Drug Interaction Report

ADJUST DOSING INTERVAL: In a clinical trial, administration of palifermin within 24 hours of chemotherapy resulted in increased severity and duration of oral mucositis, presumably due to increased sensitivity of the rapidly dividing epithelial cells in the immediate post-chemotherapy period.

MANAGEMENT: Palifermin should not be administered within 24 hours before, during infusion of, or within 24 hours after administration of myelotoxic chemotherapy.

GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations of ruxolitinib. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits.

MANAGEMENT: Patients treated with ruxolitinib should avoid consumption of grapefruit, grapefruit juice, and any supplement containing grapefruit extract. Ruxolitinib may be administered with or without food.