Drug Interaction Report

The ISOtretinoin in Claravis has a moderate potential interaction with Alcoholism.

The use of retinoids is associated with elevations in serum triglycerides and cholesterol, and decreases in HDL. In addition to cardiovascular risks, elevation of serum triglycerides to greater than 800 mg/dL has been associated with fatal fulminant pancreatitis. Patients at increased risk for developing hypertriglyceridemia during retinoid therapy include those with diabetes mellitus, obesity, high alcohol consumption, or a family history of these conditions. Blood lipid determinations should be performed prior to initiation of therapy and at 1- to 2- week intervals until the lipid response to the drug is established (usually 4 to 8 weeks). Patients with preexisting hyperlipidemia may require closer monitoring during retinoid therapy, and adjustments made accordingly in their lipid-lowering regimen.

Ritlecitinib has a major potential interaction with Cardiovascular Conditions and Disorders.

In a major safety study of a Janus kinase (JAK) inhibitor, tofacitinib, in rheumatoid arthritis patients 50 years and older with at least 1 cardiovascular risk factor, higher rates of all-cause mortality (including sudden cardiovascular death) and major adverse cardiovascular events (MACE) (defined as cardiovascular death, myocardial infarction, and stroke) were observed with the JAK inhibitor when compared with tumor necrosis factor (TNF) blockers. Patients who were current or past smokers had an additional increased risk. Based on a shared mechanism of action, this risk should be considered for other JAK inhibitors, including baricitinib, upadacitinib, ruxolitinib, fedratinib, ritlecitinib, deuruxolitinib, and pacritinib. Consider the benefits and risks for each individual patient prior and during treatment with JAK inhibitors, especially in patients with other cardiovascular risk factors, history of cardiovascular events, and patients who are current or past smokers. Patients should be informed about the symptoms of serious cardiovascular events and what to do if they occur.

The ISOtretinoin in Claravis has a major potential interaction with Depression.

The use of retinoids, primarily isotretinoin, has been associated with causing depression, psychosis and rarely, suicidal ideation. Therapy with retinoids should be administered cautiously in patients with preexisting psychiatric conditions or depression. In addition to withdrawal of therapy, evaluation and follow-up may be necessary in affected patients.

The ISOtretinoin in Claravis has a moderate potential interaction with Diabetes Mellitus.

The use of retinoids is associated with elevations in serum triglycerides and cholesterol, and decreases in HDL. In addition to cardiovascular risks, elevation of serum triglycerides to greater than 800 mg/dL has been associated with fatal fulminant pancreatitis. Patients at increased risk for developing hypertriglyceridemia during retinoid therapy include those with diabetes mellitus, obesity, high alcohol consumption, or a family history of these conditions. Blood lipid determinations should be performed prior to initiation of therapy and at 1- to 2- week intervals until the lipid response to the drug is established (usually 4 to 8 weeks). Patients with preexisting hyperlipidemia may require closer monitoring during retinoid therapy, and adjustments made accordingly in their lipid-lowering regimen.

The ISOtretinoin in Claravis has a moderate potential interaction with High Cholesterol.

The use of retinoids is associated with elevations in serum triglycerides and cholesterol, and decreases in HDL. In addition to cardiovascular risks, elevation of serum triglycerides to greater than 800 mg/dL has been associated with fatal fulminant pancreatitis. Patients at increased risk for developing hypertriglyceridemia during retinoid therapy include those with diabetes mellitus, obesity, high alcohol consumption, or a family history of these conditions. Blood lipid determinations should be performed prior to initiation of therapy and at 1- to 2- week intervals until the lipid response to the drug is established (usually 4 to 8 weeks). Patients with preexisting hyperlipidemia may require closer monitoring during retinoid therapy, and adjustments made accordingly in their lipid-lowering regimen.

Ritlecitinib has a major potential interaction with History, Tuberculosis.

Avoid the use of ritlecitinib in patients with an active, serious infection. Consider the risks and benefits of treatment in patients with chronic or recurrent infection, exposed to tuberculosis (TB), with a history of serious infection or an opportunistic infection, who have resided or traveled in areas of endemic TB or mycoses, or with underlying conditions that may predispose them to infection. Patients should be screened for TB before treatment initiation. This drug should not be given to patients with active TB or untreated latent TB; anti-TB therapy should be started prior to initiating treatment. Screening for viral hepatitis should be performed in accordance with clinical guidelines before starting therapy. Treatment interruption should be considered in patients with viral reactivation (e.g., herpes zoster).

Ritlecitinib has a major potential interaction with Immunodeficiency.

Avoid the use of ritlecitinib in patients with an active, serious infection. Consider the risks and benefits of treatment in patients with chronic or recurrent infection, exposed to tuberculosis (TB), with a history of serious infection or an opportunistic infection, who have resided or traveled in areas of endemic TB or mycoses, or with underlying conditions that may predispose them to infection. Patients should be screened for TB before treatment initiation. This drug should not be given to patients with active TB or untreated latent TB; anti-TB therapy should be started prior to initiating treatment. Screening for viral hepatitis should be performed in accordance with clinical guidelines before starting therapy. Treatment interruption should be considered in patients with viral reactivation (e.g., herpes zoster).

Ritlecitinib has a major potential interaction with Infection.

Avoid the use of ritlecitinib in patients with an active, serious infection. Consider the risks and benefits of treatment in patients with chronic or recurrent infection, exposed to tuberculosis (TB), with a history of serious infection or an opportunistic infection, who have resided or traveled in areas of endemic TB or mycoses, or with underlying conditions that may predispose them to infection. Patients should be screened for TB before treatment initiation. This drug should not be given to patients with active TB or untreated latent TB; anti-TB therapy should be started prior to initiating treatment. Screening for viral hepatitis should be performed in accordance with clinical guidelines before starting therapy. Treatment interruption should be considered in patients with viral reactivation (e.g., herpes zoster).

The ISOtretinoin in Claravis has a moderate potential interaction with Liver Disease.

The use of retinoids has been associated with elevations in liver enzymes and toxic hepatitis. Therapy with retinoids should be administered cautiously in patients with liver disease. Monitoring liver enzymes is recommended in these patients.

Ritlecitinib has a moderate potential interaction with Liver Disease.

Ritlecitinib is not recommended in patients with severe (Child Pugh C) hepatic impairment.

The ISOtretinoin in Claravis has a moderate potential interaction with Osteoporosis.

Isotretinoin may have a negative effect on bone mineral density in some patients. Clinical trials have shown BMD declines in adolescents during a 20 week treatment. Therefore, physicians should use caution when prescribing isotretinoin in patients with a history of childhood osteoporosis, osteomalacia, or other disorders of bone metabolism.

The ISOtretinoin in Claravis has a major potential interaction with Pseudotumor Cerebri.

The use of retinoids has been associated with cases of pseudotumor cerebri (benign intracranial hypertension). Early signs and symptoms include papilledema, headache, nausea and vomiting, and visual disturbances. Patients who experience symptoms of this disorder while on retinoid therapy should be referred to a neurologist. If the diagnosis is confirmed, the retinoid should be discontinued permanently.

The ISOtretinoin in Claravis has a major potential interaction with Psychosis.

The use of retinoids, primarily isotretinoin, has been associated with causing depression, psychosis and rarely, suicidal ideation. Therapy with retinoids should be administered cautiously in patients with preexisting psychiatric conditions or depression. In addition to withdrawal of therapy, evaluation and follow-up may be necessary in affected patients.

Ritlecitinib has a major potential interaction with Smoking.

In a major safety study of a Janus kinase (JAK) inhibitor, tofacitinib, in rheumatoid arthritis patients 50 years and older with at least 1 cardiovascular risk factor, higher rates of all-cause mortality (including sudden cardiovascular death) and major adverse cardiovascular events (MACE) (defined as cardiovascular death, myocardial infarction, and stroke) were observed with the JAK inhibitor when compared with tumor necrosis factor (TNF) blockers. Patients who were current or past smokers had an additional increased risk. Based on a shared mechanism of action, this risk should be considered for other JAK inhibitors, including baricitinib, upadacitinib, ruxolitinib, fedratinib, ritlecitinib, deuruxolitinib, and pacritinib. Consider the benefits and risks for each individual patient prior and during treatment with JAK inhibitors, especially in patients with other cardiovascular risk factors, history of cardiovascular events, and patients who are current or past smokers. Patients should be informed about the symptoms of serious cardiovascular events and what to do if they occur.

The ISOtretinoin in Claravis has a moderate potential interaction with Weight Loss.

The use of retinoids is associated with elevations in serum triglycerides and cholesterol, and decreases in HDL. In addition to cardiovascular risks, elevation of serum triglycerides to greater than 800 mg/dL has been associated with fatal fulminant pancreatitis. Patients at increased risk for developing hypertriglyceridemia during retinoid therapy include those with diabetes mellitus, obesity, high alcohol consumption, or a family history of these conditions. Blood lipid determinations should be performed prior to initiation of therapy and at 1- to 2- week intervals until the lipid response to the drug is established (usually 4 to 8 weeks). Patients with preexisting hyperlipidemia may require closer monitoring during retinoid therapy, and adjustments made accordingly in their lipid-lowering regimen.