Drug Interaction Report
3 potential interactions and/or warnings found for the following 2 drugs:
- Iclusig (ponatinib)
- tovorafenib
Interactions between your drugs
PONATinib tovorafenib
Applies to: Iclusig (ponatinib), tovorafenib
Consumer information for this interaction is not currently available.
MONITOR CLOSELY: Coadministration of ponatinib and drugs that interfere with platelet function or coagulation may potentiate the risk of bleeding complications. Treatment with ponatinib is associated with severe, sometimes fatal hemorrhage including cerebral and gastrointestinal hemorrhage. In clinical trials, hemorrhagic events occurred in 24% of patients treated with ponatinib, and serious events occurred in 5% of patients. The incidence of serious bleeding events was higher in patients with accelerated phase or blast phase chronic myeloid leukemia and Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ALL). Most hemorrhagic events occurred in patients with grade 4 thrombocytopenia.
MANAGEMENT: Concomitant use of other medications that interfere with platelet function or coagulation should be considered cautiously in patients treated with ponatinib. Close clinical and laboratory observation for bleeding complications is recommended during therapy. The INR should be monitored more frequently during coadministration of warfarin. Patients should be advised to promptly report any signs of bleeding to their physician, including pain, swelling, headache, dizziness, weakness, prolonged bleeding from cuts, increased menstrual flow, vaginal bleeding, nosebleeds, bleeding of gums from brushing, unusual bleeding or bruising, red or brown urine, or red or black stools.
Drug and food interactions
PONATinib food
Applies to: Iclusig (ponatinib)
Do not consume grapefruit, grapefruit juice, or any supplements that contain grapefruit extract during treatment with PONATinib unless directed otherwise by your doctor. Grapefruit juice can increase the blood levels of PONATinib. You may be more likely to experience side effects such as nausea; vomiting; abdominal pain; constipation; skin rash; mouth sores; high blood pressure; blood clots; fluid retention; heart failure; liver damage; and impaired bone marrow function resulting in low numbers of different types of blood cells, which can increase the risk of anemia, bleeding problems and infections. You should contact your doctor immediately if you develop sudden dizziness, fainting, chest pain, palpitation, shortness of breath, weakness on one side of the body, speech impairment, leg pain or swelling, or any signs of infection, as these may be symptoms of potentially serious side effects associated with PONATinib. You should also seek prompt medical attention if you have signs and symptoms of liver damage such as 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 yellowing of the skin or eyes. 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.
Therapeutic duplication warnings
Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.
Multikinase inhibitors
Therapeutic duplication
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:
- Iclusig (ponatinib)
- tovorafenib
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.
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. |
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Further information
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