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Drug Interactions between clonidine / epinephrine / ketorolac / ropivacaine and encorafenib

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

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Interactions between your drugs

Moderate

ROPivacaine encorafenib

Applies to: clonidine / epinephrine / ketorolac / ropivacaine and encorafenib

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Coadministration with encorafenib may significantly reduce the plasma concentrations and effects of drugs that are primarily metabolized by CYP450 3A4, which may lead to decreased efficacy of the concomitant drug(s). Encorafenib is a potent CYP450 3A4 inducer in vivo. Administration of a single 2 mg dose of the sensitive CYP450 3A4 substrate midazolam after repeated administration of encorafenib 450 mg once daily and binimetinib 45 mg twice daily resulted in decreased systemic exposure (AUC) and peak plasma concentration (Cmax) of midazolam by approximately 82% and 74%, respectively, compared to midazolam alone.

MANAGEMENT: Concomitant use of encorafenib and sensitive CYP450 3A4 substrates or substrates with narrow therapeutic ranges should generally be avoided. These drugs include, but are not limited to: alfentanil, cisapride, colchicine, cyclosporine, fentanyl, ivacaftor, lovastatin, simvastatin, oral midazolam, triazolam, pimozide, quinidine, sildenafil, ergot derivatives, macrolide immunosuppressants, and vinca alkaloids. The prescribing information for the concomitant medication may be consulted to assess the benefits versus risks of coadministration, as well as any dosage adjustments that may be required during coadministration and/or following the discontinuation of a potent CYP450 3A4 inducer.

References

  1. (2023) "Product Information. Braftovi (encorafenib)." Array BioPharma Inc.
  2. (2024) "Product Information. Braftovi (encorafenib)." Pierre Fabre Ltd
  3. (2023) "Product Information. Braftovi (encorafenib)." Pierre Fabre Australia Pty Limited

Drug and food interactions

Major

encorafenib food

Applies to: encorafenib

You should preferably avoid consumption of grapefruit and grapefruit juice while taking encorafenib. Grapefruit and grapefruit juice can significantly increase the blood levels of encorafenib. This may increase the risk of serious side effects such as bleeding complications, eye and vision problems, liver problems, irregular heart rhythm, and development of new skin cancers. 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

cloNIDine food

Applies to: clonidine / epinephrine / ketorolac / ropivacaine

CloNIDine and ethanol may have additive effects in lowering your blood pressure. You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate. These side effects are most likely to be seen at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. 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

ketorolac food

Applies to: clonidine / epinephrine / ketorolac / ropivacaine

Ask your doctor before using ketorolac together with ethanol. Do not drink alcohol while taking ketorolac. Alcohol can increase your risk of stomach bleeding caused by ketorolac. Call your doctor at once if you have symptoms of bleeding in your stomach or intestines. This includes black, bloody, or tarry stools, or coughing up blood or vomit that looks like coffee grounds. 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

EPINEPHrine food

Applies to: clonidine / epinephrine / ketorolac / ropivacaine

Both EPINEPHrine and caffeine can increase blood pressure and heart rate, and combining them may enhance these effects. Talk to your doctor before using these medications, especially if you have a history of high blood pressure or heart disease. You may need a dose adjustment or more frequent monitoring by your doctor 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.

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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.


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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.