Drug Interactions between istradefylline and nintedanib

Grapefruit juice and Seville orange juice can increase the blood levels of nintedanib. This may increase the risk and/or severity of side effects such as liver problems, diarrhea, nausea, vomiting, stomach or intestinal wall perforation, bleeding, and cardiovascular problems such as heart attack, chest pain, or stroke. It is best to avoid or minimize the consumption of Seville oranges, Seville orange juice, grapefruit, and grapefruit juice during treatment. You should take nintedanib with food and swallow it whole with water. Taking nintedanib with food may help with absorption of the medication and reduce gastrointestinal side effects. Talk to your doctor or pharmacist if you have questions on how to take this or other medications you are prescribed. 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.

Smoking tobacco may reduce the blood levels and effects of istradefylline. Contact your doctor if istradefylline is not adequately controlling your symptoms. It is best to avoid smoking during istradefylline therapy. Talk to a healthcare professional if you have any questions or concerns. If you start smoking or undergo smoking cessation, your doctor may need to monitor you more closely to determine if you need a dose adjustment of istradefylline. Your doctor may already be aware of the risks and may have taken appropriate precautions including adjusting your dose and monitoring you closely for any potential complications. 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.