Drug General Information (ID: DDI3SPONLQ)
Drug Name			Physostigmine		Drug Info		Brigatinib		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Ophthalmic Glaucoma Agents/Antidotes				Multikinase Inhibitors
Structure

Mechanism of Physostigmine-Brigatinib Interaction (Severity Level: Moderate)
Increased risk of bradycardia Click to Show/Hide Mechanism Graph
Drug Name		Physostigmine				Brigatinib
Mechanism		Bradycardia				Bradycardia
Key Mechanism Factor 1
		Factor Name		Bradycardia
		Factor Description		Bradycardia is a slow heart rate in which the heart beats less than 60 times per minute. If the heart rate is very slow and the heart is not pumping enough oxygen-rich blood to the body, and you may feel dizzy, very tired or weak, and short of breath.
Mechanism Description		Increased risk of bradycardia by the combination of Physostigmine and Brigatinib

Recommended Action
Management		Caution is advised if brigatinib is used concomitantly with beta-blockers, calcium channel blockers, digitalis, or other drugs that can slow the heart rate or atrioventricular conduction such as alectinib, atazanavir, fingolimod, flecainide, ivabradine, lacosamide, lithium, mefloquine, moricizine, propafenone, succinylcholine, thalidomide, H2-receptor antagonists, tricyclic antidepressants, and anticholinesterase or cholinergic agents. Heart rate and blood pressure should be monitored frequently, and patients should be advised to seek medical attention if they experience dizziness, lightheadedness, fainting, or irregular heartbeat.

References
1	Product Information. Alunbrig (brigatinib). Ariad Pharmaceuticals Inc, Cambridge, MA.