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Drug Interactions between fedratinib and Jevantique Lo

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

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Interactions between your drugs

Major

ethinyl estradiol fedratinib

Applies to: Jevantique Lo (ethinyl estradiol / norethindrone) and fedratinib

Consumer information for this interaction is not currently available.

MONITOR CLOSELY: Coadministration of Janus kinase (JAK) inhibitors and combined hormonal contraceptives, hormone replacement therapy (HRT), or estrogen receptor modulators may potentiate the risk of venous thromboembolism (VTE). Serious and sometimes fatal VTE events including pulmonary embolism (PE) and deep vein thrombosis (DVT) have been observed in patients taking JAK inhibitors. In a randomized safety study of patients with rheumatoid arthritis with at least one cardiovascular risk factor (e.g., prior VTE, body mass index greater than or equal to 35 kg/m2, older age, history of chronic lung disease), an increased risk for VTE was observed with tofacitinib compared to tumor necrosis factor (TNF) inhibitors. Similarly, in a meta-analysis evaluating 16 randomized controlled trials for the incidence of venous thromboembolism with JAK inhibitor use (including tofacitinib, upadacitinib, filgotinib, and baricitinib), a potential increase in the risk of VTE, although not clinically significant, was observed compared to placebo or TNF inhibitors. Subgroup analyses showed higher VTE events with tofacitinib compared to TNF inhibitors and with higher doses of JAK inhibitors. Data surrounding the use of JAK inhibitors with hormonal contraceptives, HRT and or estrogen receptor modulators are not available.

MANAGEMENT: Caution and close clinical monitoring are advised when JAK inhibitors are administered in patients with an increased risk for venous thromboembolism (VTE), such as those taking combined hormonal contraceptives, hormone replacement therapy (HRT) and/or estrogen receptor modulators. While not discussed in US product labeling, international labeling for some JAK inhibitors recommends avoiding concomitant use due to their potential to increase the risk of VTE. Other international labeling suggests JAK inhibitors may be administered if necessary, but with additional monitoring. Patients and their caregivers should be advised to seek medical attention if they experience signs and symptoms of VTE. Individual product labeling should be consulted for further guidance.

References

  1. (2011) "Product Information. Jakafi (ruxolitinib)." Incyte Corporation
  2. (2019) "Product Information. Rinvoq (upadacitinib)." AbbVie US LLC
  3. (2022) "Product Information. Cibinqo (abrocitinib)." Pfizer U.S. Pharmaceuticals Group
  4. (2022) "Product Information. Vonjo (pacritinib)." CTI BioPharma Corp.
  5. (2021) "Product Information. Xeljanz (tofacitinib)." Pfizer U.S. Pharmaceuticals Group, SUPPL-28
  6. (2021) "Product Information. Xeljanz (tOFACitinib)." Pfizer Australia Pty Ltd, pfpxeljt11021
  7. (2022) "Product Information. Xeljanz (tofacitinib)." Pfizer Ltd, XJ 5mg 26_0 GB
  8. (2022) "Product Information. Inrebic (fedratinib)." Bristol-Myers Squibb
  9. (2021) "Product Information. Inrebic (fedratinib)." Bristol-Myers Squibb Pharmaceuticals Ltd
  10. (2022) "Product Information. Olumiant (baricitinib)." Lilly, Eli and Company, SUPPL-7
  11. (2023) "Product Information. Litfulo (ritlecitinib)." Pfizer U.S. Pharmaceuticals Group
  12. (2023) "Product Information. Ojjaara (momelotinib)." GlaxoSmithKline
  13. (2023) "Product Information. Olumiant (bARICITinib)." Eli Lilly Australia Pty Ltd, vA9.0_May2023
  14. (2024) "Product Information. Olumiant (baricitinib)." Eli Lilly and Company Ltd
View all 14 references
Major

norethindrone fedratinib

Applies to: Jevantique Lo (ethinyl estradiol / norethindrone) and fedratinib

Consumer information for this interaction is not currently available.

MONITOR CLOSELY: Coadministration of Janus kinase (JAK) inhibitors and combined hormonal contraceptives, hormone replacement therapy (HRT), or estrogen receptor modulators may potentiate the risk of venous thromboembolism (VTE). Serious and sometimes fatal VTE events including pulmonary embolism (PE) and deep vein thrombosis (DVT) have been observed in patients taking JAK inhibitors. In a randomized safety study of patients with rheumatoid arthritis with at least one cardiovascular risk factor (e.g., prior VTE, body mass index greater than or equal to 35 kg/m2, older age, history of chronic lung disease), an increased risk for VTE was observed with tofacitinib compared to tumor necrosis factor (TNF) inhibitors. Similarly, in a meta-analysis evaluating 16 randomized controlled trials for the incidence of venous thromboembolism with JAK inhibitor use (including tofacitinib, upadacitinib, filgotinib, and baricitinib), a potential increase in the risk of VTE, although not clinically significant, was observed compared to placebo or TNF inhibitors. Subgroup analyses showed higher VTE events with tofacitinib compared to TNF inhibitors and with higher doses of JAK inhibitors. Data surrounding the use of JAK inhibitors with hormonal contraceptives, HRT and or estrogen receptor modulators are not available.

MANAGEMENT: Caution and close clinical monitoring are advised when JAK inhibitors are administered in patients with an increased risk for venous thromboembolism (VTE), such as those taking combined hormonal contraceptives, hormone replacement therapy (HRT) and/or estrogen receptor modulators. While not discussed in US product labeling, international labeling for some JAK inhibitors recommends avoiding concomitant use due to their potential to increase the risk of VTE. Other international labeling suggests JAK inhibitors may be administered if necessary, but with additional monitoring. Patients and their caregivers should be advised to seek medical attention if they experience signs and symptoms of VTE. Individual product labeling should be consulted for further guidance.

References

  1. (2011) "Product Information. Jakafi (ruxolitinib)." Incyte Corporation
  2. (2019) "Product Information. Rinvoq (upadacitinib)." AbbVie US LLC
  3. (2022) "Product Information. Cibinqo (abrocitinib)." Pfizer U.S. Pharmaceuticals Group
  4. (2022) "Product Information. Vonjo (pacritinib)." CTI BioPharma Corp.
  5. (2021) "Product Information. Xeljanz (tofacitinib)." Pfizer U.S. Pharmaceuticals Group, SUPPL-28
  6. (2021) "Product Information. Xeljanz (tOFACitinib)." Pfizer Australia Pty Ltd, pfpxeljt11021
  7. (2022) "Product Information. Xeljanz (tofacitinib)." Pfizer Ltd, XJ 5mg 26_0 GB
  8. (2022) "Product Information. Inrebic (fedratinib)." Bristol-Myers Squibb
  9. (2021) "Product Information. Inrebic (fedratinib)." Bristol-Myers Squibb Pharmaceuticals Ltd
  10. (2022) "Product Information. Olumiant (baricitinib)." Lilly, Eli and Company, SUPPL-7
  11. (2023) "Product Information. Litfulo (ritlecitinib)." Pfizer U.S. Pharmaceuticals Group
  12. (2023) "Product Information. Ojjaara (momelotinib)." GlaxoSmithKline
  13. (2023) "Product Information. Olumiant (bARICITinib)." Eli Lilly Australia Pty Ltd, vA9.0_May2023
  14. (2024) "Product Information. Olumiant (baricitinib)." Eli Lilly and Company Ltd
View all 14 references

Drug and food interactions

Moderate

norethindrone food

Applies to: Jevantique Lo (ethinyl estradiol / norethindrone)

Grapefruit juice may increase the blood levels of certain medications such as norethindrone. You may want to limit your consumption of grapefruit and grapefruit juice during treatment with norethindrone. However, if you have been regularly consuming grapefruit or grapefruit juice with the medication, then it is advisable for you to talk with your doctor before changing the amounts of these products in your diet, as this may alter the effects of your medication. Contact your doctor if your condition changes or you experience increased side effects. Orange juice is not expected to interact.

Switch to professional interaction data

Moderate

fedratinib food

Applies to: fedratinib

Grapefruit juice can increase the blood levels of fedratinib. This may increase the risk of serious side effects such as Wernicke's encephalopathy, a potentially fatal condition of the brain associated with thiamine (vitamin B1) deficiency; low blood cell counts, which can lead to anemia, bleeding, and infections; severe diarrhea, nausea, and vomiting; problems in the liver or pancreas; and development of other cancers. You should avoid the consumption of grapefruit and grapefruit juice during treatment with fedratinib. You may take the medication with or without food, but taking it with a high-fat meal may help reduce nausea and vomiting. Talk to your doctor or pharmacist if you have questions on how to take this or other medications you are prescribed. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Minor

ethinyl estradiol food

Applies to: Jevantique Lo (ethinyl estradiol / norethindrone)

Information for this minor interaction is available on the professional version.

Minor

ethinyl estradiol food

Applies to: Jevantique Lo (ethinyl estradiol / norethindrone)

Information for this minor interaction is available on the professional version.

Minor

norethindrone food

Applies to: Jevantique Lo (ethinyl estradiol / norethindrone)

Information for this minor interaction is available on the professional version.

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.


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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.