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Drug Interactions between ivosidenib and Retevmo

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

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Interactions between your drugs

Major

ivosidenib selpercatinib

Applies to: ivosidenib and Retevmo (selpercatinib)

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Coadministration with potent or moderate inducers of CYP450 3A4 may significantly decrease the plasma concentrations of selpercatinib, which is primarily metabolized by the isoenzyme. When a single dose of selpercatinib (160 mg) was coadministered with multiple doses of rifampin (600 mg once daily), a potent CYP450 3A4 inducer, selpercatinib peak plasma concentration (Cmax) and systemic exposure (AUC) decreased by 70% and 87%, respectively. Based on pharmacokinetic modeling, administration of multiple doses of selpercatinib (160 mg twice daily) with multiple doses of the moderate CYP450 3A4 inducers bosentan (62.5 mg twice daily) or efavirenz (600 mg once daily) is predicted to decrease selpercatinib Cmax by 34% to 57% and AUC by 40% to 70%. Reduced efficacy of selpercatinib may occur. In addition, when two or more medications with similar adverse effect profiles are given concurrently, the likelihood of experiencing these adverse reactions may be increased. For example, coadministration with other agents that can prolong the QT interval (e.g., apalutamide, encorafenib, enzalutamide) may result in additive effects and an increased risk of ventricular arrhythmias like torsade de pointes.

MANAGEMENT: According to the manufacturer, due to the potential reduction in therapeutic efficacy, concomitant use of selpercatinib with moderate or potent CYP450 3A4 inducers should generally be avoided.

Drug and food interactions

Major

ivosidenib food

Applies to: ivosidenib

Do not consume grapefruit or grapefruit juice during treatment with ivosidenib unless directed otherwise by your doctor. Grapefruit juice can increase the blood levels of ivosidenib. This may increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). Talk to your doctor if you have any questions or concerns. You may take ivosidenib with or without food, but avoid taking it with a high-fat meal, as this can also increase blood levels of the medication. An example of a high-fat meal includes 2 eggs fried in butter, 2 strips of bacon, 2 slices of white bread with butter, 1 croissant with 1 slice of cheese, and 8 ounces of whole milk (approximately 1,000 calories and 58 grams of fat). You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment. 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.

Major

selpercatinib food

Applies to: Retevmo (selpercatinib)

You should limit or avoid consumption of grapefruit and grapefruit juice during treatment with selpercatinib unless directed otherwise by your doctor. Grapefruit juice may increase the blood levels of selpercatinib. High levels of selpercatinib can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). The risk and/or severity of other side effects may also increase, including nausea, vomiting, constipation, diarrhea, rash, muscle and joint pain, swelling of arms or legs, liver problems, high blood pressure, and bleeding complications. Talk to your doctor if you experience intolerable or troublesome side effects, or you have other questions or concerns. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with selpercatinib. 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.

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.


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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.