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Drug Interactions between pralsetinib and vadadustat

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

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Interactions between your drugs

Moderate

pralsetinib vadadustat

Applies to: pralsetinib and vadadustat

Consumer information for this interaction is not currently available.

MONITOR: Coadministration with inhibitors of CYP450 3A4 may increase the plasma concentrations of pralsetinib, which is primarily metabolized by the isoenzyme. A physiologically based pharmacokinetic (PBPK) model predicted pralsetinib's peak plasma concentration (Cmax) and systemic exposure (AUC) would increase by 1.2- and 2.2-fold, respectively, when coadministered with the potent CYP450 3A4 inhibitor voriconazole (400 mg twice daily on Day 1, followed by 200 mg twice daily). Similarly, another PBPK model predicted that concomitant use of the moderate CYP450 3A4 inhibitor fluconazole (400 mg daily) would increase the Cmax and AUC of pralsetinib by 1.2- and 1.7-fold, respectively. The extent to which other, less potent CYP450 3A4 inhibitors may interact with pralsetinib is unknown. Increased exposure to pralsetinib may increase the risk and/or frequency of adverse effects such as interstitial lung disease/pneumonitis, liver transaminase elevations, hypertension, and hemorrhage. Some clinical trials have also observed prolongation of the QT interval in patients on pralsetinib, though this was not observed in a study of 34 patients with rearranged during transfection (RET)-altered solid tumors on pralsetinib at the recommended dosage.

MANAGEMENT: Caution is advised when pralsetinib is used with CYP450 3A4 inhibitors. Monitor closely for adverse effects whenever a CYP450 3A4 inhibitor is added to therapy. Alternative treatments may be required if an interaction is suspected.

Drug and food interactions

Major

pralsetinib food

Applies to: 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.

Moderate

vadadustat food

Applies to: vadadustat

Consumer information for this interaction is not currently available.

MONITOR: Smoking and alcohol consumption during therapy with vadadustat may increase the risk of gastrointestinal erosions. Serious erosions, including gastrointestinal bleeding and the need for red blood cell transfusions, have been reported during vadadustat clinical trials. Patients with a history of gastrointestinal erosion, peptic ulcer disease, and current tobacco smokers and alcohol drinkers may be at higher risk of gastrointestinal injury.

MANAGEMENT: Caution is advised if vadadustat is prescribed to current tobacco smokers or alcohol drinkers. Patients should be advised to contact their physician if they develop potential signs and symptoms of gastrointestinal injury such as abdominal pain, hematemesis, trouble swallowing, chest or throat pain, and/or black, tarry stools.

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.

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