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Can you take Cabozantinib with Fleet Prep Kit 3?

2 drug interactions and 30 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

sodium biphosphate cabozantinib

Applies to: Fleet Prep Kit 3 (bisacodyl / sodium biphosphate / sodium phosphate) and cabozantinib

The following interaction applies only to products containing sodium biphosphate that are used for bowel cleansing. It does not apply to products containing sodium biphosphate that are used for other, non-laxative related purposes.

cabozantinib can cause an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect. The risk is increased if you have low blood levels of magnesium or potassium, which can occur with bowel cleansing preparations or excessive use of medications that have a laxative effect. You should use sodium biphosphate exactly as prescribed by your doctor, and drink plenty of clear liquids before, during, and after the cleansing process to avoid becoming dehydrated. Your doctor may be able to recommend specific fluids you can drink before starting sodium biphosphate to help maintain your electrolyte levels. He/she may also want to monitor your electrolyte levels and/or heart rhythm. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications. In addition, you should let your doctor know if you experience signs and symptoms of low electrolyte levels such as weakness, tiredness, drowsiness, dizziness, confusion, tingling, numbness, muscle pain, cramps, nausea, or vomiting. 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:

bisacodyl cabozantinib

Applies to: Fleet Prep Kit 3 (bisacodyl / sodium biphosphate / sodium phosphate) and cabozantinib

Cabozantinib can cause an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect. The risk is increased if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances, such as low blood levels of magnesium or potassium. These electrolyte disturbances can occur with bowel cleansing preparations or excessive use of medications that have a laxative effect, such as bisacodyl. Do not exceed the dose and duration recommended on the product label or prescribed by your doctor. You should seek immediate medical attention if you experience sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications, whether taken together or separately. In addition, you should let your doctor know if you experience signs and symptoms of low magnesium or potassium blood level such as weakness, tiredness, drowsiness, dizziness, confusion, tingling, numbness, muscle pain, cramps, nausea, or vomiting. 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 biphosphate Food/Lifestyle

Applies to: Fleet Prep Kit 3 (bisacodyl / sodium biphosphate / sodium phosphate)

Oral medications may not be properly absorbed when they are taken within one hour before starting sodium biphosphate for bowel cleansing. Talk to your doctor or pharmacist to see if you should adjust the dosing schedule of your other medications before you begin bowel cleansing treatment. 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:

cabozantinib Food/Lifestyle

Applies to: cabozantinib

Cabozantinib should be taken on an empty stomach, one hour before or two hours after a meal. Do not consume grapefruit, grapefruit juice, or any supplements that contain grapefruit extract during treatment with cabozantinib unless directed otherwise by your doctor. Grapefruit juice can increase the blood levels of cabozantinib. You may be more likely to experience side effects such as nausea; vomiting; diarrhea; loss of appetite; weight loss; mouth sores; abdominal pain; skin rash (primarily on the palms of the hands and soles of the feet); delayed wound healing; high blood pressure; and impaired bone marrow function resulting in low numbers of different types of blood cells, which can increase the risk of bleeding problems and infections. 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:

bisacodyl multivitamins with minerals

Applies to: Fleet Prep Kit 3 (bisacodyl / sodium biphosphate / sodium phosphate)

Chronic use of bisacodyl may reduce your body's ability to absorb certain vitamins (A, D, E, and K) and minerals like calcium. To reduce the risk of diminished absorption of multivitamins with minerals, it is best to use bisacodyl only occasionally or for short periods. If your doctor does prescribe these medications together, you may need a dose adjustment or special test to safely use both medications. 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

27 potential interactions Applies to: 23 conditions, including High Blood Pressure, Heart Failure, Heart Attack, Diverticulitis, and Inflammatory Bowel Disease.

Appendicitis

Major:

Fleet Prep Kit 3

The bisacodyl in Fleet Prep Kit 3 has a major potential interaction with Appendicitis.

The use of stimulant laxatives is contraindicated in patients with or who may have acute surgical abdomen or appendicitis. These patients may be candidates for emergency surgery. Stimulant laxatives should also not be administered to patients with abdominal pain, particularly if the cause has not been determined.

Bleeding Disorder

Major:

cabozantinib

Cabozantinib has a major potential interaction with Bleeding Disorder.

Fatal hemorrhagic events have been reported with the use of cabozantinib. Therapy with cabozantinib is not recommended in patients that have or are at risk for severe hemorrhage.

Major:

Fleet Prep Kit 3

The bisacodyl in Fleet Prep Kit 3 has a major potential interaction with Bleeding Disorder.

The use of stimulant laxatives is contraindicated in patients with anal or rectal fissures. These preparations may cause irritation, burning sensation, and proctitis.

Dehydration

Major:

Fleet Prep Kit 3

The sodium biphosphate and sodium phosphate in Fleet Prep Kit 3 both have a major potential interaction with Dehydration.

The use of sodium phosphates is contraindicated in patients with congenital megacolon, intestinal obstruction, imperforate anus, active inflammatory disease or congestive heart failure. Serious, potentially life-threatening electrolyte imbalance such as hypocalcemia and hyperphosphatemia can result with prolonged or excessive use of phosphate laxatives. Hypernatremia and dehydration can occur due to improper dilution of hypertonic saline laxatives. Therapy with sodium phosphates should be administered cautiously and frequency of administration limited in patients with renal dysfunction, colostomy, cardiac dysfunction, or electrolyte imbalance. Clinical monitoring of electrolyte concentrations is recommended.

Diverticulitis

Moderate:

cabozantinib

Cabozantinib has a moderate potential interaction with Diverticulitis.

Therapy with cabozantinib 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. Discontinue cabozantinib in patients who experience a fistula which cannot be appropriately managed or a GI perforation.

Fluid Retention

Major:

Fleet Prep Kit 3

The sodium phosphate in Fleet Prep Kit 3 has a major potential interaction with Fluid Retention.

Alkalinizing agents containing sodium can induce sodium and water retention and result in hypernatremia, hypokalemia, hyperosmolality, edema and aggravation of congestive heart failure. Therapy with sodium- containing alkalinizing agents should not be used in patients with hypernatremia or fluid retention. Clinical monitoring of acid/base balance and electrolytes prior to, during, a following completion of therapy with alkalinizing agents is recommended.

Gastrointestinal Obstruction

Major:

Fleet Prep Kit 3

The sodium biphosphate and sodium phosphate in Fleet Prep Kit 3 both have a major potential interaction with Gastrointestinal Obstruction.

The use of sodium phosphates is contraindicated in patients with congenital megacolon, intestinal obstruction, imperforate anus, active inflammatory disease or congestive heart failure. Serious, potentially life-threatening electrolyte imbalance such as hypocalcemia and hyperphosphatemia can result with prolonged or excessive use of phosphate laxatives. Hypernatremia and dehydration can occur due to improper dilution of hypertonic saline laxatives. Therapy with sodium phosphates should be administered cautiously and frequency of administration limited in patients with renal dysfunction, colostomy, cardiac dysfunction, or electrolyte imbalance. Clinical monitoring of electrolyte concentrations is recommended.

Major:

Fleet Prep Kit 3

The bisacodyl, sodium biphosphate and sodium phosphate in Fleet Prep Kit 3 all have a major potential interaction with Gastrointestinal Obstruction.

The use of laxatives is contraindicated in patients with intestinal obstruction disorders. Patients with intestinal obstruction disorders may need their underlying condition treated to correct the constipation. Some laxatives require reduction in the colon to their active form to be effective which may be a problem in patients with intestinal obstruction.

Gastrointestinal Perforation

Moderate:

cabozantinib

Cabozantinib has a moderate potential interaction with Gastrointestinal Perforation.

Therapy with cabozantinib 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. Discontinue cabozantinib in patients who experience a fistula which cannot be appropriately managed or a GI perforation.

Heart Attack

Moderate:

cabozantinib

Cabozantinib has a moderate potential interaction with Heart Attack.

Arterial and venous thromboembolic events have been reported with the use of cabozantinib. Use with caution in patients who are at risk, or have a history of these events. It is recommended to monitor closely for signs and symptoms of thromboembolism. Discontinue cabozantinib in patients who develop an acute myocardial infarction or any other arterial thromboembolic complication.

Heart Failure

Major:

Fleet Prep Kit 3

The sodium biphosphate and sodium phosphate in Fleet Prep Kit 3 both have a major potential interaction with Heart Failure.

The use of sodium phosphates is contraindicated in patients with congenital megacolon, intestinal obstruction, imperforate anus, active inflammatory disease or congestive heart failure. Serious, potentially life-threatening electrolyte imbalance such as hypocalcemia and hyperphosphatemia can result with prolonged or excessive use of phosphate laxatives. Hypernatremia and dehydration can occur due to improper dilution of hypertonic saline laxatives. Therapy with sodium phosphates should be administered cautiously and frequency of administration limited in patients with renal dysfunction, colostomy, cardiac dysfunction, or electrolyte imbalance. Clinical monitoring of electrolyte concentrations is recommended.

High Blood Pressure

Moderate:

cabozantinib

Cabozantinib has a moderate potential interaction with High Blood Pressure.

The use of cabozantinib causes hypertension. Blood pressure should be well-controlled prior to initiating cabozantinib and monitored 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. Discontinue cabozantinib therapy for severe hypertension that cannot be controlled with anti-hypertensive therapy and if there is evidence of hypertensive crisis or severe hypertension despite optimal medical management. Close monitoring is recommended.

Hyperkalemia

Major:

Fleet Prep Kit 3

The sodium phosphate in Fleet Prep Kit 3 has a major potential interaction with Hyperkalemia.

The use of phosphates is in general contraindicated in conditions where high potassium, high phosphate, or low calcium may be encountered such as hypoparathyroidism, osteomalacia, acute pancreatitis, or chronic renal disease.

Hypernatremia

Major:

Fleet Prep Kit 3

The sodium phosphate in Fleet Prep Kit 3 has a major potential interaction with Hypernatremia.

Alkalinizing agents containing sodium can induce sodium and water retention and result in hypernatremia, hypokalemia, hyperosmolality, edema and aggravation of congestive heart failure. Therapy with sodium- containing alkalinizing agents should not be used in patients with hypernatremia or fluid retention. Clinical monitoring of acid/base balance and electrolytes prior to, during, a following completion of therapy with alkalinizing agents is recommended.

Hypocalcemia

Major:

Fleet Prep Kit 3

The sodium biphosphate and sodium phosphate in Fleet Prep Kit 3 both have a major potential interaction with Hypocalcemia.

The use of phosphates is in general contraindicated in conditions where high potassium, high phosphate, or low calcium may be encountered such as hypoparathyroidism, osteomalacia, acute pancreatitis, or chronic renal disease.

Hypoparathyroidism

Major:

Fleet Prep Kit 3

The sodium biphosphate and sodium phosphate in Fleet Prep Kit 3 both have a major potential interaction with Hypoparathyroidism.

Therapy with phosphates should be administered with extreme caution in patients with hyperphosphatemia (hypoparathyroidism or severe renal impairment). Elevated serum concentrations of phosphate and calcium can exceed the solubility level and result in calcium-phosphate precipitates that deposit in vascular and renal systems as well as other soft tissues of the body. Clinical monitoring of serum calcium and phosphate concentrations is necessary.

Inflammatory Bowel Disease

Major:

Fleet Prep Kit 3

The bisacodyl, sodium biphosphate and sodium phosphate in Fleet Prep Kit 3 all have a major potential interaction with Inflammatory Bowel Disease.

The use of laxatives is contraindicated in patients with inflammatory bowel disease. Patients with inflammatory bowel disease may experience colonic perforation with use of stimulant laxatives.

Major:

Fleet Prep Kit 3

The sodium biphosphate and sodium phosphate in Fleet Prep Kit 3 both have a major potential interaction with Inflammatory Bowel Disease.

The use of sodium phosphates is contraindicated in patients with congenital megacolon, intestinal obstruction, imperforate anus, active inflammatory disease or congestive heart failure. Serious, potentially life-threatening electrolyte imbalance such as hypocalcemia and hyperphosphatemia can result with prolonged or excessive use of phosphate laxatives. Hypernatremia and dehydration can occur due to improper dilution of hypertonic saline laxatives. Therapy with sodium phosphates should be administered cautiously and frequency of administration limited in patients with renal dysfunction, colostomy, cardiac dysfunction, or electrolyte imbalance. Clinical monitoring of electrolyte concentrations is recommended.

Interstitial Lung Disease

Moderate:

cabozantinib

Cabozantinib 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.

Liver Disease

Moderate:

cabozantinib

Cabozantinib has a moderate potential interaction with Liver Disease.

Increased exposure to cabozantinib has been observed in patients with mild to moderate hepatic impairment. It is recommended to reduce the cabozantinib dose in patients with mild or moderate hepatic impairment. The use of cabozantinib is not recommended in patients with severe hepatic impairment. It is recommended to monitor liver function and urine bilirubin tests periodically during therapy.

Pancreatitis

Major:

Fleet Prep Kit 3

The sodium biphosphate and sodium phosphate in Fleet Prep Kit 3 both have a major potential interaction with Pancreatitis.

The use of phosphates is in general contraindicated in conditions where high potassium, high phosphate, or low calcium may be encountered such as hypoparathyroidism, osteomalacia, acute pancreatitis, or chronic renal disease.

Phosphate Imbalance

Major:

Fleet Prep Kit 3

The sodium biphosphate and sodium phosphate in Fleet Prep Kit 3 both have a major potential interaction with Phosphate Imbalance.

The use of sodium phosphates is contraindicated in patients with congenital megacolon, intestinal obstruction, imperforate anus, active inflammatory disease or congestive heart failure. Serious, potentially life-threatening electrolyte imbalance such as hypocalcemia and hyperphosphatemia can result with prolonged or excessive use of phosphate laxatives. Hypernatremia and dehydration can occur due to improper dilution of hypertonic saline laxatives. Therapy with sodium phosphates should be administered cautiously and frequency of administration limited in patients with renal dysfunction, colostomy, cardiac dysfunction, or electrolyte imbalance. Clinical monitoring of electrolyte concentrations is recommended.

Posterior Reversible Encephalopathy Syndrome

Moderate:

cabozantinib

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

Reversible posterior leukoencephalopathy syndrome (RPLS) has been reported in patients receiving cabozantinib. 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.

Pulmonary Impairment

Moderate:

cabozantinib

Cabozantinib 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:

Fleet Prep Kit 3

The sodium biphosphate and sodium phosphate in Fleet Prep Kit 3 both have a major potential interaction with Renal Dysfunction.

Therapy with phosphates should be administered with extreme caution in patients with hyperphosphatemia (hypoparathyroidism or severe renal impairment). Elevated serum concentrations of phosphate and calcium can exceed the solubility level and result in calcium-phosphate precipitates that deposit in vascular and renal systems as well as other soft tissues of the body. Clinical monitoring of serum calcium and phosphate concentrations is necessary.

Moderate:

cabozantinib

Cabozantinib has a moderate potential interaction with Renal Dysfunction.

No dose adjustment is required in patients with mild or moderate renal impairment. There is no experience with cabozantinib in patients with severe renal impairment. Care should be exercised in these patients.

Thrombotic/Thromboembolic Disorder

Moderate:

cabozantinib

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

Arterial and venous thromboembolic events have been reported with the use of cabozantinib. Use with caution in patients who are at risk, or have a history of these events. It is recommended to monitor closely for signs and symptoms of thromboembolism. Discontinue cabozantinib in patients who develop an acute myocardial infarction or any other arterial thromboembolic complication.

More resources

cabozantinib

A total of 560 drugs are known to interact with cabozantinib.

Fleet Prep Kit 3

A total of 469 drugs are known to interact with Fleet Prep Kit 3.

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.