Beqalzi (sonrotoclax) is a medicine used to treat mantle cell lymphoma (MCL), a rare type of blood cancer. While Beqalzi can be an effective treatment, it is important to know that it can interact with other medicines and substances.
An interaction occurs when one substance changes how a medication affects the body. Understanding these interactions can reduce the risk of side effects and help your medicine work as intended.
This article does not include all possible Beqalzi interactions. Always tell your health care provider and pharmacist about all prescription drugs, over-the-counter medicines, and any vitamins, herbs, or other supplements you use.
Understanding Beqalzi Interactions
Beqalzi is taken by mouth once daily. It is broken down mainly by the liver. Some medicines can slow down or speed up the rate at which the body processes Beqalzi. This may increase the risk of side effects or make Beqalzi less effective.
Some interactions can be especially important to avoid during the first several weeks of treatment, when the dose is gradually increased during the “ramp-up” phase.
Below are several important drug interactions to be aware of when taking Beqalzi.
1. Certain antibiotics and antifungal medicines
Antibiotics are used for bacterial infections, and antifungal medicines are used for fungal infections. Some of these medicines can interact with Beqalzi. Taking them together may increase the amount of Beqalzi in the body and raise the risk of side effects.
Examples include:
- Clarithromycin
- Erythromycin
- Fluconazole
- Itraconazole
- Posaconazole
- Voriconazole
These medicines can block or slow down the enzyme (CYP3A) that breaks down Beqalzi. When this enzyme is blocked, the body may take longer than usual to break down Beqalzi. This can cause Beqalzi levels to increase and raise the risk of side effects.
Some of these medicines should not be taken during the Beqalzi ramp-up phase. If you need one of these treatments, your health care provider may pause Beqalzi, lower your dose, or recommend a different medicine.
Do not start antibiotic or antifungal medicines on your own without checking with your care team, even if you have these medicines at home or took them in the past.
2. Some HIV and antiviral medicines
Some HIV and antiviral medicines may interact with Beqalzi. The interaction could either increase the risk of side effects or make Beqalzi less effective, depending on the specific medicine.
Examples include:
- Efavirenz
- Lopinavir
- Nelfinavir
- Ritonavir
Some of these medicines block or slow down the enzyme (CYP3A) that breaks down Beqalzi. This can increase the amount of Beqalzi in the body and raise the risk of side effects. Other HIV or antiviral medicines can speed up this enzyme, which may lower the amount of Beqalzi in the body and make it less effective for treating MCL.
Your health care provider may suggest a different medicine, adjust your Beqalzi dose, or monitor you more closely if these medicines must be used together.
3. Some seizure medicines
Certain seizure medicines can interact with Beqalzi and make it less effective.
Examples include:
These medicines can speed up the enzyme (CYP3A) that breaks down Beqalzi. When this happens, the body clears Beqalzi faster than usual, which may lower the amount of medicine in the body and reduce how well it works.
These medicines are generally avoided during Beqalzi treatment. Your health care provider may recommend a different seizure medicine if needed.
4. Certain calcium channel blockers
Calcium channel blockers are a group of medicines used for treating heart conditions or high blood pressure. Some of these medicines, including diltiazem and verapamil, can interact with Beqalzi.
These medicines can block or slow down the enzyme (CYP3A) that breaks down Beqalzi. This can slow down how quickly the body clears Beqalzi, leading to higher levels of the medicine and a greater risk of side effects.
If you need to take both medicines, your health care provider may adjust your Beqalzi dose or monitor you more closely.
5. Rifampin
Rifampin is a medicine used to treat an infection called tuberculosis.
Rifampin can speed up the enzyme (CYP3A) that breaks down Beqalzi. This may lower the amount of Beqalzi in the body, making it less effective.
These medicines are typically not used together. Your health care provider may recommend a different treatment.
Beqalzi and Alcohol
There are no known direct interactions between Beqalzi and alcohol. However, alcohol may worsen certain side effects such as tiredness, diarrhea, dehydration, or dizziness.
Also, heavy alcohol use can weaken your immune system, potentially making it harder for your body to fight infections and cancer.
For these reasons, it is best to limit or avoid alcohol while taking Beqalzi. Ask your health care provider if you have questions about alcohol use.
Other Interactions With Beqalzi
Supplement interactions
Some supplements may interact with Beqalzi. One example is St. John’s wort, an herbal supplement that some people use to help with depression.
Taking St. John’s wort with Beqalzi may lower the effectiveness of Beqalzi. St. John’s wort can speed up how quickly the body breaks down Beqalzi, reducing the amount of medicine in the body. It’s best to avoid taking St. John’s wort while using Beqalzi.
Tell your health care team about all supplements you take. Other herbal and dietary supplements may cause interactions, including supplements that contain certain fruits, as described below.
Food interactions
Beqalzi should be taken with food, but it’s important to avoid certain fruit products. These include:
These fruits may increase the amount of Beqalzi in the body, raising the risk of side effects. It’s best to avoid these foods and beverages while taking Beqalzi.
Vaccines
According to the American Cancer Society, vaccines are an important way for people with cancer to help protect themselves against certain infections. This is especially important because blood cancers such as lymphoma, as well as some treatments, can weaken the immune system and increase the risk of infections.
However, not all vaccines are right for everyone with cancer. The type of vaccine you need and the best time to receive it depend on factors such as your cancer, your treatment plan, and the strength of your immune system. Before receiving any vaccine while taking Beqalzi, talk to your health care provider about which vaccines are recommended for you and when to receive them.
How to Avoid Beqalzi Interactions
The following steps can help lower your risk of drug interactions while taking Beqalzi:
- Take Beqalzi exactly as prescribed.
- Keep an updated list of all medicines and supplements you use and share it with your health care providers and pharmacy.
- Ask your health care provider before you start or stop any medicines or supplements.
- Properly dispose of unused or expired medicines to prevent accidental use.
Your health care provider can help decide whether Beqalzi is safe for you and if your treatment plan needs any changes to help avoid or manage interactions.
