Drug Interactions between pemigatinib and selexipag

Pemigatinib may be taken with or without food. Do not consume grapefruit, grapefruit juice, or any supplements that contain grapefruit extract during treatment with pemigatinib unless directed otherwise by your doctor. Grapefruit juice can increase the blood levels of pemigatinib. This may increase the frequency and severity of serious side effects such as elevated phosphate levels in the blood (which can eventually lead to low blood calcium levels; calcium deposits in the skin, muscles, and other tissues; anemia; muscle cramps; seizures; and irregular heart rhythm), eye and vision problems, joint pain, mouth sores and inflammation, hair loss, diarrhea, nausea, vomiting, and constipation. 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.

Information for this minor interaction is available on the professional version.

Liver impairment can increase exposure to selexipag and its metabolites. No dose adjustment is necessary in patients with mild impairment, but a once a day regimen is recommended in patients with moderate hepatic impairment. There is no experience with selexipag in patients with severe hepatic impairment and its use should be avoided in these patients.

The recommended dosage of pemigatinib should be reduced in patients with severe hepatic dysfunction. No dose adjustment is recommended for patients with mild or moderate hepatic impairment.

No adjustment to the dosing regimen of selexipag is required in patients with estimated glomerular filtration rate > 15 mL/min/1.73m2. There is no clinical experience with selexipag in patients with glomerular filtration rates lower than this, or in patients undergoing dialysis.

The recommended dosage of pemigatinib should be reduced in patients with severe renal disease. No dose adjustment is recommended for patients with mild or moderate renal impairment, or those patients with end-stage renal disease receiving intermittent hemodialysis.

Pemigatinib can cause retinal pigment epithelial detachment (RPED), which may cause symptoms such as blurred vision, visual floaters, or photopsia. A comprehensive ophthalmological examination including an optical coherence tomography should be performed prior to treatment initiation. Patients with visual disturbances should be closely monitored.