Evicenter
P&T meetings

Aqneursa (levacetylleucine)

Ataxia-telangiectasia

Also known as IB1001
Manufacturer
IntraBio
Last updated
206 sources

Product information and disease descriptionProduct descriptionProduct informationDrug/Drug, drug/disease interactions

Effects of other drugs on levacetylleucine

4 evidence topics · 5 sources

N-acetyl-DL-leucine and N-acetyl-D-leucine

“Avoid concomitant use of AQNEURSA with N-acetyl-DL-leucine and N-acetyl-D-leucine.” (opens the prescribing information at this quote)

“The D-enantiomer, N-acetyl-D-leucine, competes with levacetylleucine for monocarboxylate transporter uptake, which may reduce the levacetylleucine efficacy.” (opens the prescribing information at this quote)

“Aqneursa interacts with N-acetyl-DL-leucine and simultaneous use should be avoided.” (opens the source at this quote in a new tab)

“Concomitant use of levacetylleucine with N-acetyl-DL-leucine and N-acetyl-D-leucine should be avoided.” (opens the source at this quote in a new tab)

Nonclinical basis of the enantiomer interaction

“Second, when administered as purified N-acetyl-L-leucine, both the Cmax and the AUC for N-acetyl-L-leucine were higher compared to administration as the racemate, even when scaled for the relative dose.” (opens the source at this quote in a new tab)

“It can be agreed that there are PK differences between the racemate and the L-enantiomer and that non-clinical PK data suggest that the D-enantiomer negatively impacts the uptake of the L-enantiomer.” (opens the source at this quote in a new tab)

Levacetylleucine as a transporter substrate

“Levacetylleucine is a substrate of organic anion transporter (OAT)1 and OAT3, but not organic cation transporter (OCT)2, breast cancer resistance protein (BCRP), or P-glycoprotein (P-gp).” (opens the prescribing information at this quote)

“It was shown in vitro that levacetylleucine is a substrate for OAT1/3. However, since the renal pathway is not the primary route of elimination, the clinical risk of drug-drug interactions with modulators of these transporters is likely minimal.” (opens the source at this quote in a new tab)

“Uptake could be abolished by addition of the inhibitor diclofenac.” (opens the source at this quote in a new tab)

Enzyme modulators and absence of clinical interaction studies

“No interaction studies have been performed.” (opens the source at this quote in a new tab)

“It was shown in vitro that levacetylleucine is metabolized without the involvement of the body's primary detoxification enzymes (CYP, UGT, SULT).” (opens the source at this quote in a new tab)

“This indicates that levacetylleucine is metabolized efficiently, without the risk of overloading the detoxification enzyme systems, the DDI risk with these enzyme modulators could be ruled out.” (opens the source at this quote in a new tab)