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Drug Interactions between Cyramza and ponatinib

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Major

PONATinib ramucirumab

Applies to: ponatinib and Cyramza (ramucirumab)

MONITOR CLOSELY: Coadministration of ramucirumab and drugs that interfere with platelet function or coagulation may potentiate the risk of bleeding complications. Ramucirumab can cause bleeding, including severe and sometimes fatal hemorrhagic complications. In one clinical study, the incidence of severe bleeding was 3.4% for ramucirumab versus 2.6% for placebo.

MANAGEMENT: Concomitant use of ramucirumab and medications that interfere with platelet function or coagulation should be approached cautiously. Close clinical and laboratory observation for bleeding complications is recommended. Patients should be advised to promptly report any signs of bleeding to their physician, including pain, swelling, headache, dizziness, weakness, prolonged bleeding from cuts, increased menstrual flow, vaginal bleeding, nosebleeds, bleeding of gums from brushing, unusual bleeding or bruising, red or brown urine, or red or black stools. Ramucirumab should be permanently discontinued in patients who experience severe bleeding.

References

  1. (2014) "Product Information. Cyramza (ramucirumab)." Eli Lilly and Company

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Drug and food interactions

Moderate

PONATinib food

Applies to: ponatinib

GENERALLY AVOID: Coadministration with grapefruit juice is likely to increase the plasma concentrations of ponatinib, which is primarily metabolized by CYP450 3A4. However, the interaction has not been studied. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit.

MANAGEMENT: The consumption of grapefruit, grapefruit juice, and supplements that contain grapefruit extract should be avoided during treatment with ponatinib.

References

  1. (2012) "Product Information. Iclusig (ponatinib)." Ariad Pharmaceuticals Inc

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Therapeutic duplication warnings

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

Duplication

Vegf/vegfr inhibitors

Therapeutic duplication

The recommended maximum number of medicines in the 'VEGF/VEGFR inhibitors' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'VEGF/VEGFR inhibitors' category:

  • Cyramza (ramucirumab)
  • ponatinib

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer