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Drug Interactions between taletrectinib and thalidomide

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

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Interactions between your drugs

Moderate

thalidomide taletrectinib

Applies to: thalidomide and taletrectinib

Consumer information for this interaction is not currently available.

MONITOR: Thalidomide can cause bradycardia and may have additive effects with other drugs that decrease heart rate. Cases of bradycardia have been associated with thalidomide use, some requiring medical interventions. The clinical significance and underlying etiology of the bradycardia observed with thalidomide treatment have not been established. However, the potential for additive bradycardic effects should be considered when used with other drugs that slow cardiac conduction such as beta-blockers, calcium channel blockers, digitalis, flecainide, moricizine, and propafenone. Non-cardiac drugs that may also cause bradycardia include atazanavir, lacosamide, lithium, mefloquine, succinylcholine, H2-receptor antagonists, tricyclic antidepressants, and anticholinesterase or cholinergic agents. Because bradycardia is a risk factor for torsade de pointes arrhythmia, concerns also exist when thalidomide is used with drugs that prolong the QT interval or cause torsade de pointes.

MANAGEMENT: Caution is advised when thalidomide is used with drugs that can slow the heart rate or induce torsade de pointes arrhythmia. Patients should be monitored for bradycardia, atrioventricular block and syncope, and advised to seek medical attention if they experience dizziness, lightheadedness, fainting, shortness of breath, or slow or irregular heartbeat. A dose reduction of thalidomide or discontinuation may be required.

Drug and food/lifestyle interactions

Major

taletrectinib food/lifestyle

Applies to: taletrectinib

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Coadministration with grapefruit juice may increase the plasma concentrations of taletrectinib. The proposed mechanism for the interaction is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit. Inhibition of hepatic CYP450 3A4 may also contribute. The interaction has not been studied with grapefruit juice but has been reported for other CYP450 3A4 inhibitors. In a clinical study, taletrectinib peak plasma concentration (Cmax) increased by 1.8-fold and systemic exposure (AUC) increased by 3.3-fold following concomitant administration of itraconazole, a potent CYP450 3A inhibitor. According to the product labeling, administration of taletrectinib with a moderate CYP450 3A inhibitor is predicted to increase taletrectinib Cmax and AUC by up to 1.5- and 2.6-fold, respectively. Increased exposure to taletrectinib may increase the risk and/or severity of adverse effects such as hepatotoxicity with liver enzyme elevations, lung toxicities, QT prolongation, hyperuricemia, myalgia with creatine phosphokinase elevation, and skeletal fractures.

ADJUST DOSING INTERVAL: Coadministration with high-fat food (1000 calories, 50% fat) increased taletrectinib Cmax and AUC by 1.5-fold, and the predicted increase in the QTc interval is 20.5 msec.

MANAGEMENT: The manufacturer recommends avoiding food or drink containing grapefruit during treatment with taletrectinib. In addition, taletrectinib should be administered on an empty stomach at about the same time each day, at least 2 hours before or 2 hours after food intake.

Moderate

thalidomide food/lifestyle

Applies to: thalidomide

Alcohol can increase the nervous system side effects of thalidomide such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with thalidomide. Do not use more than the recommended dose of thalidomide, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

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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