Drug Interactions between mitotane and pralsetinib

Food should not be consumed for at least 2 hours before and at least 1 hour after taking pralsetinib. Do not consume grapefruit, grapefruit juice, any supplements that contain grapefruit, Seville oranges, or Seville orange juice as these products can increase the blood levels of pralsetinib. This may increase the risk and/or severity of serious side effects such as lung problems, liver problems, high blood pressure, fatigue, muscle and joint pain, and bleeding complications. Some sources also warn that combining these medicines could 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 disease, conduction abnormalities, or electrolyte disturbance (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. 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.

High fat food significantly enhances the absorption of mitotane. You should take each dose of mitotane with a full meal containing high fat (e.G., containing milk, chocolate, or oil) and with a full glass of water. Taking mitotane on an empty stomach may lead to inadequate blood levels and reduced effectiveness of the medication. Talk to your doctor if you have questions or have difficulty taking mitotane with food. It is best to avoid or limit the consumption of alcohol, as it can increase drowsiness or other nervous system side effects of mitotane. You should also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. 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.