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Can you take Sorafenib with Tizanidine?

1 drug interaction and 9 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

tiZANidine SORAfenib

Applies to: tizanidine and sorafenib

Using SORAfenib together with tiZANidine 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). Talk to your doctor if you have any 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 these medications, whether together or alone. 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/lifestyle interactions

Moderate food/lifestyle interactions

Moderate:

SORAfenib Food/Lifestyle

Applies to: sorafenib

You may experience reduced absorption of SORAfenib in the presence of food. Take SORAfenib on an empty stomach 1 hour before or 2 hours after a meal unless otherwise directed by your doctor. This will make it easier for your body to absorb the medication.

Disease interactions

8 potential interactions Applies to: 8 conditions, including Hypotension, Psychosis, Liver Disease, Dehydration, and Interstitial Lung Disease.

Dehydration

Major:

tizanidine

tiZANidine has a major potential interaction with Dehydration.

Tizanidine is a centrally-acting alpha-2 adrenergic agonist with 1/10 to 1/50 the potency of clonidine in lowering blood pressure. According to the manufacturer, two-thirds of patients in a study given single 8 mg doses of tizanidine had a 20% reduction in either the diastolic or systolic blood pressure. The effect was seen one hour after dosing and peaked at 2 to 3 hours post-dose. Bradycardia, orthostatic hypotension, lightheadedness, dizziness and, rarely, syncope have occurred. Therapy with tizanidine should be administered cautiously in patients with or predisposed to hypotension. The risk of significant hypotension may be minimized by gradual dosage titration. Patients should be advised not to rise abruptly from a supine position.

Hypotension

Major:

tizanidine

tiZANidine has a major potential interaction with Hypotension.

Tizanidine is a centrally-acting alpha-2 adrenergic agonist with 1/10 to 1/50 the potency of clonidine in lowering blood pressure. According to the manufacturer, two-thirds of patients in a study given single 8 mg doses of tizanidine had a 20% reduction in either the diastolic or systolic blood pressure. The effect was seen one hour after dosing and peaked at 2 to 3 hours post-dose. Bradycardia, orthostatic hypotension, lightheadedness, dizziness and, rarely, syncope have occurred. Therapy with tizanidine should be administered cautiously in patients with or predisposed to hypotension. The risk of significant hypotension may be minimized by gradual dosage titration. Patients should be advised not to rise abruptly from a supine position.

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.

Liver Disease

Major:

tizanidine

tiZANidine has a major potential interaction with Liver Disease.

Tizanidine may cause hepatocellular injury. According to the manufacturer, approximately 5% of patients treated with tizanidine in clinical studies had elevations in serum transaminases greater than 3 times the upper limit of normal (or 2 times if baseline levels were elevated), compared to 0.4% in control patients. Most cases were asymptomatic and resolved rapidly following withdrawal of the drug. However, liver failure resulting in death has been reported in postmarketing use. In three cases cited by the package labeling, two involved concomitant use of hepatotoxic agents in addition to tizanidine, while the third had no other known risk factors. Because of potential hepatotoxicity, therapy with tizanidine should be administered cautiously in patients with impaired hepatic function. All patients treated with tizanidine should have liver function tests performed at baseline, 1, 3 and 6 months, and periodically thereafter. In addition, they should be instructed to immediately report any signs and symptoms of hepatic injury such as fever, rash, anorexia, nausea, vomiting, fatigue, right upper quadrant pain, dark urine and jaundice.

Psychiatric Disorders

Moderate:

tizanidine

tiZANidine has a moderate potential interaction with Psychiatric Disorders.

Formed, visual hallucinations or delusions have been reported in 3% of patients treated with tizanidine in two North American controlled clinical studies. Therapy with tizanidine should be administered cautiously in patients with a history of psychiatric disorders.

Psychosis

Moderate:

tizanidine

tiZANidine has a moderate potential interaction with Psychosis.

Formed, visual hallucinations or delusions have been reported in 3% of patients treated with tizanidine in two North American controlled clinical studies. Therapy with tizanidine should be administered cautiously in patients with a history of psychiatric disorders.

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

Major:

tizanidine

tiZANidine has a major potential interaction with Renal Dysfunction.

The clearance of tizanidine has been shown to reduce by more than 50% in elderly patients with renal impairment (creatinine clearance < 25 mL/min) compared to healthy elderly patients. Prolonged pharmacologic effects of tizanidine may occur due to drug accumulation. Therapy with tizanidine should be administered cautiously and initiated at reduced dosages in patients with impaired renal function. During titration, individual doses rather than the dosing frequency should be increased.

More resources

sorafenib

A total of 451 drugs are known to interact with sorafenib.

tizanidine

A total of 676 drugs are known to interact with tizanidine.

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.