Adalimumab
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Drug reference
lurbinectedin
Alkylating agent (tetrahydroisoquinoline; antineoplastic) · Antineoplastic
START
3.2 mg/m² IV over 60 min every 21 days
TYPICAL MAX
3.2 mg/m² q21d (reduce to 2.0 mg/m² for toxicity)
STOP IF
Severe febrile neutropenia, hepatotoxicity, or rhabdomyolysis
WATCH
CBC, LFTs, CK; pre-medicate with antiemetics + dexamethasone
CDSCO approvedATC L01CX02
KDIGO 2024 + manufacturer label
- ONSET
- 6min · infusion start
- PEAK
- 1h · end infusion
- t½
- 2.1d · t½
- DURATION
- 3w · q21d cycle
EXCRETION
Mainly faecal; minimal renal
route + CYP
INTERACTIONS
12 major
SEVERE in our sources
PREGNANCY
Can cause fetal harm — avoid; effective contraception during and 6 months after.
FDA category + note
Top interactionssee all 12 →
- AdalimumabSevereDatabaseDDInter
- AmprenavirSevereDatabaseDDInter
- ApalutamideSevereDatabaseDDInter
- AprepitantSevereDatabaseDDInter
Mechanism
Binds the minor groove of DNA and forms covalent adducts at guanine N2, blocking trans-activated transcription (particularly via Pol II degradation); also depletes tumour-associated macrophages — active in small-cell lung cancer.
Indications
Metastatic small-cell lung cancer (after progression on platinum-based chemotherapy)
Dosing
- Adult
- 3.2 mg/m² IV over 60 min every 21 days; reduce for toxicity (e.g., 2.6 or 2.0 mg/m²).
- Pediatric
- Not established.
- Renal adjustment
- No adjustment for CrCl ≥30; not studied <30.
- Hepatic adjustment
- Avoid in moderate–severe hepatic impairment.
- Geriatric
- Higher cytopenia risk; monitor closely.
- Max dose
- 3.2 mg/m² every 21 days
Pharmacokinetics
Onset
Cytoreduction over cycles
Peak effect
End of infusion
Duration
21-day cycle
Half-life
~51 h
Bioavailability
IV 100%
Protein binding
~99%
Metabolism
Hepatic CYP3A4 (primary)
Excretion
Mainly faecal; minimal renal
Contraindications
- Severe hypersensitivity
- Caution: significant cytopenias, hepatic impairment, infection
Side effects
Common
FatigueNausea/vomitingAnaemiaNeutropeniaThrombocytopeniaDiarrhoeaTransaminase elevation
Serious
- Severe myelosuppression / febrile neutropenia
- Hepatotoxicity
- Rhabdomyolysis
- Severe infection
- Tumour lysis (high disease burden)
Pregnancy & lactation
Pregnancy
Can cause fetal harm — avoid; effective contraception during and 6 months after.
Lactation
Avoid breastfeeding during and 2 weeks after therapy.
Drug interactions
Amprenavir
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Apalutamide
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Aprepitant
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Atazanavir
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Baricitinib
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Boceprevir
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Bosentan
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Carbamazepine
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Cenobamate
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Ceritinib
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Certolizumab
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Related guidelines
Ask House about lurbinectedin
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Sources: Goodman & Gilman 14e·Verified: 2026-05-20 · House clinical team·Cockpit curated: 2026-05-20