Drug Interactions between B-Donna Tablets and taletrectinib

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

B-Donna Tablets (atropine/hyoscyamine/phenobarbital/scopolamine)
taletrectinib

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Consumer
Professional

Interactions between your drugs

Major

PHENobarbital taletrectinib

Applies to: B-Donna Tablets (atropine / hyoscyamine / phenobarbital / scopolamine) and taletrectinib

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Coadministration with potent and moderate CYP450 3A inducers may significantly decrease the plasma concentrations of taletrectinib, which is a substrate of the isoenzyme. Concomitant administration with rifampin, a potent CYP450 3A inducer, decreased taletrectinib peak plasma concentration (Cmax) and systemic exposure (AUC) by 42% and 86%, respectively. Coadministration with a moderate CYP450 3A inducer is predicted to decrease taletrectinib Cmax and AUC by 40% and 66%, respectively. Reduced therapeutic effectiveness may occur.

MANAGEMENT: Concomitant use of taletrectinib with potent and moderate CYP450 3A inducers should be avoided.

Moderate

atropine hyoscyamine

Applies to: B-Donna Tablets (atropine / hyoscyamine / phenobarbital / scopolamine) and B-Donna Tablets (atropine / hyoscyamine / phenobarbital / scopolamine)

Using atropine together with hyoscyamine may increase side effects such as drowsiness, blurred vision, dry mouth, heat intolerance, flushing, decreased sweating, difficulty urinating, abdominal cramping, constipation, irregular heartbeat, confusion, and memory problems. Side effects may be more likely to occur in the elderly or those with a debilitating condition. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. 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.

Moderate

atropine scopolamine

Applies to: B-Donna Tablets (atropine / hyoscyamine / phenobarbital / scopolamine) and B-Donna Tablets (atropine / hyoscyamine / phenobarbital / scopolamine)

Using atropine together with scopolamine may increase side effects such as drowsiness, blurred vision, dry mouth, heat intolerance, flushing, decreased sweating, difficulty urinating, abdominal cramping, constipation, irregular heartbeat, confusion, and memory problems. Side effects may be more likely to occur in the elderly or those with a debilitating condition. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. 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.

Moderate

PHENobarbital scopolamine

Applies to: B-Donna Tablets (atropine / hyoscyamine / phenobarbital / scopolamine) and B-Donna Tablets (atropine / hyoscyamine / phenobarbital / scopolamine)

Using PHENobarbital together with scopolamine may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. 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.

Moderate

hyoscyamine scopolamine

Applies to: B-Donna Tablets (atropine / hyoscyamine / phenobarbital / scopolamine) and B-Donna Tablets (atropine / hyoscyamine / phenobarbital / scopolamine)

Using hyoscyamine together with scopolamine may increase side effects such as drowsiness, blurred vision, dry mouth, heat intolerance, flushing, decreased sweating, difficulty urinating, abdominal cramping, constipation, irregular heartbeat, confusion, and memory problems. Side effects may be more likely to occur in the elderly or those with a debilitating condition. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. 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.

Drug and food/lifestyle interactions

Major

taletrectinib food/lifestyle

Applies to: taletrectinib

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Coadministration with grapefruit juice may increase the plasma concentrations of taletrectinib. The proposed mechanism for the interaction 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. In a clinical study, taletrectinib peak plasma concentration (Cmax) increased by 1.8-fold and systemic exposure (AUC) increased by 3.3-fold following concomitant administration of itraconazole, a potent CYP450 3A inhibitor. According to the product labeling, administration of taletrectinib with a moderate CYP450 3A inhibitor is predicted to increase taletrectinib Cmax and AUC by up to 1.5- and 2.6-fold, respectively. Increased exposure to taletrectinib may increase the risk and/or severity of adverse effects such as hepatotoxicity with liver enzyme elevations, lung toxicities, QT prolongation, hyperuricemia, myalgia with creatine phosphokinase elevation, and skeletal fractures.

ADJUST DOSING INTERVAL: Coadministration with high-fat food (1000 calories, 50% fat) increased taletrectinib Cmax and AUC by 1.5-fold, and the predicted increase in the QTc interval is 20.5 msec.

MANAGEMENT: The manufacturer recommends avoiding food or drink containing grapefruit during treatment with taletrectinib. In addition, taletrectinib should be administered on an empty stomach at about the same time each day, at least 2 hours before or 2 hours after food intake.

Major