Relacorilant

Strong CYP3A Inducers : Avoid coadministration with LIFYORLI in combination with nab-paclitaxel. ( 7.1 ) CYP2C8 Inducers and Moderate CYP3A Inducers : Monitor for reduced effectiveness for LIFYORLI in combination with nab-paclitaxel. ( 7.1 ) CYP2C8 Inhibitors : Monitor for increased adverse reactions and modify the dosage for adverse reactions as recommended. ( 7.1 ) CYP3A Substrates : Avoid coadministration unless otherwise recommended. ( 7.2 ) Certain CYP2C8 Substrates : Avoid coadministration unless otherwise recommended. ( 7.2 )

7.1 Effect of Other Drugs on LIFYORLI in Combination with Nab-Paclitaxel Strong CYP3A Inducers Avoid coadministration of LIFYORLI plus nab-paclitaxel with strong CYP3A inducers. Both relacorilant and paclitaxel are CYP3A substrates. Coadministration of strong CYP3A inducers can decrease concentrations of relacorilant and paclitaxel, which may reduce their effectiveness [see Clinical Pharmacology ( 12.3 )] . CYP2C8 Inducers and Moderate CYP3A Inducers Monitor for reduced effectiveness of LIFYORLI plus nab-paclitaxel with CYP2C8 inducers and moderate CYP3A inducers. Paclitaxel is a substrate of CYP2C8 and CYP3A and relacorilant is a CYP3A substrate.

Coadministration of CYP2C8 inducers and moderate CYP3A inducers can decrease concentrations of paclitaxel and relacorilant, which may reduce their effectiveness. CYP2C8 Inhibitors Monitor for increased adverse reactions and modify the dosage for adverse reactions as recommended [see Dosage and Administration ( 2.3 )] . Paclitaxel is a substrate of CYP2C8. Coadministration of CYP2C8 inhibitors may increase concentrations of paclitaxel, which may increase the risk of adverse reactions.

7.2 Effect of LIFYORLI on Other Drugs CYP3A Substrates Avoid concomitant use unless otherwise recommended in the Prescribing Information for CYP3A substrates. Relacorilant is a strong CYP3A inhibitor. Relacorilant increases exposure of CYP3A substrates [see Clinical Pharmacology ( 12.3 )], which may increase the risk for adverse reactions related to these substrates. Certain CYP2C8 Substrates Avoid concomitant use unless otherwise recommended in the Prescribing Information for CYP2C8 substrates where minimal concentration changes may lead to reduced effectiveness. Relacorilant is a weak CYP2C8 inducer.

Relacorilant decreases exposure of CYP2C8 substrates [see Clinical Pharmacology ( 12.3 )] , which may decrease the effectiveness related to these substrates.

7.3 Potential for Reduced Effectiveness of Glucocorticoids or LIFYORLI with Coadministration LIFYORLI is contraindicated in patients receiving systemic glucocorticoids for lifesaving purposes (e.g., immunosuppression in organ transplantation) [see Contraindications ( 4 )]. Avoid coadministration in patients with other medical conditions requiring systemic glucocorticoids when possible. If coadministration cannot be avoided, monitor patients for reduced effectiveness of LIFYORLI and glucocorticoids. LIFYORLI is a glucocorticoid receptor antagonist, which may make systemic glucocorticoids less effective. Coadministration of systemic glucocorticoids may make LIFYORLI less effective.

8.1 Pregnancy Risk Summary LIFYORLI is used in combination with nab-paclitaxel. Refer to the Prescribing Information of nab-paclitaxel for pregnancy information. Based on findings in animals, LIFYORLI can cause fetal harm when administered to a pregnant woman. There are no available data on relacorilant use in pregnant women to inform drug-associated risk. In animal embryo-fetal development studies, oral administration of relacorilant to pregnant rabbits during the period of organogenesis resulted in embryo-fetal mortality and structural abnormalities at maternal doses of ≥ 10 mg/kg/day (0.6 times the human exposure based on area under the curve (AUC) at the recommended dose).

Oral administration of relacorilant to pregnant rats during the period of organogenesis did not result in fetal malformations [see Data ] . Advise pregnant women and females of reproductive potential of the potential risk to a fetus. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is between 2 to 4% and 15 to 20%, respectively. Data Animal Data Relacorilant is a partial agonist of the glucocorticoid receptor in rats. In an embryo-fetal development study, relacorilant was administered to pregnant rats at oral doses of 1, 2.5, and 10 mg/kg/day during the period of organogenesis.

Maternal toxicity (decreased body weight and food consumption) was observed at a dose of 10 mg/kg/day (3.8 times the human exposure based on AUC at the recommended dose). No developmental toxicity was noted at doses up to 10 mg/kg/day. In an embryo-fetal development study, relacorilant administered to pregnant rabbits at oral doses of 1, 3, and 10 mg/kg/day during the period of organogenesis resulted in embryo-fetal mortality (increased post-implantation loss, fetal resorptions, and a decrease in litter size) at 10 mg/kg/day (0.6 times the human exposure based on AUC at the recommended dose).

Fetal malformations (abnormal flexure of the forepaw, microcephaly, malrotated hindlimbs, absent interparietal bone, and fused sternebra in sternum) were observed at a dose of 10 mg/kg/day (0.6 times the human exposure based on AUC at the recommended dose). Additional adverse effects included skeletal variations of bipartite interparietal bone of the skull observed at doses ≥ 1 mg/kg/day (lower than the human exposure based on AUC at the recommended dose).