Drug Interaction Report

Hydroxychloroquine may increase the blood levels of nintedanib. This can increase the risk and/or severity of side effects such as liver problems, diarrhea, nausea, vomiting, stomach or intestinal wall perforation, bleeding, and cardiovascular problems such as heart attack, chest pain, or stroke. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. You should seek immediate medical attention if you develop fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, light colored stools, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. 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.

You may want to limit your consumption of grapefruit or grapefruit juice during treatment with hydroxychloroquine. Grapefruit juice can significantly increase the blood levels and effects of hydroxychloroquine, which may result in an irregular heart rate or other conduction disturbances. Hydroxychloroquine should also be taken with food or milk to reduce the incidence of stomach upset. 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 hydroxychloroquine. 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.

Grapefruit juice and Seville orange juice can increase the blood levels of nintedanib. This may increase the risk and/or severity of side effects such as liver problems, diarrhea, nausea, vomiting, stomach or intestinal wall perforation, bleeding, and cardiovascular problems such as heart attack, chest pain, or stroke. It is best to avoid or minimize the consumption of Seville oranges, Seville orange juice, grapefruit, and grapefruit juice during treatment. You should take nintedanib with food and swallow it whole with water. Taking nintedanib with food may help with absorption of the medication and reduce gastrointestinal side effects. Talk to your doctor or pharmacist if you have questions on how to take this or other medications you are prescribed. 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.