Brigatinib can be increased when combined with Certolizumab pegol. |
| Chloramphenicol | The metabolism of Brigatinib can be decreased when combined with Chloramphenicol. |
| Chloroprocaine | The risk or severity of methemoglobinemia can be increased when Brigatinib is combined with Chloroprocaine. |
| Chloroquine | The metabolism of Brigatinib can be decreased when combined with Chloroquine. |
| Chlorpromazine | The metabolism of Brigatinib can be increased when combined with Chlorpromazine. |
| Cholesterol | Cholesterol may increase the excretion rate of Brigatinib which could result in a lower serum level and potentially a reduction in efficacy. |
| Cimetidine | The metabolism of Brigatinib can be decreased when combined with Cimetidine. |
| Cinchocaine | The risk or severity of methemoglobinemia can be increased when Brigatinib is combined with Cinchocaine. |
| Ciprofloxacin | The metabolism of Brigatinib can be decreased when combined with Ciprofloxacin. |
| Cisapride | The metabolism of Brigatinib can be decreased when combined with Cisapride. |
| Citalopram | The metabolism of Brigatinib can be decreased when combined with Citalopram. |
| Clarithromycin | The metabolism of Brigatinib can be decreased when combined with Clarithromycin. |
| Clevidipine | The metabolism of Brigatinib can be increased when combined with Clevidipine. |
| Clindamycin | The metabolism of Clindamycin can be increased when combined with Brigatinib. |
| Clobazam | The metabolism of Brigatinib can be increased when combined with Clobazam. |
| Clobetasol propionate | The metabolism of Brigatinib can be increased when combined with Clobetasol propionate. |
| Clofarabine | Brigatinib may decrease the excretion rate of Clofarabine which could result in a higher serum level. |
| Clofazimine | The metabolism of Brigatinib can be decreased when combined with Clofazimine. |
| Clofibrate | The metabolism of Brigatinib can be increased when combined with Clofibrate. |
| Clonazepam | The metabolism of Clonazepam can be increased when combined with Brigatinib. |
| Clopidogrel | The metabolism of Brigatinib can be decreased when combined with Clopidogrel. |
| Clozapine | The metabolism of Brigatinib can be increased when combined with Clozapine. |
| Cobicistat | The metabolism of Brigatinib can be decreased when combined with Cobicistat. |
| Cobimetinib | The metabolism of Brigatinib can be decreased when combined with Cobimetinib. |
| Cocaine | The risk or severity of methemoglobinemia can be increased when Brigatinib is combined with Cocaine. |
| Conivaptan | The metabolism of Brigatinib can be decreased when combined with Conivaptan. |
| Conjugated estrogens | Brigatinib may decrease the excretion rate of Conjugated estrogens which could result in a higher serum level. |
| Copanlisib | Brigatinib may decrease the excretion rate of Copanlisib which could result in a higher serum level. |
| Corticotropin | The metabolism of Brigatinib can be increased when combined with Corticotropin. |
| Cortisone acetate | The metabolism of Brigatinib can be increased when combined with Cortisone acetate. |
| Crizotinib | The metabolism of Brigatinib can be decreased when combined with Crizotinib. |
| Curcumin | The metabolism of Brigatinib can be decreased when combined with Curcumin. |
| Cyclophosphamide | The metabolism of Brigatinib can be increased when combined with Cyclophosphamide. |
| Cyclosporine | The metabolism of Brigatinib can be decreased when combined with Cyclosporine. |
| Cyproterone acetate | The metabolism of Brigatinib can be decreased when combined with Cyproterone acetate. |
| Dabrafenib | The serum concentration of Brigatinib can be decreased when it is combined with Dabrafenib. |
| Daclatasvir | Daclatasvir may decrease the excretion rate of Brigatinib which could result in a higher serum level. |
| Dacomitinib | The metabolism of Brigatinib can be decreased when combined with Dacomitinib. |
| Dactinomycin | Brigatinib may decrease the excretion rate of Dactinomycin which could result in a higher serum level. |
| Dalfopristin | The metabolism of Brigatinib can be decreased when combined with Dalfopristin. |
| Danazol | The metabolism of Brigatinib can be decreased when combined with Danazol. |
| Dapsone | The metabolism of Brigatinib can be decreased when combined with Dapsone. |
| Darbepoetin alfa | The risk or severity of Thrombosis can be increased when Darbepoetin alfa is combined with Brigatinib. |
| Darolutamide | The serum concentration of Brigatinib can be increased when it is combined with Darolutamide. |
| Darunavir | The serum concentration of Brigatinib can be increased when it is combined with Darunavir. |
| Dasabuvir | The metabolism of Brigatinib can be decreased when combined with Dasabuvir. |
| Dasatinib | The metabolism of Brigatinib can be decreased when combined with Dasatinib. |
| Daunorubicin | The metabolism of Brigatinib can be decreased when combined with Daunorubicin. |
| Deferasirox | The metabolism of Brigatinib can be increased when combined with Deferasirox. |
| Deflazacort | The metabolism of Brigatinib can be increased when combined with Deflazacort. |
| Delafloxacin | Brigatinib may decrease the excretion rate of Delafloxacin which could result in a higher serum level. |
| Delavirdine | The metabolism of Brigatinib can be decreased when combined with Delavirdine. |
| Desipramine | The metabolism of Brigatinib can be decreased when combined with Desipramine. |
| Desvenlafaxine | The metabolism of Brigatinib can be decreased when combined with Desvenlafaxine. |
| Dexamethasone | The metabolism of Brigatinib can be increased when combined with Dexamethasone. |
| Dexamethasone acetate | The metabolism of Brigatinib can be increased when combined with Dexamethasone acetate. |
| Dexibuprofen | The metabolism of Brigatinib can be decreased when combined with Dexibuprofen. |
| Dextropropoxyphene | The metabolism of Brigatinib can be decreased when combined with Dextropropoxyphene. |
| Diclofenac | The metabolism of Brigatinib can be decreased when combined with Diclofenac. |
| Dicloxacillin | The metabolism of Brigatinib can be increased when combined with Dicloxacillin. |
| Diethylstilbestrol | The metabolism of Brigatinib can be decreased when combined with Diethylstilbestrol. |
| Difluocortolone | The metabolism of Brigatinib can be increased when combined with Difluocortolone. |
| Dihydroergocornine | The metabolism of Brigatinib can be decreased when combined with Dihydroergocornine. |
| Dihydroergocristine | The metabolism of Brigatinib can be decreased when combined with Dihydroergocristine. |
| Dihydroergotamine | The metabolism of Brigatinib can be decreased when combined with Dihydroergotamine. |
| Diltiazem | The metabolism of Brigatinib can be decreased when combined with Diltiazem. |
| Dimethyl sulfoxide | The metabolism of Brigatinib can be decreased when combined with Dimethyl sulfoxide. |
| Diosmin | The metabolism of Brigatinib can be decreased when combined with Diosmin. |
| Diphenhydramine | The risk or severity of methemoglobinemia can be increased when Brigatinib is combined with Diphenhydramine. |
| Docetaxel | The metabolism of Brigatinib can be decreased when combined with Docetaxel. |
| Dolutegravir | Brigatinib may decrease the excretion rate of Dolutegravir which could result in a higher serum level. |
| Domperidone | The metabolism of Brigatinib can be decreased when combined with Domperidone. |
| Donepezil | Brigatinib may decrease the excretion rate of Donepezil which could result in a higher serum level. |
| Doxazosin | The metabolism of Brigatinib can be decreased when combined with Doxazosin. |
| Doxorubicin | The metabolism of Brigatinib can be decreased when combined with Doxorubicin. |
| Dronedarone | The serum concentration of Brigatinib can be increased when it is combined with Dronedarone. |
| Drospirenone | The metabolism of Brigatinib can be decreased when combined with Drospirenone. |
| Duvelisib | The metabolism of Brigatinib can be decreased when combined with Duvelisib. |
| Dyclonine | The risk or severity of methemoglobinemia can be increased when Brigatinib is combined with Dyclonine. |
| Ebastine | The metabolism of Brigatinib can be decreased when combined with Ebastine. |
| Echinacea | The metabolism of Brigatinib can be increased when combined with Echinacea. |
| Efavirenz | The metabolism of Brigatinib can be decreased when combined with Efavirenz. |
| Elagolix | The metabolism of Brigatinib can be decreased when combined with Elagolix. |
| Elbasvir | Elbasvir may decrease the excretion rate of Brigatinib which could result in a higher serum level. |
| Elexacaftor | The metabolism of Brigatinib can be decreased when combined with Elexacaftor. |
| Eltrombopag | The metabolism of Brigatinib can be decreased when combined with Eltrombopag. |
| Elvitegravir | The metabolism of Brigatinib can be decreased when combined with Elvitegravir. |
| Emapalumab | The metabolism of Brigatinib can be increased when combined with Emapalumab. |
| Emtricitabine | The excretion of Emtricitabine can be decreased when combined with Brigatinib. |
| Enasidenib | The metabolism of Brigatinib can be increased when combined with Enasidenib. |
| Enzalutamide | The serum concentration of Brigatinib can be decreased when it is combined with Enzalutamide. |
| Epinephrine | The metabolism of Brigatinib can be decreased when combined with Epinephrine. |
| Ergotamine | The metabolism of Brigatinib can be decreased when combined with Ergotamine. |
| Erlotinib | The serum concentration of Erlotinib can be decreased when it is combined with Brigatinib. |
| Ertugliflozin | Brigatinib may decrease the excretion rate of Ertugliflozin which could result in a higher serum level. |
| Erythromycin | The metabolism of Brigatinib can be decreased when combined with Erythromycin. |
| Erythropoietin | The risk or severity of Thrombosis can be increased when Erythropoietin is combined with Brigatinib. |
| Esketamine | The metabolism of Brigatinib can be increased when combined with Esketamine. |
| Eslicarbazepine | The metabolism of Brigatinib can be increased when combined with Eslicarbazepine. |
| Eslicarbazepine acetate | The metabolism of Brigatinib can be increased when combined with Eslicarbazepine acetate. |
| Estetrol | The metabolism of Brigatinib can be decreased when combined with Estetrol. |
| Estradiol | The metabolism of Brigatinib can be decreased when combined with Estradiol. |
| Estradiol acetate | The metabolism of Brigatinib can be increased when combined with Estradiol acetate. |
| Estradiol benzoate | The metabolism of Brigatinib can be increased when combined with Estradiol benzoate. |
| Estradiol cypionate | The metabolism of Brigatinib can be increased when combined with Estradiol cypionate. |
| Estradiol dienanthate | The metabolism of Brigatinib can be increased when combined with Estradiol dienanthate. |
| Estradiol valerate | The metabolism of Brigatinib can be increased when combined with Estradiol valerate. |
| Estrone sulfate | The excretion of Estrone sulfate can be decreased when combined with Brigatinib. |
| Eszopiclone | The serum concentration of Eszopiclone can be decreased when it is combined with Brigatinib. |
| Etanercept | The metabolism of Brigatinib can be increased when combined with Etanercept. |
| Etoricoxib | The metabolism of Brigatinib can be decreased when combined with Etoricoxib. |
| Etravirine | The metabolism of Brigatinib can be increased when combined with Etravirine. |
| Ezetimibe | Brigatinib may decrease the excretion rate of Ezetimibe which could result in a higher serum level. |
| Favipiravir | The metabolism of Brigatinib can be decreased when combined with Favipiravir. |
| Febuxostat | The excretion of Brigatinib can be decreased when combined with Febuxostat. |
| Fedratinib | Fedratinib may decrease the excretion rate of Brigatinib which could result in a higher serum level. |
| Felbamate | The metabolism of Brigatinib can be increased when combined with Felbamate. |
| Felodipine | The metabolism of Brigatinib can be decreased when combined with Felodipine. |
| Fenofibrate | The metabolism of Brigatinib can be decreased when combined with Fenofibrate. |
| Fexinidazole | The metabolism of Brigatinib can be decreased when combined with Fexinidazole. |
| Finerenone | The metabolism of Brigatinib can be decreased when combined with Finerenone. |
| Flecainide | The excretion of Flecainide can be decreased when combined with Brigatinib. |
| Flucloxacillin | The metabolism of Brigatinib can be increased when combined with Flucloxacillin. |
| Fluconazole | The metabolism of Brigatinib can be decreased when combined with Fluconazole. |
| Flunisolide | The metabolism of Brigatinib can be increased when combined with Flunisolide. |
| Fluocinolone acetonide | The metabolism of Brigatinib can be increased when combined with Fluocinolone acetonide. |
| Fluocinonide | The metabolism of Brigatinib can be increased when combined with Fluocinonide. |
| Fluocortolone | The metabolism of Brigatinib can be increased when combined with Fluocortolone. |
| Fluorouracil | The metabolism of Brigatinib can be decreased when combined with Fluorouracil. |
| Fluoxetine | The metabolism of Brigatinib can be decreased when combined with Fluoxetine. |
| Fluticasone | The metabolism of Brigatinib can be increased when combined with Fluticasone. |
| Fluticasone furoate | The metabolism of Brigatinib can be increased when combined with Fluticasone furoate. |
| Fluticasone propionate | The metabolism of Brigatinib can be decreased when combined with Fluticasone propionate. |
| Fluvastatin | The metabolism of Brigatinib can be decreased when combined with Fluvastatin. |
| Fluvoxamine | The metabolism of Brigatinib can be decreased when combined with Fluvoxamine. |
| Folic acid | Brigatinib may decrease the excretion rate of Folic acid which could result in a higher serum level. |
| Follitropin | The therapeutic efficacy of Follitropin can be decreased when used in combination with Brigatinib. |
| Formestane | The metabolism of Brigatinib can be increased when combined with Formestane. |
| Fosamprenavir | The metabolism of Brigatinib can be decreased when combined with Fosamprenavir. |
| Fosaprepitant | The metabolism of Brigatinib can be increased when combined with Fosaprepitant. |
| Fosnetupitant | The metabolism of Brigatinib can be decreased when combined with Fosnetupitant. |
| Fosphenytoin | The metabolism of Brigatinib can be increased when combined with Fosphenytoin. |
| Fostamatinib | The metabolism of Brigatinib can be decreased when combined with Fostamatinib. |
| Fostemsavir | Fostemsavir may decrease the excretion rate of Brigatinib which could result in a higher serum level. |
| Fusidic acid | The metabolism of Brigatinib can be decreased when combined with Fusidic acid. |
| Ganciclovir | The excretion of Ganciclovir can be decreased when combined with Brigatinib. |
| Gefitinib | Gefitinib may decrease the excretion rate of Brigatinib which could result in a higher serum level. |
| Gemfibrozil | The metabolism of Brigatinib can be decreased when combined with Gemfibrozil. |
| Gilteritinib | The metabolism of Brigatinib can be decreased when combined with Gilteritinib. |
| Ginkgo biloba | The metabolism of Brigatinib can be decreased when combined with Ginkgo biloba. |
| Glasdegib | The metabolism of Brigatinib can be decreased when combined with Glasdegib. |
| Glecaprevir | The metabolism of Brigatinib can be decreased when combined with Glecaprevir. |
| Glyburide | The metabolism of Brigatinib can be decreased when combined with Glyburide. |
| Glycerol phenylbutyrate | The metabolism of Brigatinib can be increased when combined with Glycerol phenylbutyrate. |
| Golimumab | The metabolism of Brigatinib can be increased when combined with Golimumab. |
| Grazoprevir | Grazoprevir may decrease the excretion rate of Brigatinib which could result in a higher serum level. |
| Griseofulvin | The metabolism of Brigatinib can be increased when combined with Griseofulvin. |
| Guanidine | The excretion of Guanidine can be decreased when combined with Brigatinib. |
| Halofantrine | The metabolism of Brigatinib can be decreased when combined with Halofantrine. |
| Haloperidol | The serum concentration of Haloperidol can be increased when it is combined with Brigatinib. |
| Hydralazine | The metabolism of Brigatinib can be decreased when combined with Hydralazine. |
| Hydrocortamate | The metabolism of Brigatinib can be increased when combined with Hydrocortamate. |
| Hydrocortisone | The metabolism of Brigatinib can be increased when combined with Hydrocortisone. |
| Hydrocortisone acetate | The metabolism of Brigatinib can be increased when combined with Hydrocortisone acetate. |
| Hydrocortisone butyrate | The metabolism of Brigatinib can be increased when combined with Hydrocortisone butyrate. |
| Hydrocortisone succinate | The metabolism of Brigatinib can be increased when combined with Hydrocortisone succinate. |
| Hydroxychloroquine | The metabolism of Brigatinib can be decreased when combined with Hydroxychloroquine. |
| Ibuprofen | The metabolism of Brigatinib can be decreased when combined with Ibuprofen. |
| Idelalisib | The metabolism of Brigatinib can be decreased when combined with Idelalisib. |
| Ifosfamide | The metabolism of Ifosfamide can be increased when combined with Brigatinib. |
| Imatinib | The serum concentration of Brigatinib can be increased when it is combined with Imatinib. |
| Indinavir | The metabolism of Brigatinib can be decreased when combined with Indinavir. |
| Infigratinib | The metabolism of Brigatinib can be decreased when combined with Infigratinib. |
| Infliximab | The metabolism of Brigatinib can be increased when combined with Infliximab. |
| Irbesartan | The metabolism of Brigatinib can be decreased when combined with Irbesartan. |
| Irinotecan | Brigatinib may decrease the excretion rate of Irinotecan which could result in a higher serum level. |
| Isavuconazole | The metabolism of Brigatinib can be increased when combined with Isavuconazole. |
| Isavuconazonium | The metabolism of Brigatinib can be increased when combined with Isavuconazonium. |
| Isoniazid | The metabolism of Brigatinib can be decreased when combined with Isoniazid. |
| Isradipine | The metabolism of Brigatinib can be decreased when combined with Isradipine. |
| Istradefylline | The metabolism of Brigatinib can be decreased when combined with Istradefylline. |
| Itraconazole | The metabolism of Brigatinib can be decreased when combined with Itraconazole. |
| Ivacaftor | The metabolism of Brigatinib can be decreased when combined with Ivacaftor. |
| Ivermectin | Brigatinib may decrease the excretion rate of Ivermectin which could result in a higher serum level. |
| Ivosidenib | The metabolism of Brigatinib can be increased when combined with Ivosidenib. |
| Ketamine | The metabolism of Brigatinib can be decreased when combined with Ketamine. |
| Ketazolam | The metabolism of Brigatinib can be decreased when combined with Ketazolam. |
| Ketoconazole | The metabolism of Brigatinib can be decreased when combined with Ketoconazole. |
| Ketoprofen | The metabolism of Brigatinib can be decreased when combined with Ketoprofen. |
| Ketorolac | The metabolism of Brigatinib can be decreased when combined with Ketorolac. |
| Lacosamide | The metabolism of Brigatinib can be decreased when combined with Lacosamide. |
| Lamivudine | Brigatinib may decrease the excretion rate of Lamivudine which could result in a higher serum level. |
| Lanreotide | The metabolism of Brigatinib can be decreased when combined with Lanreotide. |
| Lansoprazole | The metabolism of Brigatinib can be decreased when combined with Lansoprazole. |
| Lapatinib | The metabolism of Brigatinib can be decreased when combined with Lapatinib. |
| Lasmiditan | The serum concentration of Brigatinib can be increased when it is combined with Lasmiditan. |
| Ledipasvir | Ledipasvir may decrease the excretion rate of Brigatinib which could result in a higher serum level. |
| Lefamulin | The serum concentration of Brigatinib can be increased when it is combined with Lefamulin. |
| Leflunomide | Brigatinib may decrease the excretion rate of Leflunomide which could result in a higher serum level. |
| Lemborexant | The serum concentration of Lemborexant can be decreased when it is combined with Brigatinib. |
| Lenvatinib | Brigatinib may decrease the excretion rate of Lenvatinib which could result in a higher serum level. |
| Lesinurad | The metabolism of Brigatinib can be increased when combined with Lesinurad. |
| Letermovir | The metabolism of Brigatinib can be decreased when combined with Letermovir. |
| Levobupivacaine | The risk or severity of methemoglobinemia can be increased when Brigatinib is combined with Levobupivacaine. |
| Levofloxacin | The excretion of Levofloxacin can be decreased when combined with Brigatinib. |
| Levoketoconazole | The metabolism of Brigatinib can be decreased when combined with Levoketoconazole. |
| Levomilnacipran | The metabolism of Levomilnacipran can be increased when combined with Brigatinib. |
| Levothyroxine | The therapeutic efficacy of Levothyroxine can be decreased when used in combination with Brigatinib. |
| Lidocaine | The risk or severity of methemoglobinemia can be increased when Brigatinib is combined with Lidocaine. |
| Linagliptin | The metabolism of Brigatinib can be decreased when combined with Linagliptin. |
| Liothyronine | The therapeutic efficacy of Liothyronine can be decreased when used in combination with Brigatinib. |
| Liotrix | The therapeutic efficacy of Liotrix can be decreased when used in combination with Brigatinib. |
| Lomitapide | The metabolism of Brigatinib can be decreased when combined with Lomitapide. |
| Lonafarnib | The metabolism of Brigatinib can be decreased when combined with Lonafarnib. |
| Loperamide | The metabolism of Brigatinib can be decreased when combined with Loperamide. |
| Lopinavir | The metabolism of Brigatinib can be decreased when combined with Lopinavir. |
| Loratadine | The metabolism of Brigatinib can be decreased when combined with Loratadine. |
| Lorlatinib | The metabolism of Brigatinib can be increased when combined with Lorlatinib. |
| Losartan | The metabolism of Brigatinib can be decreased when combined with Losartan. |
| Lovastatin | The metabolism of Brigatinib can be decreased when combined with Lovastatin. |
| Lumacaftor | The metabolism of Brigatinib can be increased when combined with Lumacaftor. |
| Lumateperone | The serum concentration of Lumateperone can be decreased when it is combined with Brigatinib. |
| Lusutrombopag | Brigatinib may decrease the excretion rate of Lusutrombopag which could result in a higher serum level. |
| Manidipine | The metabolism of Brigatinib can be decreased when combined with Manidipine. |
| Maribavir | Maribavir may decrease the excretion rate of Brigatinib which could result in a higher serum level. |
| Mavacamten | The serum concentration of Brigatinib can be decreased when it is combined with Mavacamten. |
| Medroxyprogesterone acetate | The metabolism of Brigatinib can be increased when combined with Medroxyprogesterone acetate. |
| Meloxicam | The risk or severity of methemoglobinemia can be increased when Brigatinib is combined with Meloxicam. |
| Meperidine | The metabolism of Brigatinib can be decreased when combined with Meperidine. |
| Mephenytoin | The metabolism of Brigatinib can be decreased when combined with Mephenytoin. |
| Mepivacaine | The risk or severity of methemoglobinemia can be increased when Brigatinib is combined with Mepivacaine. |
| Meprednisone | The metabolism of Brigatinib can be increased when combined with Meprednisone. |
| Mestranol | The metabolism of Brigatinib can be decreased when combined with Mestranol. |
| Metformin | The excretion of Metformin can be decreased when combined with Brigatinib. |
| Methadone | The metabolism of Brigatinib can be decreased when combined with Methadone. |
| Methimazole | The metabolism of Brigatinib can be decreased when combined with Methimazole. |
| Methotrexate | Brigatinib may decrease the excretion rate of Methotrexate which could result in a higher serum level. |
| Methoxy polyethylene glycol-epoetin beta | The risk or severity of Thrombosis can be increased when Methoxy polyethylene glycol-epoetin beta is combined with Brigatinib. |
| Methylene blue | The metabolism of Brigatinib can be decreased when combined with Methylene blue. |
| Methylergometrine | The metabolism of Brigatinib can be decreased when combined with Methylergometrine. |
| Methylphenobarbital | The metabolism of Brigatinib can be increased when combined with Methylphenobarbital. |
| Methylprednisolone | The metabolism of Brigatinib can be increased when combined with Methylprednisolone. |
| Methylprednisone | The metabolism of Brigatinib can be decreased when combined with Methylprednisone. |
| Methysergide | The metabolism of Brigatinib can be decreased when combined with Methysergide. |
| Metreleptin | The metabolism of Brigatinib can be increased when combined with Metreleptin. |
| Metronidazole | The metabolism of Brigatinib can be decreased when combined with Metronidazole. |
| Metyrapone | The metabolism of Brigatinib can be increased when combined with Metyrapone. |
| Miconazole | The metabolism of Brigatinib can be decreased when combined with Miconazole. |
| Midazolam | The metabolism of Brigatinib can be decreased when combined with Midazolam. |
| Midostaurin | The metabolism of Brigatinib can be decreased when combined with Midostaurin. |
| Mifepristone | The serum concentration of Brigatinib can be increased when it is combined with Mifepristone. |
| Milnacipran | The metabolism of Milnacipran can be increased when combined with Brigatinib. |
| Miocamycin | The metabolism of Brigatinib can be decreased when combined with Miocamycin. |
| Mirtazapine | The metabolism of Brigatinib can be decreased when combined with Mirtazapine. |
| Mitapivat | The metabolism of Brigatinib can be increased when combined with Mitapivat. |
| Mitotane | The metabolism of Brigatinib can be increased when combined with Mitotane. |
| Mitoxantrone | Brigatinib may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. |
| Mobocertinib | The serum concentration of Brigatinib can be decreased when it is combined with Mobocertinib. |
| Modafinil | The metabolism of Brigatinib can be increased when combined with Modafinil. |
| Mometasone furoate | The metabolism of Brigatinib can be increased when combined with Mometasone furoate. |
| Montelukast | The metabolism of Brigatinib can be decreased when combined with Montelukast. |
| Morphine | The metabolism of Brigatinib can be decreased when combined with Morphine. |
| Mosunetuzumab | The metabolism of Brigatinib can be decreased when combined with Mosunetuzumab. |
| Mycophenolate mofetil | The metabolism of Brigatinib can be decreased when combined with Mycophenolate mofetil. |
| Nadolol | The excretion of Nadolol can be decreased when combined with Brigatinib. |
| Nafcillin | The metabolism of Brigatinib can be increased when combined with Nafcillin. |
| Naloxone | The metabolism of Brigatinib can be decreased when combined with Naloxone. |
| Naproxen | The metabolism of Brigatinib can be decreased when combined with Naproxen. |
| Nefazodone | The metabolism of Brigatinib can be decreased when combined with Nefazodone. |
| Nelfinavir | The metabolism of Brigatinib can be decreased when combined with Nelfinavir. |
| Netupitant | The metabolism of Brigatinib can be decreased when combined with Netupitant. |
| Niacin | The metabolism of Brigatinib can be decreased when combined with Niacin. |
| Nicardipine | The metabolism of Brigatinib can be decreased when combined with Nicardipine. |
| Nilotinib | The metabolism of Brigatinib can be decreased when combined with Nilotinib. |
| Nilutamide | The metabolism of Brigatinib can be decreased when combined with Nilutamide. |
| Nilvadipine | The metabolism of Brigatinib can be decreased when combined with Nilvadipine. |
| Nintedanib | The metabolism of Brigatinib can be decreased when combined with Nintedanib. |
| Nitrofurantoin | Brigatinib may decrease the excretion rate of Nitrofurantoin which could result in a higher serum level. |
| Norethisterone | The metabolism of Brigatinib can be decreased when combined with Norethisterone. |
| Norgestimate | The metabolism of Brigatinib can be increased when combined with Norgestimate. |
| Noscapine | The metabolism of Brigatinib can be decreased when combined with Noscapine. |
| Novobiocin | Novobiocin may decrease the excretion rate of Brigatinib which could result in a higher serum level. |
| Octreotide | The serum concentration of Brigatinib can be increased when it is combined with Octreotide. |
| Olaparib | The metabolism of Brigatinib can be decreased when combined with Olaparib. |
| Oliceridine | The serum concentration of Oliceridine can be decreased when it is combined with Brigatinib. |
| Olodaterol | The metabolism of Brigatinib can be decreased when combined with Olodaterol. |
| Ombitasvir | The metabolism of Brigatinib can be decreased when combined with Ombitasvir. |
| Omeprazole | The metabolism of Brigatinib can be increased when combined with Omeprazole. |
| Oritavancin | The metabolism of Brigatinib can be increased when combined with Oritavancin. |
| Orphenadrine | The metabolism of Brigatinib can be decreased when combined with Orphenadrine. |
| Osilodrostat | The metabolism of Brigatinib can be decreased when combined with Osilodrostat. |
| Osimertinib | The metabolism of Brigatinib can be decreased when combined with Osimertinib. |
| Oteseconazole | The serum concentration of Brigatinib can be increased when it is combined with Oteseconazole. |
| Oxaliplatin | Brigatinib may decrease the excretion rate of Oxaliplatin which could result in a higher serum level. |
| Oxcarbazepine | The metabolism of Brigatinib can be increased when combined with Oxcarbazepine. |
| Oxetacaine | The risk or severity of methemoglobinemia can be increased when Brigatinib is combined with Oxetacaine. |
| Oxybuprocaine | The risk or severity of methemoglobinemia can be increased when Brigatinib is combined with Oxybuprocaine. |
| Oxybutynin | The metabolism of Brigatinib can be decreased when combined with Oxybutynin. |
| Ozanimod | Brigatinib may decrease the excretion rate of Ozanimod which could result in a higher serum level. |
| Paclitaxel | The metabolism of Brigatinib can be increased when combined with Paclitaxel. |
| Pacritinib | The serum concentration of Brigatinib can be increased when it is combined with Pacritinib. |
| Palbociclib | The metabolism of Brigatinib can be decreased when combined with Palbociclib. |
| Pantoprazole | Pantoprazole may decrease the excretion rate of Brigatinib which could result in a higher serum level. |
| Paramethadione | The metabolism of Brigatinib can be decreased when combined with Paramethadione. |
| Parathyroid hormone | The therapeutic efficacy of Parathyroid hormone can be decreased when used in combination with Brigatinib. |
| Paritaprevir | Paritaprevir may decrease the excretion rate of Brigatinib which could result in a higher serum level. |
| Pasireotide | The metabolism of Brigatinib can be decreased when combined with Pasireotide. |
| Pazopanib | The metabolism of Brigatinib can be decreased when combined with Pazopanib. |
| Peginesatide | The risk or severity of Thrombosis can be increased when Peginesatide is combined with Brigatinib. |
| Pentobarbital | The metabolism of Brigatinib can be increased when combined with Pentobarbital. |
| Perampanel | The metabolism of Perampanel can be increased when combined with Brigatinib. |
| Phenobarbital | The metabolism of Brigatinib can be increased when combined with Phenobarbital. |
| Phenol | The risk or severity of methemoglobinemia can be increased when Brigatinib is combined with Phenol. |
| Phenprocoumon | The metabolism of Brigatinib can be decreased when combined with Phenprocoumon. |
| Phenylbutazone | The metabolism of Brigatinib can be increased when combined with Phenylbutazone. |
| Phenytoin | The metabolism of Brigatinib can be increased when combined with Phenytoin. |
| Pibrentasvir | Brigatinib may decrease the excretion rate of Pibrentasvir which could result in a higher serum level. |
| Pimavanserin | The metabolism of Brigatinib can be decreased when combined with Pimavanserin. |
| Pimozide | The metabolism of Brigatinib can be decreased when combined with Pimozide. |
| Pioglitazone | The metabolism of Brigatinib can be decreased when combined with Pioglitazone. |
| Piperaquine | The metabolism of Brigatinib can be decreased when combined with Piperaquine. |
| Piroxicam | The metabolism of Brigatinib can be decreased when combined with Piroxicam. |
| Pitavastatin | The metabolism of Brigatinib can be decreased when combined with Pitavastatin. |
| Pitolisant | The serum concentration of Brigatinib can be decreased when it is combined with Pitolisant. |
| Ponatinib | The metabolism of Brigatinib can be decreased when combined with Ponatinib. |
| Posaconazole | The metabolism of Brigatinib can be decreased when combined with Posaconazole. |
| Potassium Iodide | The therapeutic efficacy of Potassium Iodide can be decreased when used in combination with Brigatinib. |
| Potassium perchlorate | The therapeutic efficacy of Potassium perchlorate can be decreased when used in combination with Brigatinib. |
| Pralatrexate | Brigatinib may decrease the excretion rate of Pralatrexate which could result in a higher serum level. |
| Pralsetinib | The metabolism of Brigatinib can be increased when combined with Pralsetinib. |
| Pramocaine | The risk or severity of methemoglobinemia can be increased when Brigatinib is combined with Pramocaine. |
| Pravastatin | Pravastatin may decrease the excretion rate of Brigatinib which could result in a higher serum level. |
| Prazosin | Brigatinib may decrease the excretion rate of Prazosin which could result in a higher serum level. |
| Prednisolone | The metabolism of Brigatinib can be increased when combined with Prednisolone. |
| Prednisolone acetate | The metabolism of Brigatinib can be increased when combined with Prednisolone acetate. |
| Prednisolone phosphate | The metabolism of Brigatinib can be increased when combined with Prednisolone phosphate. |
| Prednisone acetate | The metabolism of Brigatinib can be increased when combined with Prednisone acetate. |
| Pretomanid | The metabolism of Brigatinib can be decreased when combined with Pretomanid. |
| Prilocaine | The risk or severity of methemoglobinemia can be increased when Brigatinib is combined with Prilocaine. |
| Primaquine | The metabolism of Brigatinib can be decreased when combined with Primaquine. |
| Primidone | The metabolism of Brigatinib can be increased when combined with Primidone. |
| Probenecid | The metabolism of Brigatinib can be increased when combined with Probenecid. |
| Procainamide | The excretion of Procainamide can be decreased when combined with Brigatinib. |
| Procaine | The risk or severity of methemoglobinemia can be increased when Brigatinib is combined with Procaine. |
| Progesterone | Progesterone may decrease the excretion rate of Brigatinib which could result in a higher serum level. |
| Proparacaine | The risk or severity of methemoglobinemia can be increased when Brigatinib is combined with Proparacaine. |
| Propofol | The metabolism of Brigatinib can be decreased when combined with Propofol. |
| Propoxycaine | The risk or severity of methemoglobinemia can be increased when Brigatinib is combined with Propoxycaine. |
| Propylthiouracil | The therapeutic efficacy of Propylthiouracil can be decreased when used in combination with Brigatinib. |
| Protirelin | The therapeutic efficacy of Protirelin can be decreased when used in combination with Brigatinib. |
| Pyrimethamine | The metabolism of Brigatinib can be decreased when combined with Pyrimethamine. |
| Quinidine | The metabolism of Brigatinib can be decreased when combined with Quinidine. |
| Quinine | The metabolism of Brigatinib can be increased when combined with Quinine. |
| Quinupristin | The metabolism of Brigatinib can be decreased when combined with Quinupristin. |
| Rabeprazole | Rabeprazole may decrease the excretion rate of Brigatinib which could result in a higher serum level. |
| Raloxifene | The metabolism of Brigatinib can be decreased when combined with Raloxifene. |
| Ranolazine | The metabolism of Ranolazine can be increased when combined with Brigatinib. |
| Regorafenib | Regorafenib may decrease the excretion rate of Brigatinib which could result in a higher serum level. |
| Relebactam | The excretion of Relebactam can be decreased when combined with Brigatinib. |
| Remdesivir | The metabolism of Brigatinib can be decreased when combined with Remdesivir. |
| Repaglinide | The metabolism of Brigatinib can be decreased when combined with Repaglinide. |
| Retapamulin | The metabolism of Retapamulin can be increased when combined with Brigatinib. |
| Revefenacin | Brigatinib may decrease the excretion rate of Revefenacin which could result in a higher serum level. |
| Ribociclib | The metabolism of Brigatinib can be decreased when combined with Ribociclib. |
| Rifabutin | The metabolism of Brigatinib can be increased when combined with Rifabutin. |
| Rifampicin | The metabolism of Brigatinib can be increased when combined with Rifampicin. |
| Rifamycin | The metabolism of Brigatinib can be increased when combined with Rifamycin. |
| Rifapentine | The metabolism of Brigatinib can be increased when combined with Rifapentine. |
| Rilonacept | The metabolism of Brigatinib can be increased when combined with Rilonacept. |
| Rilpivirine | The metabolism of Brigatinib can be decreased when combined with Rilpivirine. |
| Riluzole | Brigatinib may decrease the excretion rate of Riluzole which could result in a higher serum level. |
| Rimegepant | The metabolism of Rimegepant can be increased when combined with Brigatinib. |
| Riociguat | The metabolism of Brigatinib can be decreased when combined with Riociguat. |
| Ripretinib | Brigatinib may decrease the excretion rate of Ripretinib which could result in a higher serum level. |
| Ritonavir | The metabolism of Brigatinib can be decreased when combined with Ritonavir. |
| Rivaroxaban | Brigatinib may decrease the excretion rate of Rivaroxaban which could result in a higher serum level. |
| Rofecoxib | The metabolism of Brigatinib can be increased when combined with Rofecoxib. |
| Roflumilast | The metabolism of Brigatinib can be decreased when combined with Roflumilast. |
| Rolapitant | Rolapitant may decrease the excretion rate of Brigatinib which could result in a higher serum level. |
| Ropivacaine | The risk or severity of methemoglobinemia can be increased when Brigatinib is combined with Ropivacaine. |
| Rosiglitazone | The metabolism of Brigatinib can be decreased when combined with Rosiglitazone. |
| Rosuvastatin | The metabolism of Brigatinib can be decreased when combined with Rosuvastatin. |
| Roxadustat | The serum concentration of Brigatinib can be increased when it is combined with Roxadustat. |
| Roxithromycin | The metabolism of Brigatinib can be decreased when combined with Roxithromycin. |
| Rucaparib | The metabolism of Brigatinib can be decreased when combined with Rucaparib. |
| Rufinamide | The metabolism of Brigatinib can be increased when combined with Rufinamide. |
| Safinamide | Safinamide may decrease the excretion rate of Brigatinib which could result in a higher serum level. |
| Salmeterol | The metabolism of Brigatinib can be decreased when combined with Salmeterol. |
| Salmon calcitonin | The therapeutic efficacy of Salmon calcitonin can be decreased when used in combination with Brigatinib. |
| Saquinavir | The metabolism of Brigatinib can be decreased when combined with Saquinavir. |
| Sarilumab | The metabolism of Brigatinib can be increased when combined with Sarilumab. |
| Satralizumab | The serum concentration of Brigatinib can be decreased when it is combined with Satralizumab. |
| Secobarbital | The metabolism of Brigatinib can be increased when combined with Secobarbital. |
| Secukinumab | The metabolism of Brigatinib can be increased when combined with Secukinumab. |
| Segesterone acetate | The metabolism of Segesterone acetate can be increased when combined with Brigatinib. |
| Selegiline | The metabolism of Brigatinib can be decreased when combined with Selegiline. |
| Selexipag | The metabolism of Brigatinib can be decreased when combined with Selexipag. |
| Selpercatinib | The serum concentration of Selpercatinib can be decreased when it is combined with Brigatinib. |
| Selumetinib | The metabolism of Brigatinib can be decreased when combined with Selumetinib. |
| Siltuximab | The metabolism of Brigatinib can be increased when combined with Siltuximab. |
| Simeprevir | The metabolism of Brigatinib can be decreased when combined with Simeprevir. |
| Simvastatin | The metabolism of Brigatinib can be decreased when combined with Simvastatin. |
| Siponimod | The metabolism of Brigatinib can be decreased when combined with Siponimod. |
| Sitagliptin | The metabolism of Brigatinib can be decreased when combined with Sitagliptin. |
| Somatostatin | The metabolism of Brigatinib can be decreased when combined with Somatostatin. |
| Somatrogon | The metabolism of Brigatinib can be increased when combined with Somatrogon. |
| Sorafenib | The metabolism of Brigatinib can be decreased when combined with Sorafenib. |
| Sotagliflozin | Sotagliflozin may decrease the excretion rate of Brigatinib which could result in a higher serum level. |
| Sotorasib | The serum concentration of Brigatinib can be decreased when it is combined with Sotorasib. |
| Spironolactone | The metabolism of Brigatinib can be decreased when combined with Spironolactone. |
| St. John’s Wort | The metabolism of Brigatinib can be increased when combined with St. John’s Wort. |
| Stiripentol | The metabolism of Brigatinib can be decreased when combined with Stiripentol. |
| Sulfadiazine | The metabolism of Brigatinib can be decreased when combined with Sulfadiazine. |
| Sulfamethoxazole | The metabolism of Brigatinib can be decreased when combined with Sulfamethoxazole. |
| Sulfaphenazole | The metabolism of Brigatinib can be decreased when combined with Sulfaphenazole. |
| Sulfasalazine | Sulfasalazine may decrease the excretion rate of Brigatinib which could result in a higher serum level. |
| Sulfinpyrazone | The metabolism of Brigatinib can be increased when combined with Sulfinpyrazone. |
| Sumatriptan | Brigatinib may decrease the excretion rate of Sumatriptan which could result in a higher serum level. |
| Sunitinib | Sunitinib may decrease the excretion rate of Brigatinib which could result in a higher serum level. |
| Suvorexant | The metabolism of Brigatinib can be decreased when combined with Suvorexant. |
| Tacrolimus | The metabolism of Brigatinib can be decreased when combined with Tacrolimus. |
| Tafamidis | The serum concentration of Brigatinib can be increased when it is combined with Tafamidis. |
| Talazoparib | Brigatinib may decrease the excretion rate of Talazoparib which could result in a higher serum level. |
| Tamoxifen | The metabolism of Brigatinib can be increased when combined with Tamoxifen. |
| Tasimelteon | The metabolism of Brigatinib can be decreased when combined with Tasimelteon. |
| Taurocholic acid | Taurocholic acid may decrease the excretion rate of Brigatinib which could result in a higher serum level. |
| Tazarotene | The metabolism of Brigatinib can be decreased when combined with Tazarotene. |
| Tazemetostat | The metabolism of Brigatinib can be decreased when combined with Tazemetostat. |
| Tecovirimat | The metabolism of Brigatinib can be increased when combined with Tecovirimat. |
| Tegafur | The metabolism of Brigatinib can be decreased when combined with Tegafur. |
| Tegaserod | The metabolism of Brigatinib can be decreased when combined with Tegaserod. |
| Telaprevir | The metabolism of Brigatinib can be decreased when combined with Telaprevir. |
| Telithromycin | The metabolism of Brigatinib can be decreased when combined with Telithromycin. |
| Telmisartan | Telmisartan may decrease the excretion rate of Brigatinib which could result in a higher serum level. |
| Telotristat ethyl | The serum concentration of Brigatinib can be decreased when it is combined with Telotristat ethyl. |
| Teniposide | The metabolism of Brigatinib can be decreased when combined with Teniposide. |
| Tenofovir alafenamide | The metabolism of Brigatinib can be decreased when combined with Tenofovir alafenamide. |
| Tepotinib | Tepotinib may decrease the excretion rate of Brigatinib which could result in a higher serum level. |
| Terbinafine | The metabolism of Brigatinib can be increased when combined with Terbinafine. |
| Terfenadine | The metabolism of Brigatinib can be decreased when combined with Terfenadine. |
| Teriflunomide | The metabolism of Brigatinib can be decreased when combined with Teriflunomide. |
| Teriparatide | The therapeutic efficacy of Teriparatide can be decreased when used in combination with Brigatinib. |
| Testosterone | The metabolism of Brigatinib can be increased when combined with Testosterone. |
| Testosterone cypionate | The metabolism of Brigatinib can be decreased when combined with Testosterone cypionate. |
| Testosterone enanthate | The metabolism of Brigatinib can be decreased when combined with Testosterone enanthate. |
| Tetracaine | The risk or severity of methemoglobinemia can be increased when Brigatinib is combined with Tetracaine. |
| Tetracycline | The metabolism of Brigatinib can be decreased when combined with Tetracycline. |
| Theophylline | The metabolism of Brigatinib can be decreased when combined with Theophylline. |
| Thiamylal | The metabolism of Brigatinib can be increased when combined with Thiamylal. |
| Thyroid, porcine | The therapeutic efficacy of Thyroid, porcine can be decreased when used in combination with Brigatinib. |
| Thyrotropin alfa | The therapeutic efficacy of Thyrotropin alfa can be decreased when used in combination with Brigatinib. |
| Ticagrelor | The metabolism of Brigatinib can be decreased when combined with Ticagrelor. |
| Ticlopidine | The metabolism of Brigatinib can be decreased when combined with Ticlopidine. |
| Tipranavir | The metabolism of Brigatinib can be decreased when combined with Tipranavir. |
| Tivozanib | The metabolism of Tivozanib can be increased when combined with Brigatinib. |
| Tocilizumab | The metabolism of Brigatinib can be increased when combined with Tocilizumab. |
| Tolbutamide | The metabolism of Brigatinib can be decreased when combined with Tolbutamide. |
| Topiramate | The metabolism of Brigatinib can be increased when combined with Topiramate. |
| Topotecan | The excretion of Topotecan can be decreased when combined with Brigatinib. |
| Torasemide | The metabolism of Brigatinib can be decreased when combined with Torasemide. |
| Tramadol | The metabolism of Tramadol can be increased when combined with Brigatinib. |
| Trametinib | The metabolism of Brigatinib can be decreased when combined with Trametinib. |
| Treprostinil | The metabolism of Brigatinib can be decreased when combined with Treprostinil. |
| Tretinoin | The metabolism of Brigatinib can be decreased when combined with Tretinoin. |
| Triamcinolone | The metabolism of Brigatinib can be increased when combined with Triamcinolone. |
| Triclabendazole | The metabolism of Brigatinib can be decreased when combined with Triclabendazole. |
| Trilaciclib | Brigatinib may decrease the excretion rate of Trilaciclib which could result in a higher serum level. |
| Trimethadione | The metabolism of Brigatinib can be decreased when combined with Trimethadione. |
| Trimethoprim | The metabolism of Brigatinib can be decreased when combined with Trimethoprim. |
| Troglitazone | The metabolism of Brigatinib can be increased when combined with Troglitazone. |
| Troleandomycin | The metabolism of Brigatinib can be decreased when combined with Troleandomycin. |
| Tucatinib | The metabolism of Tucatinib can be decreased when combined with Brigatinib. |
| Ubrogepant | The serum concentration of Ubrogepant can be increased when it is combined with Brigatinib. |
| Valproic acid | The metabolism of Brigatinib can be decreased when combined with Valproic acid. |
| Vandetanib | Vandetanib may decrease the excretion rate of Brigatinib which could result in a higher serum level. |
| Velpatasvir | The metabolism of Brigatinib can be decreased when combined with Velpatasvir. |
| Vemurafenib | The metabolism of Brigatinib can be increased when combined with Vemurafenib. |
| Venetoclax | The metabolism of Brigatinib can be decreased when combined with Venetoclax. |
| Venlafaxine | Venlafaxine may increase the excretion rate of Brigatinib which could result in a lower serum level and potentially a reduction in efficacy. |
| Verapamil | The metabolism of Brigatinib can be decreased when combined with Verapamil. |
| Viloxazine | The metabolism of Brigatinib can be decreased when combined with Viloxazine. |
| Vinblastine | The metabolism of Brigatinib can be increased when combined with Vinblastine. |
| Vincristine | Brigatinib may decrease the excretion rate of Vincristine which could result in a higher serum level. |
| Vismodegib | Vismodegib may decrease the excretion rate of Brigatinib which could result in a higher serum level. |
| Vitamin E | The metabolism of Brigatinib can be increased when combined with Vitamin E. |
| Vorapaxar | The metabolism of Brigatinib can be decreased when combined with Vorapaxar. |
| Voriconazole | The metabolism of Brigatinib can be decreased when combined with Voriconazole. |
| Vortioxetine | The metabolism of Brigatinib can be decreased when combined with Vortioxetine. |
| Voxelotor | The serum concentration of Brigatinib can be increased when it is combined with Voxelotor. |
| Voxilaprevir | The metabolism of Brigatinib can be decreased when combined with Voxilaprevir. |
| Warfarin | The metabolism of Warfarin can be increased when combined with Brigatinib. |
| Zafirlukast | The metabolism of Brigatinib can be decreased when combined with Zafirlukast. |
Pregnancy and Lactation
AU TGA pregnancy category: D
US FDA pregnancy category: Not assigned.
Pregnancy
- Based on its mechanism of action and findings in animals, this drug can cause fetal harm when administered to a pregnant woman. Administration to pregnant rats during the period of organogenesis resulted in dose-related skeletal anomalies at doses as low as 12.5 mg/kg/day (approximately 0.7 times the human exposure at 180 mg once daily) as well as increased post-implantation loss, malformations, and decreased fetal body weight at doses of 25 mg/kg/day (approximately 1.26 times the human exposure at 180 mg once daily) or greater.
Breastfeeding
No information is available on the clinical use of this drug during breastfeeding.
- Use is not recommended.
- Excreted into human milk: Unknown
- Excreted into animal milk: Data not available
What special precautions should I follow?
Before taking brigatinib,
- tell your doctor and pharmacist if you are allergic to brigatinib, any other medications, or any of the ingredients in brigatinib tablets. Ask your pharmacist for a list of the ingredients.
- tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: antifungals such as itraconazole (Onmel, Sporanox, Tolsura), ketoconazole, buprenorphine and naloxone (Suboxone), carbamazepine (Equetro, Tegretol, Teril, others), clarithromycin, cyclosporine (Gengraf, Neoral, Sandimmune), diltiazem (Cardizem, Cartia, Diltzac, others), efavirenz (Sustiva, in Atripla, Symfi), erythromycin (E.E.S., Eryc, Erythrocin), indinavir (Crixivan), nefazodone, nelfinavir (Viracept), nevirapine (Viramune), phenobarbital; phenytoin (Dilantin, Phenytek), pioglitazone (Actos, in Actoplus Met, Duetact, Oseni), rifabutin (Mycobutin), rifampin (Rifadin, Rimactane, in Rifamate, in Rifater), ritonavir (Norvir, in Kaletra, Technivie, Viekira), sirolimus (Rapamune), tacrolimus (Astagraf, Envarsus, Prograf), or verapamil (Calan, Verelan, in Tarka). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with brigatinib, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.
- tell your doctor what herbal products you are taking, especially St. John’s wort.
- tell your doctor if you have or have ever had high blood pressure; a slow heartbeat; diabetes or other blood sugar problems; or kidney or liver disease.
- tell your doctor if you are pregnant, plan to become pregnant, or plan to father a child. Brigatinib may interfere with the action of hormonal contraceptives (birth control pills, patches, rings, implants, or injections), so you should not use these as your only method of birth control during your treatment. You must use a non-hormonal birth control such as a barrier method (device that blocks sperm from entering the uterus such as a condom or a diaphragm). Ask your doctor to help you choose a method of birth control that will work for you. If you are female, you will need to use non-hormonal birth control during your treatment and for 4 months after your final dose. If you are male, you and your female partner should use birth control during your treatment and continue to use birth control for 3 months after your final dose. Brigatinib may harm the fetus.
- tell your doctor if you are breastfeeding. You should not breastfeed during your treatment with brigatinib and for up to 1 week after your final dose.
- you should know that this medication may decrease fertility in men. Talk to your doctor about the risks of taking brigatinib.
References
