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Can you take Duloxetine with Gefitinib?

1 drug interaction and 24 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

gefitinib DULoxetine

Applies to: gefitinib and duloxetine

Gefitinib may increase the blood levels and effects of DULoxetine. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Let your doctor know if your condition changes or you experience increased side effects of DULoxetine such as nausea, dry mouth, insomnia, drowsiness, constipation, or any unusual symptoms. If you have high blood pressure, you may need closer monitoring of your blood pressure while you are receiving these medications. You should also avoid activities requiring mental alertness such as driving or operating machinery until you know how these medications affect you. 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:

DULoxetine Food/Lifestyle

Applies to: duloxetine

DULoxetine may cause liver damage, and taking it with alcohol may increase that risk. You should avoid or limit the use of alcohol while being treated with DULoxetine. Call your doctor immediately if you have fever, chills, joint pain or swelling, excessive tiredness or weakness, unusual bleeding or bruising, skin rash or itching, loss of appetite, nausea, vomiting, dark colored urine, or yellowing of the skin or the whites of your eyes, as these may be symptoms of liver damage. 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

23 potential interactions Applies to: 20 conditions, including High Blood Pressure, Depression, Bipolar Disorder, Urinary Tract Infection, and Seizures.

Bipolar Disorder

Major:

duloxetine

DULoxetine has a major potential interaction with Bipolar Disorder.

Adult and pediatric patients with depression and other psychiatric disorders may experience worsening of their symptoms and may have the emergence of suicidal thoughts and behavior. Patients should be monitored appropriately and observed closely for worsening of their symptoms, suicidality or changes in their behavior, especially during the first few months of treatment, and at times of dose changes. Discontinuing the medication should be considered if symptoms are persistently worse, or abrupt in onset. It may be prudent to refrain from dispensing large quantities of medication to these patients.

Moderate:

duloxetine

DULoxetine has a moderate potential interaction with Bipolar Disorder.

Therapy with SNRI antidepressants can cause activation of mania and hypomania and should be used with caution in patients with personal or family history of mania, hypomania, bipolar disorder, and other mood disorders.

Dehydration

Moderate:

duloxetine

DULoxetine has a moderate potential interaction with Dehydration.

Treatment with SNRI antidepressants can cause hyponatremia. Caution should be used when treating patients with hyponatremia or at greater risk of hyponatremia such as the elderly, patients taking diuretics or who are volume depleted.

Depression

Major:

duloxetine

DULoxetine has a major potential interaction with Depression.

Adult and pediatric patients with depression and other psychiatric disorders may experience worsening of their symptoms and may have the emergence of suicidal thoughts and behavior. Patients should be monitored appropriately and observed closely for worsening of their symptoms, suicidality or changes in their behavior, especially during the first few months of treatment, and at times of dose changes. Discontinuing the medication should be considered if symptoms are persistently worse, or abrupt in onset. It may be prudent to refrain from dispensing large quantities of medication to these patients.

Dermatitis, Drug-Induced

Major:

gefitinib

Gefitinib has a major potential interaction with Dermatitis, Drug-Induced.

Cutaneous reactions, in some cases severe, have been reported with the use of EGFR inhibitors. Monitor patients who develop dermatologic or soft tissue toxicities while receiving these agents for the development of inflammatory or infectious sequelae. It is recommended to withhold treatment, and appropriate measures should be instituted as appropriate or discontinue the use of these agents for dermatologic or soft tissue toxicity associated with severe or life-threatening inflammatory or infectious complications. Advise patients to wear sunscreen and hats and limit sun exposure while receiving therapy with these agents as exposure to sunlight can exacerbate dermatologic toxicities.

Diabetes Mellitus

Moderate:

duloxetine

DULoxetine has a moderate potential interaction with Diabetes Mellitus.

In clinical trials, treatment with duloxetine delayed-release worsened the glycemic control in some patients with diabetes. Caution should be used when using duloxetine in diabetic patients and their glycemic levels should be checked regularly.

Diverticulitis

Major:

gefitinib

Gefitinib has a major potential interaction with Diverticulitis.

The use of some EGFR inhibitors may be associated with gastrointestinal perforation and fatal cases have been reported. Patients receiving concomitant anti-angiogenic agents, corticosteroids, NSAIDs, or taxane-based chemotherapy, or who have prior history of peptic ulceration or diverticular disease may be at increased risk of perforation. Permanently discontinue these agents in patients who develop gastrointestinal perforation.

Eye Conditions

Major:

gefitinib

Gefitinib has a major potential interaction with Eye Conditions.

Some epidermal growth factor receptor (EGFR) inhibitors should be administered cautiously in patients with ocular disorders such as primary keratitis, ulcerative keratitis, or conjunctivitis. It is recommended to interrupt or discontinue treatment with these agents if patients present with acute or worsening ocular disorders.

Fever

Major:

gefitinib

Gefitinib has a major potential interaction with Fever.

The use of certain EGFR 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, permanently discontinue these agents and institute appropriate measures.

Gastrointestinal Perforation

Major:

gefitinib

Gefitinib has a major potential interaction with Gastrointestinal Perforation.

The use of some EGFR inhibitors may be associated with gastrointestinal perforation and fatal cases have been reported. Patients receiving concomitant anti-angiogenic agents, corticosteroids, NSAIDs, or taxane-based chemotherapy, or who have prior history of peptic ulceration or diverticular disease may be at increased risk of perforation. Permanently discontinue these agents in patients who develop gastrointestinal perforation.

Glaucoma, Narrow Angle

Moderate:

duloxetine

DULoxetine has a moderate potential interaction with Glaucoma, Narrow Angle.

SNRI antidepressants cause pupillary dilation that may trigger an angle closure attack in patients with anatomically narrow angle without iridectomy.

High Blood Pressure

Moderate:

duloxetine

DULoxetine has a moderate potential interaction with High Blood Pressure.

Selective serotonin and norepinephrine reuptake inhibitor antidepressants (SNRIs) have been associated with sustained increases in blood pressure. Therapy with SNRI antidepressants should be administered cautiously in patients with preexisting hypertension. Blood pressure should be assessed prior to initiating treatment and monitored regularly. The dose should be reduced or discontinued if necessary.

History, Peptic Ulcer

Major:

gefitinib

Gefitinib has a major potential interaction with History, Peptic Ulcer.

The use of some EGFR inhibitors may be associated with gastrointestinal perforation and fatal cases have been reported. Patients receiving concomitant anti-angiogenic agents, corticosteroids, NSAIDs, or taxane-based chemotherapy, or who have prior history of peptic ulceration or diverticular disease may be at increased risk of perforation. Permanently discontinue these agents in patients who develop gastrointestinal perforation.

Hyponatremia

Moderate:

duloxetine

DULoxetine has a moderate potential interaction with Hyponatremia.

Treatment with SNRI antidepressants can cause hyponatremia. Caution should be used when treating patients with hyponatremia or at greater risk of hyponatremia such as the elderly, patients taking diuretics or who are volume depleted.

Liver Disease

Major:

duloxetine

DULoxetine has a major potential interaction with Liver Disease.

Postmarketing studies have reported that duloxetine and some other SNRIs like milnacipran may aggravate preexisting liver disease. The use of duloxetine delayed-release and milnacipran should be avoided in patients with chronic liver disease or cirrhosis.

Major:

gefitinib

Gefitinib has a major potential interaction with Liver Disease.

Gefitinib undergoes extensive hepatic metabolism. Obtain periodic liver function testing and withhold gefitinib for up to 14 days in patients with worsening liver function (Grade 2 or higher for ALT and/or AST elevations) and resume treatment when the adverse reaction fully resolves or improves to NCI CTCAE Grade 1. Permanently discontinue therapy in patients with severe hepatic impairment. Monitor adverse reactions when gefitinib is administered to patients with moderate and severe hepatic impairment.

Mania

Moderate:

duloxetine

DULoxetine has a moderate potential interaction with Mania.

Therapy with SNRI antidepressants can cause activation of mania and hypomania and should be used with caution in patients with personal or family history of mania, hypomania, bipolar disorder, and other mood disorders.

Pulmonary Impairment

Major:

gefitinib

Gefitinib has a major potential interaction with Pulmonary Impairment.

The use of certain EGFR 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, permanently discontinue these agents and institute appropriate measures.

Renal Dysfunction

Major:

duloxetine

DULoxetine has a major potential interaction with Renal Dysfunction.

The use of duloxetine should be avoided in patients with severe renal impairment (GFR <30 mL/min).

Moderate:

gefitinib

Gefitinib has a moderate potential interaction with Renal Dysfunction.

Less than four percent (<4%) of gefitinib and its metabolites are excreted via the kidney. Population pharmacokinetic analyses suggest that creatinine clearance (above 20 mL/min) has no clinically meaningful effect on predicted steady state trough concentration of gefitinib. No clinical studies were conducted with gefitinib in patients with severe renal impairment.

Seizures

Moderate:

duloxetine

DULoxetine has a moderate potential interaction with Seizures.

SNRI antidepressants may trigger seizures and should be administered with caution in patients with a seizure disorder.

Urinary Tract Infection

Moderate:

duloxetine

DULoxetine has a moderate potential interaction with Urinary Tract Infection.

SNRI antidepressants have a noradrenergic effect and can affect urethral resistance. Caution should be used in patients with a history of dysuria, prostatic hypertrophy, prostatitis, and other lower urinary tract obstructive disorders.

Urinary Tract Obstruction

Moderate:

duloxetine

DULoxetine has a moderate potential interaction with Urinary Tract Obstruction.

SNRI antidepressants have a noradrenergic effect and can affect urethral resistance. Caution should be used in patients with a history of dysuria, prostatic hypertrophy, prostatitis, and other lower urinary tract obstructive disorders.

More resources

duloxetine

A total of 654 drugs are known to interact with duloxetine.

gefitinib

A total of 257 drugs are known to interact with gefitinib.

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.