Can you take Osimertinib with Ritlecitinib?

Osimertinib has a major potential interaction with Arrhythmia.

QT prolongation was observed in patients treated with certain EGFR inhibitors. These agents should be administered with caution in patients with congenital long QTc syndrome, congestive heart failure, electrolyte abnormalities, or those who are taking medications known to prolong the QTc interval. Serum electrolytes should be corrected prior to initiating therapy with these agents. Periodic monitoring of ECGs and electrolytes is recommended in these patients. Permanently discontinue the use of these agents in patients who develop QTc interval prolongation with signs/symptoms of life-threatening arrhythmia.

Ritlecitinib has a major potential interaction with Cardiovascular Conditions and Disorders.

In a major safety study of a Janus kinase (JAK) inhibitor, tofacitinib, in rheumatoid arthritis patients 50 years and older with at least 1 cardiovascular risk factor, higher rates of all-cause mortality (including sudden cardiovascular death) and major adverse cardiovascular events (MACE) (defined as cardiovascular death, myocardial infarction, and stroke) were observed with the JAK inhibitor when compared with tumor necrosis factor (TNF) blockers. Patients who were current or past smokers had an additional increased risk. Based on a shared mechanism of action, this risk should be considered for other JAK inhibitors, including baricitinib, upadacitinib, ruxolitinib, fedratinib, ritlecitinib, deuruxolitinib, and pacritinib. Consider the benefits and risks for each individual patient prior and during treatment with JAK inhibitors, especially in patients with other cardiovascular risk factors, history of cardiovascular events, and patients who are current or past smokers. Patients should be informed about the symptoms of serious cardiovascular events and what to do if they occur.

Osimertinib has a major potential interaction with Dermatitis, Drug-Induced.

Cutaneous reactions, in some cases severe, have been reported with the use of EGFR inhibitors. Monitor patients who develop dermatologic or soft tissue toxicities while receiving these agents for the development of inflammatory or infectious sequelae. It is recommended to withhold treatment, and appropriate measures should be instituted as appropriate or discontinue the use of these agents for dermatologic or soft tissue toxicity associated with severe or life-threatening inflammatory or infectious complications. Advise patients to wear sunscreen and hats and limit sun exposure while receiving therapy with these agents as exposure to sunlight can exacerbate dermatologic toxicities.

Osimertinib has a major potential interaction with Eye Conditions.

Some epidermal growth factor receptor (EGFR) inhibitors should be administered cautiously in patients with ocular disorders such as primary keratitis, ulcerative keratitis, or conjunctivitis. It is recommended to interrupt or discontinue treatment with these agents if patients present with acute or worsening ocular disorders.

Osimertinib has a major potential interaction with Fever.

The use of certain EGFR 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, permanently discontinue these agents and institute appropriate measures.

Osimertinib has a major potential interaction with Heart Failure.

QT prolongation was observed in patients treated with certain EGFR inhibitors. These agents should be administered with caution in patients with congenital long QTc syndrome, congestive heart failure, electrolyte abnormalities, or those who are taking medications known to prolong the QTc interval. Serum electrolytes should be corrected prior to initiating therapy with these agents. Periodic monitoring of ECGs and electrolytes is recommended in these patients. Permanently discontinue the use of these agents in patients who develop QTc interval prolongation with signs/symptoms of life-threatening arrhythmia.

Ritlecitinib has a major potential interaction with History, Tuberculosis.

Avoid the use of ritlecitinib in patients with an active, serious infection. Consider the risks and benefits of treatment in patients with chronic or recurrent infection, exposed to tuberculosis (TB), with a history of serious infection or an opportunistic infection, who have resided or traveled in areas of endemic TB or mycoses, or with underlying conditions that may predispose them to infection. Patients should be screened for TB before treatment initiation. This drug should not be given to patients with active TB or untreated latent TB; anti-TB therapy should be started prior to initiating treatment. Screening for viral hepatitis should be performed in accordance with clinical guidelines before starting therapy. Treatment interruption should be considered in patients with viral reactivation (e.g., herpes zoster).

Ritlecitinib has a major potential interaction with Immunodeficiency.

Avoid the use of ritlecitinib in patients with an active, serious infection. Consider the risks and benefits of treatment in patients with chronic or recurrent infection, exposed to tuberculosis (TB), with a history of serious infection or an opportunistic infection, who have resided or traveled in areas of endemic TB or mycoses, or with underlying conditions that may predispose them to infection. Patients should be screened for TB before treatment initiation. This drug should not be given to patients with active TB or untreated latent TB; anti-TB therapy should be started prior to initiating treatment. Screening for viral hepatitis should be performed in accordance with clinical guidelines before starting therapy. Treatment interruption should be considered in patients with viral reactivation (e.g., herpes zoster).

Ritlecitinib has a major potential interaction with Infection.

Avoid the use of ritlecitinib in patients with an active, serious infection. Consider the risks and benefits of treatment in patients with chronic or recurrent infection, exposed to tuberculosis (TB), with a history of serious infection or an opportunistic infection, who have resided or traveled in areas of endemic TB or mycoses, or with underlying conditions that may predispose them to infection. Patients should be screened for TB before treatment initiation. This drug should not be given to patients with active TB or untreated latent TB; anti-TB therapy should be started prior to initiating treatment. Screening for viral hepatitis should be performed in accordance with clinical guidelines before starting therapy. Treatment interruption should be considered in patients with viral reactivation (e.g., herpes zoster).

Osimertinib has a moderate potential interaction with Liver Disease.

No formal pharmacokinetic studies of osimertinib have been conducted in patients with renal or hepatic impairment. Based on population pharmacokinetic (PK) analysis of osimertinib, no dose adjustment is recommended in patients with mild (CrCl 60-89 mL/min) or moderate (CrCl 30-59 mL/min) renal impairment, or mild hepatic impairment (total bilirubin

Ritlecitinib has a moderate potential interaction with Liver Disease.

Ritlecitinib is not recommended in patients with severe (Child Pugh C) hepatic impairment.

Osimertinib has a major potential interaction with Pulmonary Impairment.

The use of certain EGFR 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, permanently discontinue these agents and institute appropriate measures.

Osimertinib has a moderate potential interaction with Renal Dysfunction.

No formal pharmacokinetic studies of osimertinib have been conducted in patients with renal or hepatic impairment. Based on population pharmacokinetic (PK) analysis of osimertinib, no dose adjustment is recommended in patients with mild (CrCl 60-89 mL/min) or moderate (CrCl 30-59 mL/min) renal impairment, or mild hepatic impairment (total bilirubin

Ritlecitinib has a major potential interaction with Smoking.

In a major safety study of a Janus kinase (JAK) inhibitor, tofacitinib, in rheumatoid arthritis patients 50 years and older with at least 1 cardiovascular risk factor, higher rates of all-cause mortality (including sudden cardiovascular death) and major adverse cardiovascular events (MACE) (defined as cardiovascular death, myocardial infarction, and stroke) were observed with the JAK inhibitor when compared with tumor necrosis factor (TNF) blockers. Patients who were current or past smokers had an additional increased risk. Based on a shared mechanism of action, this risk should be considered for other JAK inhibitors, including baricitinib, upadacitinib, ruxolitinib, fedratinib, ritlecitinib, deuruxolitinib, and pacritinib. Consider the benefits and risks for each individual patient prior and during treatment with JAK inhibitors, especially in patients with other cardiovascular risk factors, history of cardiovascular events, and patients who are current or past smokers. Patients should be informed about the symptoms of serious cardiovascular events and what to do if they occur.

Osimertinib has a major potential interaction with Ventricular Arrhythmia.

Cardiomyopathy was observed in clinical trials of certain EGFR inhibitors. Assess Left Ventricular Ejection Fraction (LVEF) by echocardiogram or multigated acquisition (MUGA) scan before initiation of these agents and then at 3 month intervals while on treatment. Caution is recommended when prescribing these agents to patients with conditions that could impair left ventricular function and it is recommended to withhold treatment with these agents if ejection fraction drops below the established lower limit of normal. For symptomatic congestive heart failure or persistent, asymptomatic LV dysfunction that does not resolve within 4 weeks, permanently discontinue these agents.