Skip to main content

Drug Interactions between echinacea and ponatinib

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

Edit list (add/remove drugs)

Interactions between your drugs

Moderate

echinacea PONATinib

Applies to: echinacea and ponatinib

MONITOR: Coadministration with echinacea may alter the plasma concentrations and therapeutic effects of drugs that are substrates of CYP450 3A4. Echinacea appears to inhibit intestinal CYP450 3A4, which would lead to an increase in oral midazolam (a sensitive 3A4 substrate) bioavailability; however, plasma levels of midazolam following oral administration do not appear to be affected by echinacea. In contrast, it appears that echinacea may also induce hepatic CYP450 3A4; thereby increasing the hepatic clearance of drugs that are substrates of CYP450 3A4. According to reports, echinacea may increase the hepatic clearance of intravenous (IV) midazolam by 34% and decrease the area under the concentration-time curve (AUC) and half-life of IV midazolam by 20% and 42%, respectively.

MANAGEMENT: In general, patients should be advised to consult their healthcare provider before using any herbal or alternative medicines. If echinacea is prescribed with a drug that is a CYP450 3A4 substrate, the possibility of an altered (increased or decreased) therapeutic response should be considered. Patients should be monitored more closely following the addition or withdrawal of echinacea and the dosage of the CYP450 3A4 substrate adjusted as necessary.

References (2)
  1. Gorski JC, Huang SM, Pinto A, et al. (2004) "The effect of echinacea (Echinacea purpurea root) on cytochrome P450 activity in vivo." Clin Pharmacol Ther, 75, p. 89-100
  2. Cerner Multum, Inc. "Australian Product Information."

Drug and food interactions

Moderate

PONATinib food

Applies to: ponatinib

GENERALLY AVOID: Coadministration with grapefruit juice is likely to increase the plasma concentrations of ponatinib, which is primarily metabolized by CYP450 3A4. However, the interaction has not been studied. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit.

MANAGEMENT: The consumption of grapefruit, grapefruit juice, and supplements that contain grapefruit extract should be avoided during treatment with ponatinib.

References (1)
  1. (2012) "Product Information. Iclusig (ponatinib)." Ariad Pharmaceuticals Inc

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.

See also

Report options

Loading...
QR code containing a link to this page

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.

Medical Disclaimer