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Drug Interactions between Krazati and nintedanib

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

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Interactions between your drugs

Moderate

nintedanib adagrasib

Applies to: nintedanib and Krazati (adagrasib)

Consumer information for this interaction is not currently available.

MONITOR: Coadministration with potent inhibitors of P-glycoprotein (P-gp) or dual inhibitors of P-gp and CYP450 3A4 may increase the plasma concentrations of nintedanib, which is a substrate of the efflux transporter and a minor substrate of the isoenzyme. In a dedicated drug interaction study, administration of nintedanib with the potent P-gp and CYP450 3A4 inhibitor, ketoconazole, increased nintedanib peak plasma concentration (Cmax) by 83% and systemic exposure (AUC) by 61%. No data are available for use with other, less potent inhibitors.

MANAGEMENT: Caution is advised if nintedanib is prescribed with potent P-gp inhibitors or dual P-gp and CYP450 3A4 inhibitors. Pharmacologic response to nintedanib should be monitored more closely whenever one of these inhibitors is added to or withdrawn from therapy, and the nintedanib dosing adjusted or interrupted as necessary in accordance with the product labeling. Patients should be closely monitored for increased adverse effects such as liver enzyme and bilirubin elevations, diarrhea, nausea, vomiting, gastrointestinal perforation, bleeding, and arterial thromboembolic events (e.g., myocardial infarction).

References

  1. (2022) "Product Information. Ofev (nintedanib)." Boehringer Ingelheim
  2. (2021) "Product Information. Ofev (nintedanib)." Boehringer Ingelheim (Canada) Ltd
  3. (2024) "Product Information. Ofev (nintedanib)." Boehringer Ingelheim Pty Ltd
  4. (2023) "Product Information. Ofev (nintedanib)." Boehringer Ingelheim Ltd
  5. (2023) "Product Information. Vargatef (nintedanib)." Boehringer Ingelheim Ltd
View all 5 references

Drug and food interactions

Major

adagrasib food

Applies to: Krazati (adagrasib)

You should avoid consumption of grapefruit and grapefruit juice during approximately the first 8 days of treatment with adagrasib. During this time, grapefruit juice may increase the blood levels of adagrasib. This may increase the risk of side effects such as diarrhea, fatigue, musculoskeletal pain, hepatotoxicity, renal impairment, and an irregular heart rhythm that may be serious and potentially life-threatening. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with adagrasib. Talk to your doctor if you have any questions or concerns. 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.

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Moderate

nintedanib food

Applies to: nintedanib

Grapefruit juice and Seville orange juice can increase the blood levels of nintedanib. This may increase the risk and/or severity of side effects such as liver problems, diarrhea, nausea, vomiting, stomach or intestinal wall perforation, bleeding, and cardiovascular problems such as heart attack, chest pain, or stroke. It is best to avoid or minimize the consumption of Seville oranges, Seville orange juice, grapefruit, and grapefruit juice during treatment. You should take nintedanib with food and swallow it whole with water. Taking nintedanib with food may help with absorption of the medication and reduce gastrointestinal side effects. 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.

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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.

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.

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