Drug Interactions between EC-Naprosyn and upadacitinib

Consumption of grapefruit, grapefruit juice, and supplements that contain grapefruit should be avoided during treatment with upadacitinib as they may increase the blood levels of upadacitinib, which may increase the risk and/or severity of side effects such as low blood cell counts, anemia, serious infections, and elevated blood lipid levels. Contact your doctor if you develop symptoms such as paleness, fatigue, dizziness, fainting, fever, chills, diarrhea, sore throat, muscle aches, shortness of breath, blood in phlegm, weight loss, red or inflamed skin, body sores, or pain or burning during urination.

Smoking during treatment with upadacitinib may increase your risk of serious cardiovascular events and of developing malignancies. Tell your doctor if you are a current or past smoker. Talk to your doctor if you have any questions or concerns. Get emergency help right away if you develop any symptoms of a heart attack or stroke during treatment with upadacitinib, including severe tightness, pain, pressure, or heaviness in your chest, neck, or jaw; weakness in one side of your body; slurred speech; shortness of breath or feeling lightheaded. 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.

Ask your doctor before using naproxen together with ethanol (alcohol). Do not drink alcohol while taking naproxen. Alcohol can increase your risk of stomach bleeding caused by naproxen. 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.

Consumer information for this interaction is not currently available.

MONITOR: Smoking cessation may lead to elevated plasma concentrations and enhanced pharmacologic effects of drugs that are substrates of CYP450 1A2 (and possibly CYP450 1A1) and/or certain drugs with a narrow therapeutic index (e.g., flecainide, pentazocine). One proposed mechanism is related to the loss of CYP450 1A2 and 1A1 induction by polycyclic aromatic hydrocarbons in tobacco smoke; when smoking cessation agents are initiated and smoking stops, the metabolism of certain drugs may decrease leading to increased plasma concentrations. The mechanism by which smoking cessation affects narrow therapeutic index drugs that are not known substrates of CYP450 1A2 or 1A1 is unknown. The clinical significance of this interaction is unknown as clinical data are lacking.

MANAGEMENT: Until more information is available, caution is advisable if smoking cessation agents are used concomitantly with drugs that are substrates of CYP450 1A2 or 1A1 and/or those with a narrow therapeutic range. Patients receiving smoking cessation agents may require periodic dose adjustments and closer clinical and laboratory monitoring of medications that are substrates of CYP450 1A2 or 1A1.