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Drug Interactions between mifepristone and selpercatinib

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

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Interactions between your drugs

Major

miFEPRIStone selpercatinib

Applies to: mifepristone and selpercatinib

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Coadministration with potent inhibitors of CYP450 3A4 may significantly increase 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 itraconazole (200 mg once daily), a potent CYP450 3A4 inhibitor, selpercatinib peak plasma concentration (Cmax) and systemic exposure (AUC) increased by 30% and 133%, respectively. Increased exposure to selpercatinib may increase the risk of serious adverse effects such as QT interval prolongation, liver transaminase and bilirubin elevations, hypertension, hemorrhage, edema, and hypersensitivity reactions (e.g., fever, rash, arthralgias/myalgias with concurrent decreased platelets or transaminitis). 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 may result in additive effects and an increased risk of ventricular arrhythmias like torsade de pointes.

MANAGEMENT: Concomitant use of selpercatinib with potent CYP450 3A4 inhibitors should be avoided when possible. However, if coadministration is required, a dosage reduction of selpercatinib is advised. The manufacturer's product labeling should be consulted for specific dosage modification recommendations for concomitant use of selpercatinib with potent CYP450 3A4 inhibitors. Close monitoring for adverse effects is advisable, including more frequent ECGs and laboratory monitoring of liver enzymes, bilirubin, electrolytes, glucose, and blood counts. Selpercatinib treatment should be discontinued, interrupted, or dosage reduced in patients with serious or life-threatening toxicities in accordance with the product labeling. After the inhibitor has been discontinued for 3 to 5 elimination half-lives, the selpercatinib dosage that was taken prior to initiating the inhibitor may be resumed.

Drug and food interactions

Major

selpercatinib food

Applies to: 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.

Moderate

miFEPRIStone food

Applies to: mifepristone

Food increases the blood levels of this medication. If you are only receiving one or two doses, you may take it without regard to meals. However, if you are receiving the medication for long-term treatment, you should take it with food at the same time everyday to maintain consistent blood levels and effects. Avoid consuming grapefruit or grapefruit juice during treatment, as it may increase blood levels of the medication to undesirable levels and increase the risk of side effects, including headache, dizziness, fatigue, nausea, vomiting, cramping, diarrhea, hypokalemia (low blood potassium), fluid retention, swelling, and high blood pressure. 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.

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.