Drug General Information (ID: DDIL103X9A)
Drug Name			Belinostat		Drug Info		Remdesivir		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antineoplastics				Purine Nucleosides
Structure

Mechanism of Belinostat-Remdesivir Interaction (Severity Level: Moderate)
Increased risk of hepatotoxicity Click to Show/Hide Mechanism Graph
Drug Name		Belinostat				Remdesivir
Mechanism		Hepatotoxicity				Hepatotoxicity
Key Mechanism Factor 1
		Factor Name		Hepatotoxicity
		Factor Description		Combination of drugs that can induce hepatotoxicity may increase the risk of liver injury. Symptoms vary depending on the level of exposure and the total extent of liver damage, and may cause few symptoms if the damage is mild, and eventually lead to liver failure in patients with severe damage.
Mechanism Description		Increased risk of hepatotoxicity by the combination of Belinostat and Remdesivir

Recommended Action
Management		Until more information is available, concomitant use of remdesivir with known hepatotoxic drugs should be avoided when possible. Liver function should be evaluated prior to starting remdesivir and monitored during treatment as clinically appropriate. Remdesivir should not be initiated in patients with ALT greater than or equal to 5 times the upper limit of normal (ULN) at baseline. Likewise, remdesivir should be discontinued immediately if ALT increases to 5 times ULN or greater during treatment (may be restarted when ALT falls below 5 times ULN), or if ALT elevation is accompanied by signs or symptoms of liver inflammation or increasing conjugated bilirubin, alkaline phosphatase, or INR.

References
1	Cerner Multum, Inc. "Australian Product Information.".
2	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
3	European Medicines Agency "Summary on compassionate use. Remdesivir Gilead.".
4	Gilead Sciences, Inc "About Remdesivir.".
5	US Food and Drug Administration "Fact sheet for health care providers emergency use authorization (EUA) of remdesivir (GS-5734TM)".