Drug Interactions between Aldroxicon II and infigratinib
This report displays the potential drug interactions for the following 2 drugs:
- Aldroxicon II (aluminum hydroxide/magnesium hydroxide/simethicone)
- infigratinib
Interactions between your drugs
aluminum hydroxide infigratinib
Applies to: Aldroxicon II (aluminum hydroxide / magnesium hydroxide / simethicone) and infigratinib
GENERALLY AVOID: Coadministration of gastric acid-lowering agents including locally acting antacids may reduce the plasma concentrations of infigratinib and its two active metabolites, BHS697 and CQM157. The interaction has been studied with the proton pump inhibitor, lansoprazole. Following coadministration with multiple doses of lansoprazole, infigratinib peak plasma concentration (Cmax) and total systemic exposure (AUC) decreased by 49% and 45%, respectively; BHS697 Cmax and AUC decreased by 44% and 32%, respectively; and CQM157 Cmax and AUC decreased by 55% and 72%, respectively. Reduced efficacy of infigratinib may occur.
MANAGEMENT: Concomitant use of infigratinib with locally acting antacids should generally be avoided. If coadministration with these agents is required, the manufacturer recommends that infigratinib be administered at least 2 hours before or 2 hours after locally acting antacids.
References
- (2021) "Product Information. Truseltiq (infigratinib)." QED Therapeutics Inc
magnesium hydroxide infigratinib
Applies to: Aldroxicon II (aluminum hydroxide / magnesium hydroxide / simethicone) and infigratinib
GENERALLY AVOID: Coadministration of gastric acid-lowering agents including locally acting antacids may reduce the plasma concentrations of infigratinib and its two active metabolites, BHS697 and CQM157. The interaction has been studied with the proton pump inhibitor, lansoprazole. Following coadministration with multiple doses of lansoprazole, infigratinib peak plasma concentration (Cmax) and total systemic exposure (AUC) decreased by 49% and 45%, respectively; BHS697 Cmax and AUC decreased by 44% and 32%, respectively; and CQM157 Cmax and AUC decreased by 55% and 72%, respectively. Reduced efficacy of infigratinib may occur.
MANAGEMENT: Concomitant use of infigratinib with locally acting antacids should generally be avoided. If coadministration with these agents is required, the manufacturer recommends that infigratinib be administered at least 2 hours before or 2 hours after locally acting antacids.
References
- (2021) "Product Information. Truseltiq (infigratinib)." QED Therapeutics Inc
Drug and food interactions
aluminum hydroxide food
Applies to: Aldroxicon II (aluminum hydroxide / magnesium hydroxide / simethicone)
GENERALLY AVOID: The concomitant administration of aluminum-containing products (e.g., antacids and phosphate binders) and citrates may significantly increase serum aluminum concentrations, resulting in toxicity. Citrates or citric acid are contained in numerous soft drinks, citrus fruits, juices, and effervescent and dispersible drug formulations. Citrates enhance the gastrointestinal absorption of aluminum by an unknown mechanism, which may involve the formation of a soluble aluminum-citrate complex. Various studies have reported that citrate increases aluminum absorption by 4.6- to 50-fold in healthy subjects. Patients with renal insufficiency are particularly at risk of developing hyperaluminemia and encephalopathy. Fatalities have been reported. Patients with renal failure or on hemodialysis may also be at risk from soft drinks and effervescent and dispersible drug formulations that contain citrates or citric acid. It is unknown what effect citrus fruits or juices would have on aluminum absorption in healthy patients.
MANAGEMENT: The concomitant use of aluminum- and citrate-containing products and foods should be avoided by renally impaired patients. Hemodialysis patients should especially be cautioned about effervescent and dispersible over-the-counter remedies and soft drinks. Some experts also recommend that healthy patients should separate doses of aluminum-containing antacids and citrates by 2 to 3 hours.
ADJUST DOSING INTERVAL: The administration of aluminum-containing antacids with enteral nutrition may result in precipitation, formation of bezoars, and obstruction of feeding tubes. The proposed mechanism is the formation of an insoluble complex between the aluminum and the protein in the enteral feeding. Several cases of esophageal plugs and nasogastric tube obstructions have been reported in patients receiving high-protein liquids and an aluminum hydroxide-magnesium hydroxide antacid or an aluminum hydroxide antacid.
MANAGEMENT: Some experts recommend that antacids should not be mixed with or given after high protein formulations, that the antacid dose should be separated from the feeding by as much as possible, and that the tube should be thoroughly flushed before administration.
References
- Cerner Multum, Inc. "UK Summary of Product Characteristics."
- Wohlt PD, Zheng L, Gunderson S, Balzar SA, Johnson BD, Fish JT (2009) "Recommendations for the use of medications with continuous enteral nutrition." Am J Health Syst Pharm, 66, p. 1438-67
infigratinib food
Applies to: infigratinib
ADJUST DOSING INTERVAL: Food may increase the oral bioavailability of infigratinib. Coadministration with a high-fat, high-calorie meal (800 to 1,000 calories, with approximately 50% of total calories from fat) in healthy subjects increased mean infigratinib peak plasma concentration (Cmax) and total systemic exposure (AUC) by 60% to 80% and 80% to 120%, respectively, and increased the median time to Cmax from 4 hours to 6 hours. When coadministered with a low-fat, low-calorie meal (approximately 330 calories, with 20% of total calories from fat), mean infigratinib Cmax and AUC increased by 90% and 70%, respectively, while the median time to Cmax did not change.
GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations of infigratinib and one of its active metabolites, BHS697, both of which are primarily metabolized by CYP450 3A4 in vitro. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit. Inhibition of hepatic CYP450 3A4 may also contribute. The interaction has not been studied with grapefruit juice but has been reported for other CYP450 3A4 inhibitors. Coadministration of infigratinib with multiple doses of itraconazole, a potent CYP450 3A4 inhibitor, increased infigratinib peak plasma concentration (Cmax) and total systemic exposure (AUC) by 164% and 622%, respectively, and the AUC for the active metabolite, BHS697, by 174%. In general, the effect of grapefruit juice is concentration-, dose- and preparation-dependent, and can vary widely among brands. Certain preparations of grapefruit juice (e.g., high dose, double strength) have sometimes demonstrated potent inhibition of CYP450 3A4, while other preparations (e.g., low dose, single strength) have typically demonstrated moderate inhibition. Increased exposure to infigratinib and BHS697 may increase the incidence and severity of serious adverse reactions such as infections, anemia, pyrexia, abdominal pain, hypercalcemia, hyperphosphatemia, ocular toxicity (e.g., retinal pigment epithelial detachment), sepsis, stomatitis, diarrhea, palmar-plantar erythrodysesthesia syndrome, increased blood creatinine, increased lipase, and onycholysis.
MANAGEMENT: Infigratinib should be administered on an empty stomach at least one hour before or two hours after food. Patients should avoid consumption of grapefruit, grapefruit juice, or supplements that contain grapefruit during treatment with infigratinib.
References
- (2021) "Product Information. Truseltiq (infigratinib)." QED Therapeutics Inc
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
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
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. | |
No interaction information available. |
Further information
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