Drug Interactions between selpercatinib and tepotinib

You should limit or avoid consumption of grapefruit and grapefruit juice during treatment with selpercatinib unless directed otherwise by your doctor. Grapefruit juice may increase the blood levels of selpercatinib. High levels of selpercatinib can 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 may also increase, including nausea, vomiting, constipation, diarrhea, rash, muscle and joint pain, swelling of arms or legs, liver problems, high blood pressure, and bleeding complications. Talk to your doctor if you experience intolerable or troublesome side effects, or you have other questions or concerns. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with selpercatinib. 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 helps with the absorption of tepotinib into the blood stream. You should take this medication with food at approximately the same time each day.

The recommended maximum number of medicines in the 'multikinase inhibitors' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'multikinase inhibitors' category:

• selpercatinib
• tepotinib

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.