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Referências Bibliográficas

Base de evidências utilizada para construção das recomendações de interação medicamentosa. Todas as interações são fundamentadas em artigos publicados em periódicos indexados, bulas oficiais (FDA/EMA) e guidelines de sociedades médicas. Total: 34 referências.

Guideline / Recomendação (3)

1.

Lewis R, Brüggemann RJ, Padoin C, Maertens J, Bentley A, Gustin C, et al. Triazole antifungal agents and targeted cancer therapies in haematology: recommendations for clinical management. J Antimicrob Chemother. 2024;79(6):1203-1217.

VenetoclaxIbrutinibeAcalabrutinibeZanubrutinibeMidostaurinaGilteritinibeRuxolitinibeCiclosporinaTacrolimoSirolimoEverolimo
3.

Brüggemann RJ, Verheggen R, Boerrigter E, Stanzani M, Verweij PE, Blijlevens NMA, Lewis RE Management of drug–drug interactions of targeted therapies for haematological malignancies and triazole antifungal agents. Lancet Haematol. 2022;9(1):e58-e72.

VenetoclaxIbrutinibeAcalabrutinibeMidostaurinaVincristina
4.

Stemler J, Cornely OA Antifungal prophylaxis in acute myeloid leukemia treated with targeted therapy: a practical approach. HemaSphere. 2022;6(7):e741.

VenetoclaxMidostaurinaGilteritinibeIvosidenibe

Consenso (1)

8.

Chau MM, Kong DCM, van Hal SJ, Urbancic K, Trubiano JA, Slavin MA, Thursky KA Consensus guidelines for optimising antifungal drug delivery and monitoring to avoid toxicity and improve outcomes in patients with haematological malignancy and haemopoietic stem cell transplant recipients, 2021. Intern Med J. 2021;51(Suppl 7):37-66.

CiclosporinaTacrolimoSirolimoEverolimo

Revisão (7)

2.

Azanza JR, Mensa J, Barberán J, Vázquez L, Aguado JM Recommendations for the use of azole antifungals in haematology-oncology patients. Rev Esp Quimioter. 2023;36(2):157-179.

VenetoclaxIbrutinibeDasatinibeNilotinibeVincristinaMidostaurina
31.

Salvatorelli E, Menna P, Minotti G Managing the adverse effects of midostaurin: focus on drug interactions. Chemotherapy. 2023;68(3):170-182.

Midostaurina
22.

Megías-Vericat JE, Solana-Altabella A, Ballesta-López O, et al. Drug-drug interactions of newly approved small molecule inhibitors for acute myeloid leukemia. Ann Hematol. 2022;101:1805-1818.

IvosidenibeEnasidenibeGilteritinibeGlasdegibe
5.

Groll AH, Townsend R, Desai A, Azie N, Jones ME, Engelhardt M, et al. Drug-drug interactions between triazole antifungal agents used to treat invasive aspergillosis and immunosuppressants metabolized by cytochrome P450 3A4. Transpl Infect Dis. 2017;19(5):e12751.

CiclosporinaTacrolimoSirolimoEverolimo
19.

Haouala A, Widmer N, Duchosal MA, Montemurro M, Buclin T, Bentata L Drug interactions with the tyrosine kinase inhibitors imatinib, dasatinib, and nilotinib. Cancer Treat Rev. 2011;37(4):290-303.

ImatinibeDasatinibeNilotinibe
10.

Dodds-Ashley E Management of drug and food interactions with azole antifungal agents in transplant recipients. Pharmacotherapy. 2010;30(8):842-854.

CiclosporinaTacrolimoSirolimo
30.

Brüggemann RJ, Alffenaar JW, Blijlevens NM, et al. Clinical relevance of the pharmacokinetic interactions of azole antifungal drugs with other coadministered agents. Clin Infect Dis. 2009;48(10):1441-1458.

ItraconazolVoriconazolPosaconazolFluconazol

Estudo Clínico (13)

33.

Hayashi H, Yamagiwa T, Kanda J, et al. Impact of venetoclax trough levels on safety and efficacy in the treatment of acute myeloid leukemia. Sci Rep. 2026.

Venetoclax
34.

Sciumè M, Bosi A, Canzi M, et al. Real-life monocentric experience of venetoclax-based regimens for acute myeloid leukemia. Hematol Oncol. 2024.

Venetoclax
7.

Fructuoso-González L, Gutiérrez-Gutiérrez B, Rodríguez-Benítez P, et al. Isavuconazole-tacrolimus interaction in kidney transplant recipients. J Antimicrob Chemother. 2023;78(10):2559-2562.

TacrolimoIsavuconazol
17.

DiNardo CD, Jonas BA, Pullarkat V, et al. Azacitidine and venetoclax in previously untreated acute myeloid leukemia (VIALE-A). N Engl J Med. 2020;383(7):617-629.

Venetoclax
25.

Tam CS, Trotman J, Opat S, et al. Phase 1 study of the selective BTK inhibitor zanubrutinib in B-cell malignancies and safety and efficacy evaluation in CLL. Blood. 2020;136(18):2038-2050.

Zanubrutinibe
20.

Schlenk RF, Weber D, Fiedler W, et al. Midostaurin added to chemotherapy and continued single-agent maintenance therapy in acute myeloid leukemia with FLT3-ITD (RATIFY post-hoc analysis). Leukemia. 2019;33(10):2420-2428.

Midostaurina
26.

Aldoss I, Dadwal S, Zhang J, et al. Invasive fungal infections in acute myeloid leukemia treated with venetoclax and hypomethylating agents. Leuk Lymphoma. 2019;60(11):2820-2822.

VenetoclaxIsavuconazol
9.

Girmenia C, Iori AP Safety of interaction of echinocandins with cyclosporine and tacrolimus in hematopoietic stem cell transplant recipients. Expert Opin Drug Saf. 2017;16(3):329-339.

CiclosporinaTacrolimoCaspofunginaMicafungina
18.

Moriyama B, Henning SA, Leung J, et al. Adverse interactions between antifungal azoles and vincristine: review and analysis of cases. Clin Infect Dis. 2012;54(12):1753-1767.

Vincristina
24.

Kubiak DW, Koo S, Hammer MM, et al. A prospective study of posaconazole-sirolimus drug interaction in allogeneic hematopoietic stem cell transplant recipients. Antimicrob Agents Chemother. 2012;56(6):3468-3472.

SirolimoPosaconazol
29.

Sánchez-Ortega I, Patiño B, Arnan M, et al. Clinical efficacy and safety of posaconazole prophylaxis in allogeneic hematopoietic stem cell transplant recipients. Biol Blood Marrow Transplant. 2012;18(5):759-767.

CiclosporinaTacrolimoPosaconazol
23.

Saad AH, DePestel DD, Carver PL Factors influencing the magnitude and clinical significance of drug interactions between azole antifungals and select immunosuppressants. Clin Infect Dis. 2006;43(5):e36-e38.

SirolimoVoriconazol
28.

Venkataramanan R, Zang S, Gayowski T, Singh N Voriconazole inhibition of the metabolism of tacrolimus in a liver transplant recipient and in human liver microsomes. Antimicrob Agents Chemother. 2002;46(9):3091-3093.

TacrolimoVoriconazol

Farmacocinética / PK (10)

11.

Tian DD, Guo P, Engel SS, et al. Physiologically based pharmacokinetic modeling of pirtobrutinib to predict drug-drug interactions. CPT Pharmacometrics Syst Pharmacol. 2025;14(12):2221-2231.

Pirtobrutinibe
32.

Yang J, Wang H, Liu D, et al. A population pharmacokinetics study of venetoclax concomitant with voriconazole in patients with hematologic malignancies. Drug Des Dev Ther. 2025;19:3681-3690.

VenetoclaxVoriconazol
21.

Flanagan S, Goodman DB, Engel S, et al. Lack of clinically relevant drug-drug interactions between rezafungin and common concomitant medications. Antimicrob Agents Chemother. 2023;67(6):e01339-23.

Rezafungina
13.

Zhou D, Podoll T, Engel J, et al. Evaluation of the drug-drug interaction potential of acalabrutinib and its active metabolite, ACP-5862, using a physiologically based pharmacokinetic modeling approach. J Clin Pharmacol. 2020;60(10):1306-1318.

Acalabrutinibe
15.

James AJ, Smith CC, Litzow M, et al. Pharmacokinetic profile of gilteritinib: a novel FLT3 tyrosine kinase inhibitor. J Clin Pharmacol. 2020;60(S2):S73-S84.

Gilteritinibe
27.

Agarwal S, Salem AH, Danilov AV, et al. Effect of ketoconazole, a strong CYP3A inhibitor, on the pharmacokinetics of venetoclax, a BCL-2 inhibitor, in patients with non-Hodgkin lymphoma. Clin Pharmacol Ther. 2017;101(S1):S80.

Venetoclax
6.

Lempers VJ, van den Heuvel JJ, Russel FG, Aarnoutse RE, Burger DM, Brüggemann RJ, Koenderink JB Inhibitory potential of antifungal drugs on ATP-binding cassette transporters P-glycoprotein, MRP1 to MRP5, BCRP, and BSEP. Curr Opin Pharmacol. 2015;24:38-44.

CiclosporinaTacrolimoSirolimoEverolimo
12.

de Jong J, Sukbuntherng J, Skee D, et al. The effect of CYP3A perpetrators on ibrutinib exposure in healthy participants. Cancer Chemother Pharmacol. 2015;75(5):1007-1017.

Ibrutinibe
14.

Dutreix C, Munarini F, Lorenzo S, Roesel J, Wang Y Investigation into CYP3A4-mediated drug-drug interactions on midostaurin in healthy volunteers. Cancer Chemother Pharmacol. 2013;72(6):1223-1234.

Midostaurina
16.

Shi JG, Chen X, McGee RF, et al. The pharmacokinetics, pharmacodynamics, and safety of orally dosed INCB018424 phosphate in healthy volunteers. J Clin Pharmacol. 2012;52(11):1603-1612.

Ruxolitinibe

Bulas Oficiais (Prescribing Information)

Além dos artigos acima, as seguintes bulas oficiais (FDA/EMA) foram consultadas para recomendações de ajuste de dose:

Venclexta® (venetoclax) — AbbVie 2024Imbruvica® (ibrutinibe) — Janssen 2024Calquence® (acalabrutinibe) — AstraZeneca 2024Brukinsa® (zanubrutinibe) — BeiGene 2024Jaypirca® (pirtobrutinibe) — Eli Lilly 2024Rydapt® (midostaurina) — Novartis 2024Xospata® (gilteritinibe) — Astellas 2024Vanflyta® (quizartinibe) — Daiichi Sankyo 2023Tibsovo® (ivosidenibe) — Servier 2024Rezlidhia® (olutasidenibe) — Rigel 2022Jakafi® (ruxolitinibe) — Incyte 2024Sprycel® (dasatinibe) — BMS 2024Tasigna® (nilotinibe) — Novartis 2024Cresemba® (isavuconazol) — AstellasNoxafil® (posaconazol) — MerckCancidas® (caspofungina) — MerckPrograf® (tacrolimo) — AstellasAfinitor® (everolimo) — NovartisRezzayo® (rezafungina) — Cidara 2023

Como Citar Esta Ferramenta

Morales HMP. InfectoSmart Drug Interaction Checker: Interações entre terapias hematológicas e antifúngicos [ferramenta online]. Versão 2.2. Março 2026. Disponível em: [URL].