Tepmetko Drug Interactions

Pharmacokinetic interactions: CYP inducers and P-gp inducers: Tepotinib is a substrate for P-glycoprotein (P-gp) (see Pharmacology: Pharmacokinetics under Actions). Strong P-gp inducers may have the potential to decrease tepotinib exposure. Strong CYP inducers may also decrease tepotinib exposure. Concomitant use of strong P-gp inducers (e.g. carbamazepine, phenytoin, rifampicin, St. John's wort) should be avoided.
Dual strong CYP3A inhibitors and P-gp inhibitors: The effect of strong CYP3A inhibitors or P-gp inhibitors on tepotinib has not been studied clinically. However, metabolism and in vitro data suggest concomitant use of medicinal products that are strong CYP3A inhibitors and P-gp inhibitors may increase tepotinib exposure (see Pharmacology: Pharmacokinetics under Actions), which may increase the incidence and severity of adverse reactions of tepotinib. Concomitant use of tepotinib with dual strong CYP3A and P-gp inhibitors (e.g. itraconazole) should be avoided.
P-gp substrates: Tepotinib can inhibit the transport of sensitive substrates of P-gp (see Pharmacology: Pharmacokinetics under Actions). Monitoring of the clinical effects of P-gp-dependent substances with a narrow therapeutic index (e.g. digoxin) is recommended during co-administration with TEPMETKO.
BCRP substrates: Tepotinib can inhibit the transport of sensitive substrates of the breast cancer resistance protein (BCRP) (see Pharmacology: Pharmacokinetics under Actions). Monitoring of the clinical effects of sensitive BCRP substrates is recommended during co-administration with TEPMETKO.
Metformin: Based on in vitro data, tepotinib or its metabolite may have the potential to alter the exposure to co-administered metformin in humans through inhibition of metformin's renal excretion or hepatic uptake mediated via OCT1 and 2 and MATE1 and 2 (see Pharmacology: Pharmacokinetics under Actions). Monitoring of the clinical effects of metformin is recommended during co-administration with TEPMETKO.