Interactions between Ibtrozi and Nefazodone

The taletrectinib in Ibtrozi has a moderate potential interaction with Arrhythmia.

Taletrectinib can cause QTc interval prolongation, which can increase the risk for ventricular tachyarrhythmias (e.g., torsades de pointes) or sudden death. In patients with risk factors for QT prolongation such as long QT syndromes, clinically significant bradyarrhythmias, or severe/uncontrolled heart failure, the frequency of monitoring should be adjusted accordingly. Prior to therapy, monitor ECGs and electrolytes in all patients and then periodically as indicated.

Nefazodone has a moderate potential interaction with Bipolar Disorder.

All antidepressants may occasionally cause mania or hypomania, particularly in patients with bipolar disorder. Therapy with antidepressants should be administered cautiously in patients with a history of mania/hypomania.

Nefazodone has a moderate potential interaction with Bipolar Disorder.

Adults, young adults and children 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. Phenylpiperazine antidepressants are not approved for use in pediatric patients.

Nefazodone has a major potential interaction with Cerebrovascular Insufficiency.

Nefazodone has alpha-1 adrenergic blocking activity and may cause significant decreases in blood pressure, including orthostatic hypotension, in approximately 5% of patients. Therapy with nefazodone should be administered cautiously in patients with preexisting hypotension or conditions that could be exacerbated by hypotension, such as a history of myocardial infarction, angina, or ischemic stroke. Patients with dehydration (e.g., due to severe diarrhea or vomiting) may be predisposed to hypotension and should also be managed carefully during therapy with nefazodone. Blood pressure should be monitored at regular intervals, particularly during dosage escalation or whenever dosage has been altered, and patients should be advised not to rise abruptly from a sitting or recumbent position.

Nefazodone has a major potential interaction with Dehydration.

Nefazodone has alpha-1 adrenergic blocking activity and may cause significant decreases in blood pressure, including orthostatic hypotension, in approximately 5% of patients. Therapy with nefazodone should be administered cautiously in patients with preexisting hypotension or conditions that could be exacerbated by hypotension, such as a history of myocardial infarction, angina, or ischemic stroke. Patients with dehydration (e.g., due to severe diarrhea or vomiting) may be predisposed to hypotension and should also be managed carefully during therapy with nefazodone. Blood pressure should be monitored at regular intervals, particularly during dosage escalation or whenever dosage has been altered, and patients should be advised not to rise abruptly from a sitting or recumbent position.

Nefazodone has a moderate potential interaction with Depression.

Adults, young adults and children 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. Phenylpiperazine antidepressants are not approved for use in pediatric patients.

Nefazodone has a major potential interaction with Diarrhea.

Nefazodone has alpha-1 adrenergic blocking activity and may cause significant decreases in blood pressure, including orthostatic hypotension, in approximately 5% of patients. Therapy with nefazodone should be administered cautiously in patients with preexisting hypotension or conditions that could be exacerbated by hypotension, such as a history of myocardial infarction, angina, or ischemic stroke. Patients with dehydration (e.g., due to severe diarrhea or vomiting) may be predisposed to hypotension and should also be managed carefully during therapy with nefazodone. Blood pressure should be monitored at regular intervals, particularly during dosage escalation or whenever dosage has been altered, and patients should be advised not to rise abruptly from a sitting or recumbent position.

The taletrectinib in Ibtrozi has a moderate potential interaction with Fracture, bone.

Taletrectinib can increase the risk of skeletal fractures. In clinical studies, some fractures occurred in the setting of predisposing factors such as osteoporosis, bone metastasis, and age-related degenerative conditions. There are no data on the effects of taletrectinib on healing of known fractures and risk of future fractures. Promptly evaluate patients with signs/symptoms of fractures (e.g., pain, changes in mobility, deformity).

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

Some antidepressants exert mydriatic activity that can induce increased intraocular pressure and result in angle-closure (narrow-angle) glaucoma in a patient with anatomically narrow angles who does not have a patent iridectomy. Prior to initiating therapy with these agents, patients should be examined to determine whether they are susceptible to angle closure, and have a prophylactic procedure (e.g., iridectomy), if they are susceptible. The use of these drugs in patients with untreated anatomically narrow angles should be avoided.

The taletrectinib in Ibtrozi has a moderate potential interaction with Heart Failure.

Taletrectinib can cause QTc interval prolongation, which can increase the risk for ventricular tachyarrhythmias (e.g., torsades de pointes) or sudden death. In patients with risk factors for QT prolongation such as long QT syndromes, clinically significant bradyarrhythmias, or severe/uncontrolled heart failure, the frequency of monitoring should be adjusted accordingly. Prior to therapy, monitor ECGs and electrolytes in all patients and then periodically as indicated.

Nefazodone has a major potential interaction with History - Cerebrovascular Disease.

Nefazodone has alpha-1 adrenergic blocking activity and may cause significant decreases in blood pressure, including orthostatic hypotension, in approximately 5% of patients. Therapy with nefazodone should be administered cautiously in patients with preexisting hypotension or conditions that could be exacerbated by hypotension, such as a history of myocardial infarction, angina, or ischemic stroke. Patients with dehydration (e.g., due to severe diarrhea or vomiting) may be predisposed to hypotension and should also be managed carefully during therapy with nefazodone. Blood pressure should be monitored at regular intervals, particularly during dosage escalation or whenever dosage has been altered, and patients should be advised not to rise abruptly from a sitting or recumbent position.

Nefazodone has a major potential interaction with History - Myocardial Infarction.

Nefazodone has alpha-1 adrenergic blocking activity and may cause significant decreases in blood pressure, including orthostatic hypotension, in approximately 5% of patients. Therapy with nefazodone should be administered cautiously in patients with preexisting hypotension or conditions that could be exacerbated by hypotension, such as a history of myocardial infarction, angina, or ischemic stroke. Patients with dehydration (e.g., due to severe diarrhea or vomiting) may be predisposed to hypotension and should also be managed carefully during therapy with nefazodone. Blood pressure should be monitored at regular intervals, particularly during dosage escalation or whenever dosage has been altered, and patients should be advised not to rise abruptly from a sitting or recumbent position.

Nefazodone has a major potential interaction with Hypotension.

Nefazodone has alpha-1 adrenergic blocking activity and may cause significant decreases in blood pressure, including orthostatic hypotension, in approximately 5% of patients. Therapy with nefazodone should be administered cautiously in patients with preexisting hypotension or conditions that could be exacerbated by hypotension, such as a history of myocardial infarction, angina, or ischemic stroke. Patients with dehydration (e.g., due to severe diarrhea or vomiting) may be predisposed to hypotension and should also be managed carefully during therapy with nefazodone. Blood pressure should be monitored at regular intervals, particularly during dosage escalation or whenever dosage has been altered, and patients should be advised not to rise abruptly from a sitting or recumbent position.

The taletrectinib in Ibtrozi has a moderate potential interaction with Interstitial Lung Disease.

Taletrectinib can cause severe, life-threatening, or fatal interstitial lung disease (ILD) or pneumonitis. Monitor patients for new or worsening pulmonary symptoms indicative of ILD/pneumonitis. Immediately withhold therapy in patients with suspected ILD/pneumonitis; dose reduction or permanent discontinuation of taletrectinib may be required based on severity.

Nefazodone has a major potential interaction with Ischemic Heart Disease.

Nefazodone has alpha-1 adrenergic blocking activity and may cause significant decreases in blood pressure, including orthostatic hypotension, in approximately 5% of patients. Therapy with nefazodone should be administered cautiously in patients with preexisting hypotension or conditions that could be exacerbated by hypotension, such as a history of myocardial infarction, angina, or ischemic stroke. Patients with dehydration (e.g., due to severe diarrhea or vomiting) may be predisposed to hypotension and should also be managed carefully during therapy with nefazodone. Blood pressure should be monitored at regular intervals, particularly during dosage escalation or whenever dosage has been altered, and patients should be advised not to rise abruptly from a sitting or recumbent position.

Nefazodone has a major potential interaction with Liver Disease.

In general, treatment with nefazodone should not be initiated in patients with active liver disease or elevated baseline serum transaminase levels. Cases of hepatic failure resulting in death or liver transplant, at an estimated rate of 1 per 250,000 to 300,000 patient-years of nefazodone treatment in the U.S. (approximately 3 to 4 times the background rate), have been reported during postmarketing use. The time to liver injury for the reported cases typically ranged from 2 weeks to 6 months of use. Dark urine and nonspecific prodromal symptoms (e.g., nausea, anorexia, malaise, gastrointestinal complaints) were reported in some, but not all, cases prior to the onset of jaundice. There is no evidence that preexisting liver disease increases the likelihood of developing liver failure. However, baseline abnormalities can delay the recognition or confound the diagnosis of a drug-induced hepatotoxic effect, thus use of nefazodone is discouraged in this population. In patients who do receive nefazodone therapy, routine liver function testing should be considered to permit early detection of hepatic injury. Nefazodone therapy should be promptly discontinued if clinical signs or symptoms suggestive of liver injury occur, or if serum transaminase levels exceed 3 times the upper limit of normal. Therapy should be permanently discontinued in patients with presumed or confirmed drug-induced hepatotoxicity. In addition, the use of nefazodone is contraindicated in patients who were withdrawn from nefazodone because of evidence of liver injury.

The taletrectinib in Ibtrozi has a moderate potential interaction with Liver Disease.

The effect of moderate liver dysfunction (total bilirubin greater than 1.5 to 3 x ULN with any AST) or severe liver dysfunction (total bilirubin greater than 3 x ULN with any AST) on the pharmacokinetics (PK) of taletrectinib is unknown. No clinically significant PK differences were observed based on mild liver dysfunction. Taletrectinib can cause hepatotoxicity, including drug-induced liver injury. Monitor liver function tests including ALT, AST, and total bilirubin at baseline and as recommended by the manufacturer.

The taletrectinib in Ibtrozi has a moderate potential interaction with Long QT Syndrome.

Taletrectinib can cause QTc interval prolongation, which can increase the risk for ventricular tachyarrhythmias (e.g., torsades de pointes) or sudden death. In patients with risk factors for QT prolongation such as long QT syndromes, clinically significant bradyarrhythmias, or severe/uncontrolled heart failure, the frequency of monitoring should be adjusted accordingly. Prior to therapy, monitor ECGs and electrolytes in all patients and then periodically as indicated.

Nefazodone has a moderate potential interaction with Mania.

All antidepressants may occasionally cause mania or hypomania, particularly in patients with bipolar disorder. Therapy with antidepressants should be administered cautiously in patients with a history of mania/hypomania.

The taletrectinib in Ibtrozi has a moderate potential interaction with Neoplasm of Bone.

Taletrectinib can increase the risk of skeletal fractures. In clinical studies, some fractures occurred in the setting of predisposing factors such as osteoporosis, bone metastasis, and age-related degenerative conditions. There are no data on the effects of taletrectinib on healing of known fractures and risk of future fractures. Promptly evaluate patients with signs/symptoms of fractures (e.g., pain, changes in mobility, deformity).

The taletrectinib in Ibtrozi has a moderate potential interaction with Osteoporosis.

Taletrectinib can increase the risk of skeletal fractures. In clinical studies, some fractures occurred in the setting of predisposing factors such as osteoporosis, bone metastasis, and age-related degenerative conditions. There are no data on the effects of taletrectinib on healing of known fractures and risk of future fractures. Promptly evaluate patients with signs/symptoms of fractures (e.g., pain, changes in mobility, deformity).

The taletrectinib in Ibtrozi has a moderate potential interaction with Pulmonary Impairment.

Taletrectinib can cause severe, life-threatening, or fatal interstitial lung disease (ILD) or pneumonitis. Monitor patients for new or worsening pulmonary symptoms indicative of ILD/pneumonitis. Immediately withhold therapy in patients with suspected ILD/pneumonitis; dose reduction or permanent discontinuation of taletrectinib may be required based on severity.

The taletrectinib in Ibtrozi has a moderate potential interaction with Renal Dysfunction.

The effect of dialysis or severe renal dysfunction (estimated GFR less than 30 mL/min) on the pharmacokinetics of taletrectinib is unknown. No clinically significant pharmacokinetic differences were observed based on mild or moderate renal dysfunction.

Nefazodone has a moderate potential interaction with Seizures.

The use of most antidepressants is associated with a risk of seizures. There have been only rare reports of convulsions, including grand mal seizures, following the administration of nefazodone or trazodone. Although a causal relationship has not been established, therapy with these agents should be administered cautiously in patients with a history of seizures.

Nefazodone has a major potential interaction with Vomiting.

Nefazodone has alpha-1 adrenergic blocking activity and may cause significant decreases in blood pressure, including orthostatic hypotension, in approximately 5% of patients. Therapy with nefazodone should be administered cautiously in patients with preexisting hypotension or conditions that could be exacerbated by hypotension, such as a history of myocardial infarction, angina, or ischemic stroke. Patients with dehydration (e.g., due to severe diarrhea or vomiting) may be predisposed to hypotension and should also be managed carefully during therapy with nefazodone. Blood pressure should be monitored at regular intervals, particularly during dosage escalation or whenever dosage has been altered, and patients should be advised not to rise abruptly from a sitting or recumbent position.