Drug Interactions between selumetinib and vadadustat

Grapefruit juice can increase the blood levels of selumetinib. This may increase the risk and/or severity of serious side effects such as diarrhea; colitis (inflammation of the colon); skin rashes; cardiomyopathy (a condition that affects the heart muscle and its ability to pump blood); rhabdomyolysis (a rare condition involving the breakdown of skeletal muscle tissue that can cause kidney damage and death); and eye problems that can lead to blindness. Do not consume grapefruit, grapefruit juice, or any supplements that contain grapefruit extract during treatment with selumetinib. Talk to your doctor or pharmacist if you have any questions or concerns. You should seek prompt medical attention if you experience severe diarrhea; severe skin reactions (rash over a large area of the body, peeling skin, blisters); signs and symptoms of heart trouble (persistent coughing or wheezing, shortness of breath, swelling of ankles and feet, fatigue, increased heart rate); muscle problems (unexplained muscle pain, tenderness or weakness, especially with fever and/or dark colored urine); or vision problems (blurred vision, light sensitivity, dark spots or floaters, vision loss). 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.

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.