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Can you take Axitinib with Sodium phenylbutyrate / taurursodiol?

1 drug interaction and 32 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

axitinib taurursodiol

Applies to: axitinib and sodium phenylbutyrate / taurursodiol

Taurursodiol may increase the blood levels and effects of axitinib. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. Contact your doctor if your condition changes or you experience increased side effects. 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.

Food/lifestyle interactions

Moderate food/lifestyle interactions

Moderate:

sodium phenylbutyrate Food/Lifestyle

Applies to: sodium phenylbutyrate / taurursodiol

Food may affect the absorption of sodium phenylbutyrate. A high-fat, high-calorie meal (approximately 800 to 1000 calories; 500 to 600 calories from fat, 250 calories from carbohydrate, 150 calories from protein) has been shown to reduce the absorption of sodium phenylbutyrate, although it is unknown what impact this may have on the overall effectiveness of the medication. The manufacturer recommends taking sodium phenylbutyrate before a meal or snack. This is especially important if you weigh less than 70 kg (approximately 154 pounds). 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 medication without first talking to your doctor.

Moderate:

axitinib Food/Lifestyle

Applies to: axitinib

Do not consume grapefruit or grapefruit juice during treatment with axitinib unless directed otherwise by your doctor. Grapefruit juice can increase the blood levels of axitinib. This may increase the risk and/or severity of side effects such as high blood pressure, diarrhea, nausea, vomiting, constipation, decreased appetite, weight loss, and rash, itching or peeling of skin on the hands and feet. You may also be more likely to experience less common but more severe side effects such as blood clots (depending on location, can lead to complications such as stroke, heart attack, breathing difficulties, and vision abnormalities); bleeding; liver problems; thyroid problems; tearing (perforation) in the stomach or intestinal wall; and a rare nervous system condition known as reversible posterior leukoencephalopathy syndrome (RPLS). You should seek immediate medical attention if you develop signs and symptoms of these conditions including chest pain or pressure; pain in the arms, back, neck or jaw; swelling; shortness of breath; numbness or weakness on one side of the body; headache; vision changes; seizures, unusual bleeding or bruising; red or black stools; coughing up or vomiting blood or blood clots; and severe stomach or abdominal pain. 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.

Disease interactions

30 potential interactions Applies to: 26 conditions, including High Blood Pressure, Underactive Thyroid, Heart Failure, Peripheral Neuropathy, and Pulmonary Embolism.

Biliary Obstruction

Moderate:

sodium phenylbutyrate / taurursodiol

The taurursodiol in sodium phenylbutyrate / taurursodiol has a moderate potential interaction with Biliary Obstruction.

Sodium phenylbutyrate-taurursodiol contains taurursodiol, a bile acid. In patients with disorders that interfere with bile acid circulation, there may be an increased risk for diarrhea and patients should be monitored appropriately. Other conditions such as pancreatic insufficiency, intestinal malabsorption, or intestinal diseases that may alter the concentration of bile acids, may also lead to decreased absorption of this drug and its components. Consider consulting with a GI specialists with experience managing these GI disorders. Patients with disorders of enterohepatic circulation (e.g., biliary infection, active cholecystitis, etc.), severe pancreatic disorders (e.g., pancreatitis), and intestinal disorders that may alter concentrations of bile acids (e.g., ileal resection, regional ileitis, etc.) were excluded from clinical studies and there is no experience in patients with these conditions. Caution is advised.

Bleeding Disorder

Major:

axitinib

Axitinib has a major potential interaction with Bleeding Disorder.

Fatal hemorrhagic events, including cerebral hemorrhage, hematuria, hemoptysis, lower gastrointestinal hemorrhage, and melena have been reported with the use of axitinib. Therapy with axitinib has not been studied in patients who have evidence of untreated brain metastasis or recent active gastrointestinal bleeding and should not be used in these patients. If any bleeding requires medical intervention, it is recommended to temporarily interrupt the axitinib dose and to stop treatment at least 24 hours prior to scheduled surgery. The decision to resume therapy after surgery should be based on clinical judgment of adequate wound healing.

Central Nervous System Disorders

Moderate:

sodium phenylbutyrate / taurursodiol

The sodium phenylbutyrate in sodium phenylbutyrate / taurursodiol has a moderate potential interaction with Central Nervous System Disorders.

Sodium phenylbutyrate is a pro-drug and is rapidly metabolized to the active, phenylacetate. Neurotoxicity, including exacerbation of a preexisting neuropathy, has been reported with the use of intravenous phenylacetate. The acute onset and reversibility when the phenylacetate infusion was discontinued suggested a drug effect. Care should be exercised when prescribing sodium phenylbutyrate to patients at risk for neurotoxicity.

Cerebral Vascular Disorder

Moderate:

axitinib

Axitinib has a moderate potential interaction with Cerebral Vascular Disorder.

Arterial and venous thromboembolic events, including transient ischemic attack, cerebrovascular accident, myocardial infarction, pulmonary embolism, deep vein thrombosis, retinal occlusion, vein thrombosis, and deaths have been reported with the use of axitinib. Use with caution in patients who are at risk for, or who have a history of, these events. The use of axitinib has not been studied in patients who had an arterial or venous thromboembolic event within the previous 12 months. It is recommended to monitor closely for signs and symptoms of thromboembolism.

Diverticulitis

Moderate:

axitinib

Axitinib has a moderate potential interaction with Diverticulitis.

Therapy with axitinib should be used with caution in patients who may be at increased risk for gastrointestinal perforation, such as those with a history of diverticulitis. Patients presenting with new onset of abdominal symptoms should be evaluated promptly for early identification of gastrointestinal perforation. It is recommended to monitor for symptoms of gastrointestinal perforation or fistula periodically throughout the treatment.

Fluid Retention

Major:

sodium phenylbutyrate / taurursodiol

The sodium phenylbutyrate in sodium phenylbutyrate / taurursodiol has a major potential interaction with Fluid Retention.

The use of sodium phenylbutyrate may cause fluid retention in patients with congestive heart failure, renal dysfunction, or sodium retention with edema. Sodium phenylbutyrate is primarily excreted by the kidney and these patients may exhibit reduced excretion. Therapy with sodium phenylbutyrate should be administered cautiously in these patients. Monitoring plasma levels of ammonia, arginine, branched-chain amino acids and serum proteins to maintain within normal limits and glutamine to less than 1000 mcmol/L is recommended.

Gallbladder Disease

Moderate:

sodium phenylbutyrate / taurursodiol

The taurursodiol in sodium phenylbutyrate / taurursodiol has a moderate potential interaction with Gallbladder Disease.

Sodium phenylbutyrate-taurursodiol contains taurursodiol, a bile acid. In patients with disorders that interfere with bile acid circulation, there may be an increased risk for diarrhea and patients should be monitored appropriately. Other conditions such as pancreatic insufficiency, intestinal malabsorption, or intestinal diseases that may alter the concentration of bile acids, may also lead to decreased absorption of this drug and its components. Consider consulting with a GI specialists with experience managing these GI disorders. Patients with disorders of enterohepatic circulation (e.g., biliary infection, active cholecystitis, etc.), severe pancreatic disorders (e.g., pancreatitis), and intestinal disorders that may alter concentrations of bile acids (e.g., ileal resection, regional ileitis, etc.) were excluded from clinical studies and there is no experience in patients with these conditions. Caution is advised.

Gastrointestinal Perforation

Moderate:

axitinib

Axitinib has a moderate potential interaction with Gastrointestinal Perforation.

Therapy with axitinib should be used with caution in patients who may be at increased risk for gastrointestinal perforation, such as those with a history of diverticulitis. Patients presenting with new onset of abdominal symptoms should be evaluated promptly for early identification of gastrointestinal perforation. It is recommended to monitor for symptoms of gastrointestinal perforation or fistula periodically throughout the treatment.

Heart Failure

Major:

sodium phenylbutyrate / taurursodiol

The sodium phenylbutyrate in sodium phenylbutyrate / taurursodiol has a major potential interaction with Heart Failure.

The use of sodium phenylbutyrate may cause fluid retention in patients with congestive heart failure, renal dysfunction, or sodium retention with edema. Sodium phenylbutyrate is primarily excreted by the kidney and these patients may exhibit reduced excretion. Therapy with sodium phenylbutyrate should be administered cautiously in these patients. Monitoring plasma levels of ammonia, arginine, branched-chain amino acids and serum proteins to maintain within normal limits and glutamine to less than 1000 mcmol/L is recommended.

Moderate:

axitinib

Axitinib has a moderate potential interaction with Heart Failure.

Cardiac failure, including fatal events have been reported in patients receiving axitinib. It is recommended to monitor for signs or symptoms of cardiac failure throughout treatment. Management of cardiac failure may require permanent discontinuation of therapy. Care should be taken when using this agent in patients at risk.

High Blood Pressure

Moderate:

axitinib

Axitinib has a moderate potential interaction with High Blood Pressure.

The use of axitinib may causes hypertension. Blood pressure should be well-controlled prior to initiating axitinib and treated as needed with standard anti-hypertensive therapy. It is recommended to reduce the dose in case of persistent hypertension despite use of anti-hypertensive medications and to discontinue therapy if hypertension is severe and persistent despite these measures. Discontinuation of therapy should be considered if there is evidence of hypertensive crisis. Close monitoring is recommended.

History, Thrombotic/Thromboembolic Disorder

Moderate:

axitinib

Axitinib has a moderate potential interaction with History, Thrombotic/Thromboembolic Disorder.

Arterial and venous thromboembolic events, including transient ischemic attack, cerebrovascular accident, myocardial infarction, pulmonary embolism, deep vein thrombosis, retinal occlusion, vein thrombosis, and deaths have been reported with the use of axitinib. Use with caution in patients who are at risk for, or who have a history of, these events. The use of axitinib has not been studied in patients who had an arterial or venous thromboembolic event within the previous 12 months. It is recommended to monitor closely for signs and symptoms of thromboembolism.

History - Myocardial Infarction

Moderate:

axitinib

Axitinib has a moderate potential interaction with History - Myocardial Infarction.

Arterial and venous thromboembolic events, including transient ischemic attack, cerebrovascular accident, myocardial infarction, pulmonary embolism, deep vein thrombosis, retinal occlusion, vein thrombosis, and deaths have been reported with the use of axitinib. Use with caution in patients who are at risk for, or who have a history of, these events. The use of axitinib has not been studied in patients who had an arterial or venous thromboembolic event within the previous 12 months. It is recommended to monitor closely for signs and symptoms of thromboembolism.

Hyperthyroidism

Moderate:

axitinib

Axitinib has a moderate potential interaction with Hyperthyroidism.

Thyroid level fluctuations that include hypothyroidism and hyperthyroidism have been reported with the use of axitinib. It is recommended to monitor thyroid function before initiation of, and periodically throughout treatment and to maintain euthyroid state according to standard medical practice.

Interstitial Lung Disease

Moderate:

axitinib

Axitinib has a moderate potential interaction with Interstitial Lung Disease.

The use of certain multikinase inhibitors has been associated with pulmonary toxicity. Serious cases of interstitial lung disease (ILD), including fatal cases and interstitial pneumonitis or pulmonary fibrosis have been reported. Caution is recommended when using these agents in patients with a history of interstitial pneumonitis or pulmonary fibrosis or those patients presenting with acute onset of new or progressive unexplained pulmonary symptoms such as dyspnea, cough, and fever pending diagnostic evaluation. If ILD is confirmed, these agents should be permanently discontinued and appropriate measures should be instituted. Treatment should be immediately withheld in patients diagnosed with ILD/pneumonitis and permanently discontinued if no other potential causes of ILD/pneumonitis have been identified.

Ischemic Heart Disease

Moderate:

axitinib

Axitinib has a moderate potential interaction with Ischemic Heart Disease.

Arterial and venous thromboembolic events, including transient ischemic attack, cerebrovascular accident, myocardial infarction, pulmonary embolism, deep vein thrombosis, retinal occlusion, vein thrombosis, and deaths have been reported with the use of axitinib. Use with caution in patients who are at risk for, or who have a history of, these events. The use of axitinib has not been studied in patients who had an arterial or venous thromboembolic event within the previous 12 months. It is recommended to monitor closely for signs and symptoms of thromboembolism.

Liver Disease

Moderate:

axitinib

Axitinib has a moderate potential interaction with Liver Disease.

The systemic exposure to axitinib is higher in subjects with moderate hepatic impairment. Dose adjustment is recommended in patients with moderate hepatic impairment. No dose adjustment is required in patients with mild hepatic impairment. The use of axitinib has not been studied in subjects with severe hepatic impairment. It is recommended to monitor liver enzymes and bilirubin before the start of therapy and periodically thereafter.

Moderate:

sodium phenylbutyrate / taurursodiol

The sodium phenylbutyrate in sodium phenylbutyrate / taurursodiol has a moderate potential interaction with Liver Disease.

Sodium phenylbutyrate is primarily metabolized in the liver and kidney. Therapy with sodium phenylbutyrate should be administered cautiously in patients with liver disease. Monitoring plasma levels of ammonia, arginine, branched-chain amino acids and serum proteins to maintain within normal limits and glutamine to less than 1000 mcmol/L is recommended.

Malabsorption Syndrome

Moderate:

sodium phenylbutyrate / taurursodiol

The taurursodiol in sodium phenylbutyrate / taurursodiol has a moderate potential interaction with Malabsorption Syndrome.

Sodium phenylbutyrate-taurursodiol contains taurursodiol, a bile acid. In patients with disorders that interfere with bile acid circulation, there may be an increased risk for diarrhea and patients should be monitored appropriately. Other conditions such as pancreatic insufficiency, intestinal malabsorption, or intestinal diseases that may alter the concentration of bile acids, may also lead to decreased absorption of this drug and its components. Consider consulting with a GI specialists with experience managing these GI disorders. Patients with disorders of enterohepatic circulation (e.g., biliary infection, active cholecystitis, etc.), severe pancreatic disorders (e.g., pancreatitis), and intestinal disorders that may alter concentrations of bile acids (e.g., ileal resection, regional ileitis, etc.) were excluded from clinical studies and there is no experience in patients with these conditions. Caution is advised.

Myoneural Disorder

Moderate:

sodium phenylbutyrate / taurursodiol

The sodium phenylbutyrate in sodium phenylbutyrate / taurursodiol has a moderate potential interaction with Myoneural Disorder.

Sodium phenylbutyrate is a pro-drug and is rapidly metabolized to the active, phenylacetate. Neurotoxicity, including exacerbation of a preexisting neuropathy, has been reported with the use of intravenous phenylacetate. The acute onset and reversibility when the phenylacetate infusion was discontinued suggested a drug effect. Care should be exercised when prescribing sodium phenylbutyrate to patients at risk for neurotoxicity.

Peripheral Neuropathy

Moderate:

sodium phenylbutyrate / taurursodiol

The sodium phenylbutyrate in sodium phenylbutyrate / taurursodiol has a moderate potential interaction with Peripheral Neuropathy.

Sodium phenylbutyrate is a pro-drug and is rapidly metabolized to the active, phenylacetate. Neurotoxicity, including exacerbation of a preexisting neuropathy, has been reported with the use of intravenous phenylacetate. The acute onset and reversibility when the phenylacetate infusion was discontinued suggested a drug effect. Care should be exercised when prescribing sodium phenylbutyrate to patients at risk for neurotoxicity.

Posterior Reversible Encephalopathy Syndrome

Moderate:

axitinib

Axitinib has a moderate potential interaction with Posterior Reversible Encephalopathy Syndrome.

Reversible posterior leukoencephalopathy syndrome (RPLS) has been reported in patients receiving axitinib. Consider this syndrome in any patient presenting with seizures, headache, visual disturbances, confusion or altered mental function. It is recommended to discontinue therapy in patients developing RPLS. The safety of reinitiating therapy in patients previously experiencing RPLS is not known. Care and close monitoring should be considered in these patients.

Proteinuria

Moderate:

axitinib

Axitinib has a moderate potential interaction with Proteinuria.

Proteinuria has been reported in patients taking axitinib. It is recommended to monitor for proteinuria before initiation of therapy, and periodically thereafter. Reduce dose or temporarily interrupt therapy in patients who develop moderate to severe proteinuria.

Pulmonary Embolism

Moderate:

axitinib

Axitinib has a moderate potential interaction with Pulmonary Embolism.

Arterial and venous thromboembolic events, including transient ischemic attack, cerebrovascular accident, myocardial infarction, pulmonary embolism, deep vein thrombosis, retinal occlusion, vein thrombosis, and deaths have been reported with the use of axitinib. Use with caution in patients who are at risk for, or who have a history of, these events. The use of axitinib has not been studied in patients who had an arterial or venous thromboembolic event within the previous 12 months. It is recommended to monitor closely for signs and symptoms of thromboembolism.

Pulmonary Impairment

Moderate:

axitinib

Axitinib has a moderate potential interaction with Pulmonary Impairment.

The use of certain multikinase inhibitors has been associated with pulmonary toxicity. Serious cases of interstitial lung disease (ILD), including fatal cases and interstitial pneumonitis or pulmonary fibrosis have been reported. Caution is recommended when using these agents in patients with a history of interstitial pneumonitis or pulmonary fibrosis or those patients presenting with acute onset of new or progressive unexplained pulmonary symptoms such as dyspnea, cough, and fever pending diagnostic evaluation. If ILD is confirmed, these agents should be permanently discontinued and appropriate measures should be instituted. Treatment should be immediately withheld in patients diagnosed with ILD/pneumonitis and permanently discontinued if no other potential causes of ILD/pneumonitis have been identified.

Renal Dysfunction

Major:

sodium phenylbutyrate / taurursodiol

The sodium phenylbutyrate in sodium phenylbutyrate / taurursodiol has a major potential interaction with Renal Dysfunction.

The use of sodium phenylbutyrate may cause fluid retention in patients with congestive heart failure, renal dysfunction, or sodium retention with edema. Sodium phenylbutyrate is primarily excreted by the kidney and these patients may exhibit reduced excretion. Therapy with sodium phenylbutyrate should be administered cautiously in these patients. Monitoring plasma levels of ammonia, arginine, branched-chain amino acids and serum proteins to maintain within normal limits and glutamine to less than 1000 mcmol/L is recommended.

Moderate:

axitinib

Axitinib has a moderate potential interaction with Renal Dysfunction.

Based on population pharmacokinetic analyses no starting dose adjustment is needed for patients with mild to severe renal impairment. It is recommended to take caution in patients with end-stage renal disease.

Moderate:

sodium phenylbutyrate / taurursodiol

The sodium phenylbutyrate in sodium phenylbutyrate / taurursodiol has a moderate potential interaction with Renal Dysfunction.

Sodium phenylbutyrate is primarily metabolized in the liver and kidney. Therapy with sodium phenylbutyrate should be administered cautiously in patients with liver disease. Monitoring plasma levels of ammonia, arginine, branched-chain amino acids and serum proteins to maintain within normal limits and glutamine to less than 1000 mcmol/L is recommended.

Thrombotic/Thromboembolic Disorder

Moderate:

axitinib

Axitinib has a moderate potential interaction with Thrombotic/Thromboembolic Disorder.

Arterial and venous thromboembolic events, including transient ischemic attack, cerebrovascular accident, myocardial infarction, pulmonary embolism, deep vein thrombosis, retinal occlusion, vein thrombosis, and deaths have been reported with the use of axitinib. Use with caution in patients who are at risk for, or who have a history of, these events. The use of axitinib has not been studied in patients who had an arterial or venous thromboembolic event within the previous 12 months. It is recommended to monitor closely for signs and symptoms of thromboembolism.

Underactive Thyroid

Moderate:

axitinib

Axitinib has a moderate potential interaction with Underactive Thyroid.

Thyroid level fluctuations that include hypothyroidism and hyperthyroidism have been reported with the use of axitinib. It is recommended to monitor thyroid function before initiation of, and periodically throughout treatment and to maintain euthyroid state according to standard medical practice.

More resources

axitinib

A total of 266 drugs are known to interact with axitinib.

sodium phenylbutyrate / taurursodiol

A total of 590 drugs are known to interact with sodium phenylbutyrate / taurursodiol.

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.