Drug Interaction Report

Crizotinib may increase the blood levels of axitinib. In some cases, this can increase side effects such as high blood pressure, diarrhea, nausea, vomiting, constipation, decreased appetite, weight loss, and rash, itching or peeling of skin on the hands and feet. You may also be more likely to experience less common but more severe side effects such as blood clots (depending on location, can lead to complications such as stroke, heart attack, breathing difficulties, and vision abnormalities); bleeding; liver problems; thyroid problems; tearing (perforation) in the stomach or intestinal wall; and a rare nervous system condition known as reversible posterior leukoencephalopathy syndrome (RPLS). You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if you develop potential signs and symptoms of serious side effects including chest pain or pressure; pain in the arms, back, neck or jaw; swelling; shortness of breath; numbness or weakness on one side of the body; headache; vision changes; seizures, unusual bleeding or bruising; red or black stools; coughing up or vomiting blood or blood clots; and severe stomach or abdominal pain. 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.

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Do not consume grapefruit or grapefruit juice during treatment with crizotinib unless directed otherwise by your doctor. Grapefruit juice can increase the blood levels of crizotinib to dangerous levels and cause an irregular heart rhythm that may be serious. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or fast or pounding heartbeats during treatment with crizotinib. You may take crizotinib with or without food, but take it the same time each day. 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.

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Do not consume grapefruit or grapefruit juice during treatment with axitinib unless directed otherwise by your doctor. Grapefruit juice can increase the blood levels of axitinib. This may increase the risk and/or severity of side effects such as high blood pressure, diarrhea, nausea, vomiting, constipation, decreased appetite, weight loss, and rash, itching or peeling of skin on the hands and feet. You may also be more likely to experience less common but more severe side effects such as blood clots (depending on location, can lead to complications such as stroke, heart attack, breathing difficulties, and vision abnormalities); bleeding; liver problems; thyroid problems; tearing (perforation) in the stomach or intestinal wall; and a rare nervous system condition known as reversible posterior leukoencephalopathy syndrome (RPLS). You should seek immediate medical attention if you develop signs and symptoms of these conditions including chest pain or pressure; pain in the arms, back, neck or jaw; swelling; shortness of breath; numbness or weakness on one side of the body; headache; vision changes; seizures, unusual bleeding or bruising; red or black stools; coughing up or vomiting blood or blood clots; and severe stomach or abdominal pain. 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.

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The recommended maximum number of medicines in the 'multikinase inhibitors' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'multikinase inhibitors' category:

• axitinib
• crizotinib

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.