Drug Interaction Report
1 drug interaction and 20 additional warnings found for the following 2 drugs:
- axitinib
- trofinetide
Drug interactions
Moderate drug interactions
Moderate:axitinib trofinetide
Applies to: axitinib, trofinetide
Trofinetide may increase the blood levels and effects of axitinib.
Talk to your doctor if you have any questions or concerns.
You may need more frequent monitoring to safely use both medications. Contact your doctor if your condition changes or you experience increased side effects.
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.
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:Food/Lifestyle axitinib
Applies to: axitinib
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
- 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
- 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
- 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.
Disease interactions
19 potential interactionsApplies to: 19 conditions, including High Blood Pressure, Underactive Thyroid, Heart Failure, Pulmonary Embolism, and Hyperthyroidism.
Bleeding Disorder
Major:axitinib
Axitinib has a major potential interaction with Bleeding Disorder.
Fatal hemorrhagic events, including cerebral hemorrhage, hematuria, hemoptysis, lower gastrointestinal hemorrhage, and melena have been reported with the use of axitinib. Therapy with axitinib has not been studied in patients who have evidence of untreated brain metastasis or recent active gastrointestinal bleeding and should not be used in these patients. If any bleeding requires medical intervention, it is recommended to temporarily interrupt the axitinib dose and to stop treatment at least 24 hours prior to scheduled surgery. The decision to resume therapy after surgery should be based on clinical judgment of adequate wound healing.
Cerebral Vascular Disorder
Moderate:axitinib
Axitinib has a moderate potential interaction with Cerebral Vascular Disorder.
Arterial and venous thromboembolic events, including transient ischemic attack, cerebrovascular accident, myocardial infarction, pulmonary embolism, deep vein thrombosis, retinal occlusion, vein thrombosis, and deaths have been reported with the use of axitinib. Use with caution in patients who are at risk for, or who have a history of, these events. The use of axitinib has not been studied in patients who had an arterial or venous thromboembolic event within the previous 12 months. It is recommended to monitor closely for signs and symptoms of thromboembolism.
Diverticulitis
Moderate:axitinib
Axitinib has a moderate potential interaction with Diverticulitis.
Therapy with axitinib should be used with caution in patients who may be at increased risk for gastrointestinal perforation, such as those with a history of diverticulitis. Patients presenting with new onset of abdominal symptoms should be evaluated promptly for early identification of gastrointestinal perforation. It is recommended to monitor for symptoms of gastrointestinal perforation or fistula periodically throughout the treatment.
Gastrointestinal Perforation
Moderate:axitinib
Axitinib has a moderate potential interaction with Gastrointestinal Perforation.
Therapy with axitinib should be used with caution in patients who may be at increased risk for gastrointestinal perforation, such as those with a history of diverticulitis. Patients presenting with new onset of abdominal symptoms should be evaluated promptly for early identification of gastrointestinal perforation. It is recommended to monitor for symptoms of gastrointestinal perforation or fistula periodically throughout the treatment.
Heart Failure
Moderate:axitinib
Axitinib has a moderate potential interaction with Heart Failure.
Cardiac failure, including fatal events have been reported in patients receiving axitinib. It is recommended to monitor for signs or symptoms of cardiac failure throughout treatment. Management of cardiac failure may require permanent discontinuation of therapy. Care should be taken when using this agent in patients at risk.
High Blood Pressure
Moderate:axitinib
Axitinib has a moderate potential interaction with High Blood Pressure.
The use of axitinib may causes hypertension. Blood pressure should be well-controlled prior to initiating axitinib and treated as needed with standard anti-hypertensive therapy. It is recommended to reduce the dose in case of persistent hypertension despite use of anti-hypertensive medications and to discontinue therapy if hypertension is severe and persistent despite these measures. Discontinuation of therapy should be considered if there is evidence of hypertensive crisis. Close monitoring is recommended.
History, Thrombotic/Thromboembolic Disorder
Moderate:axitinib
Axitinib has a moderate potential interaction with History, Thrombotic/Thromboembolic Disorder.
Arterial and venous thromboembolic events, including transient ischemic attack, cerebrovascular accident, myocardial infarction, pulmonary embolism, deep vein thrombosis, retinal occlusion, vein thrombosis, and deaths have been reported with the use of axitinib. Use with caution in patients who are at risk for, or who have a history of, these events. The use of axitinib has not been studied in patients who had an arterial or venous thromboembolic event within the previous 12 months. It is recommended to monitor closely for signs and symptoms of thromboembolism.
History - Myocardial Infarction
Moderate:axitinib
Axitinib has a moderate potential interaction with History - Myocardial Infarction.
Arterial and venous thromboembolic events, including transient ischemic attack, cerebrovascular accident, myocardial infarction, pulmonary embolism, deep vein thrombosis, retinal occlusion, vein thrombosis, and deaths have been reported with the use of axitinib. Use with caution in patients who are at risk for, or who have a history of, these events. The use of axitinib has not been studied in patients who had an arterial or venous thromboembolic event within the previous 12 months. It is recommended to monitor closely for signs and symptoms of thromboembolism.
Hyperthyroidism
Moderate:axitinib
Axitinib has a moderate potential interaction with Hyperthyroidism.
Thyroid level fluctuations that include hypothyroidism and hyperthyroidism have been reported with the use of axitinib. It is recommended to monitor thyroid function before initiation of, and periodically throughout treatment and to maintain euthyroid state according to standard medical practice.
Interstitial Lung Disease
Moderate:axitinib
Axitinib has a moderate potential interaction with Interstitial Lung Disease.
The use of certain multikinase inhibitors has been associated with pulmonary toxicity. Serious cases of interstitial lung disease (ILD), including fatal cases and interstitial pneumonitis or pulmonary fibrosis have been reported. Caution is recommended when using these agents in patients with a history of interstitial pneumonitis or pulmonary fibrosis or those patients presenting with acute onset of new or progressive unexplained pulmonary symptoms such as dyspnea, cough, and fever pending diagnostic evaluation. If ILD is confirmed, these agents should be permanently discontinued and appropriate measures should be instituted. Treatment should be immediately withheld in patients diagnosed with ILD/pneumonitis and permanently discontinued if no other potential causes of ILD/pneumonitis have been identified.
Ischemic Heart Disease
Moderate:axitinib
Axitinib has a moderate potential interaction with Ischemic Heart Disease.
Arterial and venous thromboembolic events, including transient ischemic attack, cerebrovascular accident, myocardial infarction, pulmonary embolism, deep vein thrombosis, retinal occlusion, vein thrombosis, and deaths have been reported with the use of axitinib. Use with caution in patients who are at risk for, or who have a history of, these events. The use of axitinib has not been studied in patients who had an arterial or venous thromboembolic event within the previous 12 months. It is recommended to monitor closely for signs and symptoms of thromboembolism.
Liver Disease
Moderate:axitinib
Axitinib has a moderate potential interaction with Liver Disease.
The systemic exposure to axitinib is higher in subjects with moderate hepatic impairment. Dose adjustment is recommended in patients with moderate hepatic impairment. No dose adjustment is required in patients with mild hepatic impairment. The use of axitinib has not been studied in subjects with severe hepatic impairment. It is recommended to monitor liver enzymes and bilirubin before the start of therapy and periodically thereafter.
Posterior Reversible Encephalopathy Syndrome
Moderate:axitinib
Axitinib has a moderate potential interaction with Posterior Reversible Encephalopathy Syndrome.
Reversible posterior leukoencephalopathy syndrome (RPLS) has been reported in patients receiving axitinib. Consider this syndrome in any patient presenting with seizures, headache, visual disturbances, confusion or altered mental function. It is recommended to discontinue therapy in patients developing RPLS. The safety of reinitiating therapy in patients previously experiencing RPLS is not known. Care and close monitoring should be considered in these patients.
Proteinuria
Moderate:axitinib
Axitinib has a moderate potential interaction with Proteinuria.
Proteinuria has been reported in patients taking axitinib. It is recommended to monitor for proteinuria before initiation of therapy, and periodically thereafter. Reduce dose or temporarily interrupt therapy in patients who develop moderate to severe proteinuria.
Pulmonary Embolism
Moderate:axitinib
Axitinib has a moderate potential interaction with Pulmonary Embolism.
Arterial and venous thromboembolic events, including transient ischemic attack, cerebrovascular accident, myocardial infarction, pulmonary embolism, deep vein thrombosis, retinal occlusion, vein thrombosis, and deaths have been reported with the use of axitinib. Use with caution in patients who are at risk for, or who have a history of, these events. The use of axitinib has not been studied in patients who had an arterial or venous thromboembolic event within the previous 12 months. It is recommended to monitor closely for signs and symptoms of thromboembolism.
Pulmonary Impairment
Moderate:axitinib
Axitinib has a moderate potential interaction with Pulmonary Impairment.
The use of certain multikinase inhibitors has been associated with pulmonary toxicity. Serious cases of interstitial lung disease (ILD), including fatal cases and interstitial pneumonitis or pulmonary fibrosis have been reported. Caution is recommended when using these agents in patients with a history of interstitial pneumonitis or pulmonary fibrosis or those patients presenting with acute onset of new or progressive unexplained pulmonary symptoms such as dyspnea, cough, and fever pending diagnostic evaluation. If ILD is confirmed, these agents should be permanently discontinued and appropriate measures should be instituted. Treatment should be immediately withheld in patients diagnosed with ILD/pneumonitis and permanently discontinued if no other potential causes of ILD/pneumonitis have been identified.
Renal Dysfunction
Moderate:axitinib
Axitinib has a moderate potential interaction with Renal Dysfunction.
Based on population pharmacokinetic analyses no starting dose adjustment is needed for patients with mild to severe renal impairment. It is recommended to take caution in patients with end-stage renal disease.
Thrombotic/Thromboembolic Disorder
Moderate:axitinib
Axitinib has a moderate potential interaction with Thrombotic/Thromboembolic Disorder.
Arterial and venous thromboembolic events, including transient ischemic attack, cerebrovascular accident, myocardial infarction, pulmonary embolism, deep vein thrombosis, retinal occlusion, vein thrombosis, and deaths have been reported with the use of axitinib. Use with caution in patients who are at risk for, or who have a history of, these events. The use of axitinib has not been studied in patients who had an arterial or venous thromboembolic event within the previous 12 months. It is recommended to monitor closely for signs and symptoms of thromboembolism.
Underactive Thyroid
Moderate:axitinib
Axitinib has a moderate potential interaction with Underactive Thyroid.
Thyroid level fluctuations that include hypothyroidism and hyperthyroidism have been reported with the use of axitinib. It is recommended to monitor thyroid function before initiation of, and periodically throughout treatment and to maintain euthyroid state according to standard medical practice.
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
See also:
Learn more
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.