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Can you take Nelfinavir with Omcazio?

1 drug interaction and 17 additional warnings found for the following 2 drugs:

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Drug interactions

Major drug interactions

Major:

nelfinavir cabozantinib

Applies to: nelfinavir and Omcazio (cabozantinib)

Nelfinavir may increase the blood levels of cabozantinib. This may 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 (e.G., nausea, vomiting, diarrhea, loss of appetite, weight loss, mouth sores, abdominal pain, skin rash, delayed wound healing, high blood pressure, impaired bone marrow function) may also be increased. In addition, you may also be more likely to develop anemia, bleeding problems, or infections due to low blood cell counts. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the interaction, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. You should seek medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, heart palpitations, paleness, fatigue, dizziness, fainting, unusual bruising or bleeding, fever, chills, diarrhea, sore throat, muscle aches, shortness of breath, blood in phlegm, weight loss, red or inflamed skin, body sores, and pain or burning during urination. 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.

Food/lifestyle interactions

Moderate food/lifestyle interactions

Moderate:

cabozantinib Food/Lifestyle

Applies to: Omcazio (cabozantinib)

Cabozantinib should be taken on an empty stomach, one hour before or two hours after a meal. Do not consume grapefruit, grapefruit juice, or any supplements that contain grapefruit extract during treatment with cabozantinib unless directed otherwise by your doctor. Grapefruit juice can increase the blood levels of cabozantinib. You may be more likely to experience side effects such as nausea; vomiting; diarrhea; loss of appetite; weight loss; mouth sores; abdominal pain; skin rash (primarily on the palms of the hands and soles of the feet); delayed wound healing; high blood pressure; and impaired bone marrow function resulting in low numbers of different types of blood cells, which can increase the risk of bleeding problems and infections. 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.

Disease interactions

16 potential interactions Applies to: 15 conditions, including High Blood Pressure, Heart Attack, Diverticulitis, Diabetes Mellitus, and Thrombotic/Thromboembolic Disorder.

Abnormal Glucose Tolerance

Moderate:

nelfinavir

Nelfinavir has a moderate potential interaction with Abnormal Glucose Tolerance.

New onset diabetes mellitus, exacerbation of preexisting diabetes mellitus, hyperglycemia, and some cases of diabetic ketoacidosis have been reported during postmarketing surveillance in HIV-infected patients treated with protease inhibitors. Some patients required either initiation or dosage adjustments of insulin or oral hypoglycemic agents for treatment of these events. In some cases, hyperglycemia persisted despite discontinuation of protease inhibitor therapy. A causal relationship has not been established between protease inhibitor therapy and these events. Monitoring patients for hyperglycemia, new onset diabetes mellitus, or exacerbation of diabetes mellitus should be considered during protease inhibitor therapy.

Bleeding Disorder

Major:

Omcazio

The cabozantinib in Omcazio has a major potential interaction with Bleeding Disorder.

Fatal hemorrhagic events have been reported with the use of cabozantinib. Therapy with cabozantinib is not recommended in patients that have or are at risk for severe hemorrhage.

Coagulation Defects and Disorders

Moderate:

nelfinavir

Nelfinavir has a moderate potential interaction with Coagulation Defects and Disorders.

There have been reports of increased bleeding, including spontaneous skin hematomas and hemarthrosis, in patients with hemophilia type A and B treated with protease inhibitors; however, a causal relationship has not been established. In some patients, additional factor VIII was given. In more than half of the reported cases, protease inhibitor therapy was continued or reintroduced. Patients with hemophilia or other coagulation defects should be monitored closely for bleeding during protease inhibitor therapy.

Diabetes Mellitus

Moderate:

nelfinavir

Nelfinavir has a moderate potential interaction with Diabetes Mellitus.

New onset diabetes mellitus, exacerbation of preexisting diabetes mellitus, hyperglycemia, and some cases of diabetic ketoacidosis have been reported during postmarketing surveillance in HIV-infected patients treated with protease inhibitors. Some patients required either initiation or dosage adjustments of insulin or oral hypoglycemic agents for treatment of these events. In some cases, hyperglycemia persisted despite discontinuation of protease inhibitor therapy. A causal relationship has not been established between protease inhibitor therapy and these events. Monitoring patients for hyperglycemia, new onset diabetes mellitus, or exacerbation of diabetes mellitus should be considered during protease inhibitor therapy.

Diverticulitis

Moderate:

Omcazio

The cabozantinib in Omcazio has a moderate potential interaction with Diverticulitis.

Therapy with cabozantinib should be used with caution in patients who may be at increased risk for gastrointestinal perforation, such as those with a history of diverticulitis. Patients presenting with new onset of abdominal symptoms should be evaluated promptly for early identification of gastrointestinal perforation. It is recommended to monitor for symptoms of gastrointestinal perforation or fistula periodically throughout the treatment. Discontinue cabozantinib in patients who experience a fistula which cannot be appropriately managed or a GI perforation.

Gastrointestinal Perforation

Moderate:

Omcazio

The cabozantinib in Omcazio has a moderate potential interaction with Gastrointestinal Perforation.

Therapy with cabozantinib should be used with caution in patients who may be at increased risk for gastrointestinal perforation, such as those with a history of diverticulitis. Patients presenting with new onset of abdominal symptoms should be evaluated promptly for early identification of gastrointestinal perforation. It is recommended to monitor for symptoms of gastrointestinal perforation or fistula periodically throughout the treatment. Discontinue cabozantinib in patients who experience a fistula which cannot be appropriately managed or a GI perforation.

Heart Attack

Moderate:

Omcazio

The cabozantinib in Omcazio has a moderate potential interaction with Heart Attack.

Arterial and venous thromboembolic events have been reported with the use of cabozantinib. Use with caution in patients who are at risk, or have a history of these events. It is recommended to monitor closely for signs and symptoms of thromboembolism. Discontinue cabozantinib in patients who develop an acute myocardial infarction or any other arterial thromboembolic complication.

High Blood Pressure

Moderate:

Omcazio

The cabozantinib in Omcazio has a moderate potential interaction with High Blood Pressure.

The use of cabozantinib causes hypertension. Blood pressure should be well-controlled prior to initiating cabozantinib and monitored and treated as needed with standard anti-hypertensive therapy. It is recommended to reduce the dose in case of persistent hypertension despite use of anti-hypertensive medications and to discontinue therapy if hypertension is severe and persistent despite these measures. Discontinue cabozantinib therapy for severe hypertension that cannot be controlled with anti-hypertensive therapy and if there is evidence of hypertensive crisis or severe hypertension despite optimal medical management. Close monitoring is recommended.

Interstitial Lung Disease

Moderate:

Omcazio

The cabozantinib in Omcazio has a moderate potential interaction with Interstitial Lung Disease.

The use of certain multikinase inhibitors has been associated with pulmonary toxicity. Serious cases of interstitial lung disease (ILD), including fatal cases and interstitial pneumonitis or pulmonary fibrosis have been reported. Caution is recommended when using these agents in patients with a history of interstitial pneumonitis or pulmonary fibrosis or those patients presenting with acute onset of new or progressive unexplained pulmonary symptoms such as dyspnea, cough, and fever pending diagnostic evaluation. If ILD is confirmed, these agents should be permanently discontinued and appropriate measures should be instituted. Treatment should be immediately withheld in patients diagnosed with ILD/pneumonitis and permanently discontinued if no other potential causes of ILD/pneumonitis have been identified.

Liver Disease

Moderate:

nelfinavir

Nelfinavir has a moderate potential interaction with Liver Disease.

Nelfinavir is primarily metabolized by the liver. Patients with liver disease may be at greater risk for adverse effects from nelfinavir due to decreased drug clearance. Therapy with nelfinavir should be administered cautiously in patients with liver disease.

Moderate:

Omcazio

The cabozantinib in Omcazio has a moderate potential interaction with Liver Disease.

Increased exposure to cabozantinib has been observed in patients with mild to moderate hepatic impairment. It is recommended to reduce the cabozantinib dose in patients with mild or moderate hepatic impairment. The use of cabozantinib is not recommended in patients with severe hepatic impairment. It is recommended to monitor liver function and urine bilirubin tests periodically during therapy.

Phenylketonuria

Moderate:

nelfinavir

Nelfinavir has a moderate potential interaction with Phenylketonuria.

Viracept (brand of nelfinavir) oral powder contains 11.2 mg of phenylalanine per each gram of powder. The phenylalanine content should be considered when this product is used in patients who must restrict their intake of phenylalanine (i.e. phenylketonurics).

Posterior Reversible Encephalopathy Syndrome

Moderate:

Omcazio

The cabozantinib in Omcazio has a moderate potential interaction with Posterior Reversible Encephalopathy Syndrome.

Reversible posterior leukoencephalopathy syndrome (RPLS) has been reported in patients receiving cabozantinib. It is recommended to discontinue therapy in patients developing RPLS. The safety of reinitiating therapy in patients previously experiencing RPLS is not known. Care and close monitoring should be considered in these patients.

Pulmonary Impairment

Moderate:

Omcazio

The cabozantinib in Omcazio has a moderate potential interaction with Pulmonary Impairment.

The use of certain multikinase inhibitors has been associated with pulmonary toxicity. Serious cases of interstitial lung disease (ILD), including fatal cases and interstitial pneumonitis or pulmonary fibrosis have been reported. Caution is recommended when using these agents in patients with a history of interstitial pneumonitis or pulmonary fibrosis or those patients presenting with acute onset of new or progressive unexplained pulmonary symptoms such as dyspnea, cough, and fever pending diagnostic evaluation. If ILD is confirmed, these agents should be permanently discontinued and appropriate measures should be instituted. Treatment should be immediately withheld in patients diagnosed with ILD/pneumonitis and permanently discontinued if no other potential causes of ILD/pneumonitis have been identified.

Renal Dysfunction

Moderate:

Omcazio

The cabozantinib in Omcazio has a moderate potential interaction with Renal Dysfunction.

No dose adjustment is required in patients with mild or moderate renal impairment. There is no experience with cabozantinib in patients with severe renal impairment. Care should be exercised in these patients.

Thrombotic/Thromboembolic Disorder

Moderate:

Omcazio

The cabozantinib in Omcazio has a moderate potential interaction with Thrombotic/Thromboembolic Disorder.

Arterial and venous thromboembolic events have been reported with the use of cabozantinib. Use with caution in patients who are at risk, or have a history of these events. It is recommended to monitor closely for signs and symptoms of thromboembolism. Discontinue cabozantinib in patients who develop an acute myocardial infarction or any other arterial thromboembolic complication.

More resources

nelfinavir

A total of 589 drugs are known to interact with nelfinavir.

Omcazio

A total of 560 drugs are known to interact with Omcazio.

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.