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Drug Interactions between tepotinib and Zingiber

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

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Interactions between your drugs

Moderate

ginger tepotinib

Applies to: Zingiber (calcium / folic acid / ginger / pyridoxine) and tepotinib

MONITOR: Coadministration with inhibitors of CYP450 3A4 and/or P-glycoprotein (P-gp) may increase the plasma concentrations of tepotinib, which may increase the incidence and severity of adverse reactions such as interstitial lung disease/pneumonitis, hepatotoxicity, edema, nausea, vomiting, diarrhea, constipation, and musculoskeletal pain. Tepotinib is a substrate of both CYP450 3A4 isoenzyme and P-gp efflux transporter. However, the effect of CYP450 3A4 or P-gp inhibitors on tepotinib has not been studied clinically.

MANAGEMENT: Caution is advised when tepotinib is used with inhibitors of CYP450 3A4 and/or P-gp. Patients should be monitored for increased adverse effects, and the tepotinib dosage adjusted as necessary.

References (2)
  1. (2021) "Product Information. Tepmetko (tepotinib)." EMD Serono Inc
  2. (2022) "Product Information. Tepmetko (tepotinib)." Merck Healthcare Pty Ltd, A001-0122

Drug and food interactions

Moderate

folic acid food

Applies to: Zingiber (calcium / folic acid / ginger / pyridoxine)

MONITOR: Ethanol may increase folic acid elimination and folic acid absorption is decreased in chronic alcoholics. Excessive alcohol consumption may lead to folate deficiency.

MANAGEMENT: Monitoring of patient response to folic acid supplementation if they also consume alcohol regularly may be recommended.

References (5)
  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  2. Cerner Multum, Inc. "Australian Product Information."
  3. Agencia Española de Medicamentos y Productos Sanitarios Healthcare (2008) Centro de información online de medicamentos de la AEMPS - CIMA. https://cima.aemps.es/cima/publico/home.html
  4. Cerner Multum, Inc (2015) "ANVISA Bulário Eletrônico."
  5. (2017) "Product Information. Folic Acid (folic acid)." Method Pharmaceuticals, LLC
Moderate

calcium phosphate, tribasic food

Applies to: Zingiber (calcium / folic acid / ginger / pyridoxine)

ADJUST DOSING INTERVAL: Administration with food may increase the absorption of calcium. However, foods high in oxalic acid (spinach or rhubarb), or phytic acid (bran and whole grains) may decrease calcium absorption.

MANAGEMENT: Calcium may be administered with food to increase absorption. Consider withholding calcium administration for at least 2 hours before or after consuming foods high in oxalic acid or phytic acid.

References (6)
  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  2. Canadian Pharmacists Association (2006) e-CPS. http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink
  3. Cerner Multum, Inc. "Australian Product Information."
  4. Agencia Española de Medicamentos y Productos Sanitarios Healthcare (2008) Centro de información online de medicamentos de la AEMPS - CIMA. https://cima.aemps.es/cima/publico/home.html
  5. Mangels AR (2014) "Bone nutrients for vegetarians." Am J Clin Nutr, 100, epub
  6. Davies NT (1979) "Anti-nutrient factors affecting mineral utilization." Proc Nutr Soc, 38, p. 121-8
Moderate

tepotinib food

Applies to: tepotinib

ADJUST DOSING INTERVAL: Food enhances the oral bioavailability of tepotinib. When tepotinib was administered after a high-fat, high-calorie meal (approximately 800 to 1000 calories; 150 calories from protein, 250 calories from carbohydrate, 500 to 600 calories from fat), tepotinib peak plasma concentration (Cmax) and systemic exposure (AUC) increased by 2-fold and 1.6-fold, respectively, compared to administration under fasted conditions.

MANAGEMENT: Tepotinib should be administered with food at approximately the same time each day.

References (1)
  1. (2021) "Product Information. Tepmetko (tepotinib)." EMD Serono Inc

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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