Interactions between Sorafenib and Suclear
1 drug interaction and 15 additional warnings found for the following 2 drugs:
- sorafenib
- Suclear (polyethylene glycol 3350 with electrolytes)
Drug interactions
Moderate drug interactions
Moderate:
polyethylene glycol 3350 with electrolytes SORAfenib
Applies to: Suclear (polyethylene glycol 3350 with electrolytes) and sorafenib
Monitor
The use of bowel cleansing preparations may increase the risk of ventricular arrhythmia, particularly torsade de pointes, in patients treated with drugs that prolong the QT interval. Severe and potentially fatal cases of electrolyte disorders and arrhythmias have been reported in elderly patients using bowel cleansing products. Electrolyte disturbances including hypokalemia and hypomagnesemia are known risk factors for torsade de pointes associated with QT interval prolongation.
Management
Caution is advised when bowel cleansing preparations are prescribed in patients treated with drugs that prolong the QT interval. Monitoring of baseline and posttreatment serum electrolyte levels is recommended, particularly in the elderly. Patients should be instructed to drink plenty of clear liquids before, during, and after the bowel preparation process. Consideration should be given to consumption of 36 to 48 fluid ounces of a carbohydrate-electrolyte solution in the six hours before the first dose. Patients should be advised to seek prompt medical attention if they experience symptoms that could indicate the occurrence of torsade de pointes such as dizziness, lightheadedness, fainting, palpitation, irregular heart rhythm, shortness of breath, or syncope.
References (7)
- Hill AG, Parry BR (1996) "Hypokalaemia following bowel cleansing with sodium phosphate." N Z Med J, 109, p. 347
- Cerner Multum, Inc. "UK Summary of Product Characteristics."
- (2007) "Product Information. Fleet Phospho Soda (sodium acid phosphate-sodium phosphate)." Fleet, CB
- (2007) "Product Information. Visicol (sodium acid phosphate-sodium phosphate)." Salix Pharmaceuticals
- Cerner Multum, Inc. "Australian Product Information."
- (2010) "Product Information. Suprep Bowel Prep Kit (magnesium/potassium/sodium sulfates)." Braintree Laboratories
- (2013) "Product Information. Suclear (polyethylene glycol 3350 with electrolytes)." Braintree Laboratories
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
polyethylene glycol 3350 with electrolytes Food/Lifestyle
Applies to: Suclear (polyethylene glycol 3350 with electrolytes)
Generally avoid
Using macrogol 3350 with electrolytes with starch-based food thickeners may counteract the thickening effect of the starch. According to some authorities, this may liquefy the preparations, potentially increasing the risk for aspiration in patients with swallowing problems. In addition, combining macrogol 3350 with electrolytes can increase the gastrointestinal transit rate. Oral medications administered within one hour of starting the bowel cleansing solution may be flushed from the gastrointestinal tract and not properly absorbed.
Management
Mixing of macrogol 3350-based solutions with starch-based food thickeners should generally be avoided to minimize aspiration risk; always consult individual product package labeling and relevant institutional protocols for guidance. Patients should be advised that absorption of oral medications may be impaired during bowel cleansing treatment, so oral medications (e.g., anticonvulsants, oral contraceptives, antidiabetic agents, antibiotics) should not be administered during and within one hour of starting bowel cleansing whenever possible. If taking medications at these times cannot be avoided, monitoring for reduced therapeutic effects may be advisable.
References (3)
- (2024) "Product Information. GaviLyte-N With Flavor Packs (polyethylene glycol 3350 with electrolytes)." Gavis Pharmaceuticals
- (2021) Polyethylene glycol (PEG) laxatives and starch-based thickeners: potential interactive effect when mixed, leading to an increased risk of aspiration https://www.gov.uk/drug-safety-update/polyethylene-glycol-peg-laxatives-and-starch-based-thickeners-poten
- Potentially Harmful Interaction between Polyethylene https://ismpcanada.ca/wp-content/uploads/ISMPCSB2019-i7-PEG-Thickener.pdf
Moderate:
SORAfenib Food/Lifestyle
Applies to: sorafenib
Adjust dosing interval
Food may reduce the oral absorption and bioavailability of sorafenib. According to the product labeling, sorafenib bioavailability was reduced by 29% when administered with a high-fat meal compared to administration in the fasted state. When given with a moderate-fat meal, bioavailability was similar to that in the fasted state.
Management
To ensure maximal and consistent oral absorption, sorafenib should be taken at least one hour before or two hours after eating.
References (1)
- (2005) "Product Information. Nexavar (sorafenib)." Bayer Pharmaceutical Inc
Disease interactions
13 potential interactions Applies to: 12 conditions, including Seizures, Ulcerative Colitis, Heart Disease, Inflammatory Bowel Disease, and Hyponatremia.
Dehydration
Moderate:
Suclear
The polyethylene glycol 3350 with electrolytes in Suclear has a moderate potential interaction with Dehydration.
Use caution when prescribing PEG electrolyte solutions to patients with impaired renal function or patients taking concomitant medications that may affect renal function. Ensure adequate hydration and consider performing baseline and post-colonoscopy laboratory tests (electrolytes, creatinine, and BUN) in these patients.
Esophageal Obstruction
Moderate:
Suclear
The polyethylene glycol 3350 with electrolytes in Suclear has a moderate potential interaction with Esophageal Obstruction.
Patients with impaired gag reflex, unconscious or semi-conscious patients, and patients prone to regurgitation or aspiration should be administered polyethylene glycol (PEG) electrolyte solutions cautiously. Patients experiencing severe bloating, distention or abdominal pain may need to receive PEG electrolyte solutions at a slower rate.
Gastrointestinal Obstruction
Major:
Suclear
The polyethylene glycol 3350 with electrolytes in Suclear has a major potential interaction with Gastrointestinal Obstruction.
The use of polyethylene glycol (PEG) solutions is contraindicated in patients with gastrointestinal obstruction, perforation, or toxic megacolon. If gastrointestinal obstruction or perforation is suspected, appropriate studies should be performed prior to administration of these agents. Use with caution in patients with severe active ulcerative colitis. Increased activity of the gut caused by these agents could worsen these conditions.
Major:
Suclear
The polyethylene glycol 3350 with electrolytes in Suclear has a major potential interaction with Gastrointestinal Obstruction.
The use of laxatives is contraindicated in patients with intestinal obstruction disorders. Patients with intestinal obstruction disorders may need their underlying condition treated to correct the constipation. Some laxatives require reduction in the colon to their active form to be effective which may be a problem in patients with intestinal obstruction.
Gastrointestinal Perforation
Major:
Suclear
The polyethylene glycol 3350 with electrolytes in Suclear has a major potential interaction with Gastrointestinal Perforation.
The use of polyethylene glycol (PEG) solutions is contraindicated in patients with gastrointestinal obstruction, perforation, or toxic megacolon. If gastrointestinal obstruction or perforation is suspected, appropriate studies should be performed prior to administration of these agents. Use with caution in patients with severe active ulcerative colitis. Increased activity of the gut caused by these agents could worsen these conditions.
Heart Disease
Moderate:
Suclear
The polyethylene glycol 3350 with electrolytes in Suclear has a moderate potential interaction with Heart Disease.
The use of ionic osmotic laxative products for bowel preparation has been associated with rare reports of serious arrhythmias. Use caution when prescribing PEG electrolyte solutions in patients at increased risk of arrhythmias (e.g., patients with a history of prolonged QT, uncontrolled arrhythmias, recent myocardial infarction, unstable angina, congestive heart failure, or cardiomyopathy). Clinical monitoring of cardiovascular status is recommended prior to, during, and after therapy.
Hyponatremia
Moderate:
Suclear
The polyethylene glycol 3350 with electrolytes in Suclear has a moderate potential interaction with Hyponatremia.
PEG electrolyte solutions have been associated with seizure activity, and/or loss of consciousness. The seizure cases were associated with electrolyte abnormalities and low serum osmolality. Therapy with these agents should be administered cautiously in patients with a history of or predisposition to seizures or in patients with known or suspected hyponatremia.
Inflammatory Bowel Disease
Major:
Suclear
The polyethylene glycol 3350 with electrolytes in Suclear has a major potential interaction with Inflammatory Bowel Disease.
The use of laxatives is contraindicated in patients with inflammatory bowel disease. Patients with inflammatory bowel disease may experience colonic perforation with use of stimulant laxatives.
Interstitial Lung Disease
Moderate:
sorafenib
SORAfenib has a moderate potential interaction with Interstitial Lung Disease.
The use of certain multikinase 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, these agents should be permanently discontinued and appropriate measures should be instituted. Treatment should be immediately withheld in patients diagnosed with ILD/pneumonitis and permanently discontinued if no other potential causes of ILD/pneumonitis have been identified.
Pulmonary Impairment
Moderate:
sorafenib
SORAfenib has a moderate potential interaction with Pulmonary Impairment.
The use of certain multikinase 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, these agents should be permanently discontinued and appropriate measures should be instituted. Treatment should be immediately withheld in patients diagnosed with ILD/pneumonitis and permanently discontinued if no other potential causes of ILD/pneumonitis have been identified.
Renal Dysfunction
Moderate:
Suclear
The polyethylene glycol 3350 with electrolytes in Suclear has a moderate potential interaction with Renal Dysfunction.
Use caution when prescribing PEG electrolyte solutions to patients with impaired renal function or patients taking concomitant medications that may affect renal function. Ensure adequate hydration and consider performing baseline and post-colonoscopy laboratory tests (electrolytes, creatinine, and BUN) in these patients.
Seizures
Moderate:
Suclear
The polyethylene glycol 3350 with electrolytes in Suclear has a moderate potential interaction with Seizures.
PEG electrolyte solutions have been associated with seizure activity, and/or loss of consciousness. The seizure cases were associated with electrolyte abnormalities and low serum osmolality. Therapy with these agents should be administered cautiously in patients with a history of or predisposition to seizures or in patients with known or suspected hyponatremia.
Ulcerative Colitis
Major:
Suclear
The polyethylene glycol 3350 with electrolytes in Suclear has a major potential interaction with Ulcerative Colitis.
The use of polyethylene glycol (PEG) solutions is contraindicated in patients with gastrointestinal obstruction, perforation, or toxic megacolon. If gastrointestinal obstruction or perforation is suspected, appropriate studies should be performed prior to administration of these agents. Use with caution in patients with severe active ulcerative colitis. Increased activity of the gut caused by these agents could worsen these conditions.
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sorafenib
A total of 451 drugs are known to interact with sorafenib.
- Sorafenib is in the following drug classes: multikinase inhibitors, VEGF/VEGFR inhibitors.
- Sorafenib is used to treat the following conditions:
Suclear
A total of 420 drugs are known to interact with Suclear.
- Suclear is in the drug class laxatives.
- Suclear is used to treat the following conditions:
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
Further information
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