Drug Interaction Report
1 drug interaction and 18 additional warnings found for the following 2 drugs:
- Relyyt (capsaicin / menthol topical)
- selpercatinib
Drug interactions
Minor drug interactions
Minor:menthol topical selpercatinib
Applies to: Relyyt (capsaicin / menthol topical), selpercatinib
Coadministration with orally administered menthol may decrease plasma concentrations of drugs that are substrates of the CYP450 3A4 and/or CYP450 2C9 isoenzymes. The proposed mechanism is increased clearance due to menthol-mediated induction of CYP450 3A4 and CYP450 2C9. In vivo data suggests that concomitant administration of oral menthol reduced the systemic exposure (AUC) of triazolam (a CYP450 3A4 substrate) by 40%, and phenytoin (a CYP450 2C9 substrate) by 20%. Until further data are available, no specific precautions are recommended.
The information above is from our professional interaction data. Consumer information is not available for this interaction.
Food/lifestyle interactions
Major food/lifestyle interactions
Major:Food/Lifestyle selpercatinib
Applies to: selpercatinib
You should limit or avoid consumption of grapefruit and grapefruit juice during treatment with selpercatinib unless directed otherwise by your doctor.
Grapefruit juice may increase the blood levels of selpercatinib. High levels of selpercatinib can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect.
You may be more susceptible if you have:
- a heart condition called congenital long QT syndrome
- other cardiac diseases
- conduction abnormalities
- electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting)
The risk and/or severity of other side effects may also increase, including:
- nausea
- vomiting
- constipation
- diarrhea
- rash
- muscle and joint pain
- swelling of arms or legs
- liver problems
- high blood pressure
- bleeding complications
Talk to your doctor if you experience intolerable or troublesome side effects, or you have other questions or concerns.
You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with selpercatinib.
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
17 potential interactionsApplies to: 16 conditions, including High Blood Pressure, Heart Failure, Arrhythmia, Hypokalemia, and Hypocalcemia.
Arrhythmia
Moderate:selpercatinib
Selpercatinib has a moderate potential interaction with Arrhythmia.
Selpercatinib can cause concentration-dependent QT interval prolongation. Monitor patients who are at significant risk of developing QTc prolongation, including patients with known long QT syndromes, clinically significant bradyarrhythmias, and severe or uncontrolled heart failure. This drug has not been studied in patients with clinically significant active cardiovascular disease or recent myocardial infarction. Assess QT interval, electrolytes, and TSH at baseline and periodically during treatment, adjusting frequency based upon risk factors, including diarrhea or drug interactions. Correct hypokalemia, hypomagnesemia, and hypocalcemia prior to initiating therapy.
Bleeding Disorder
Moderate:selpercatinib
Selpercatinib has a moderate potential interaction with Bleeding Disorder.
Serious including fatal hemorrhagic events can occur with the use of selpercatinib. Care should be exercised when using this agent in patients with bleeding disorders. It is recommended to permanently discontinue treatment in patients with severe or life-threatening hemorrhage.
Cardiovascular Conditions and Disorders
Moderate:selpercatinib
Selpercatinib has a moderate potential interaction with Cardiovascular Conditions and Disorders.
Selpercatinib can cause concentration-dependent QT interval prolongation. Monitor patients who are at significant risk of developing QTc prolongation, including patients with known long QT syndromes, clinically significant bradyarrhythmias, and severe or uncontrolled heart failure. This drug has not been studied in patients with clinically significant active cardiovascular disease or recent myocardial infarction. Assess QT interval, electrolytes, and TSH at baseline and periodically during treatment, adjusting frequency based upon risk factors, including diarrhea or drug interactions. Correct hypokalemia, hypomagnesemia, and hypocalcemia prior to initiating therapy.
Electrolyte Abnormalities
Moderate:selpercatinib
Selpercatinib has a moderate potential interaction with Electrolyte Abnormalities.
Selpercatinib can cause concentration-dependent QT interval prolongation. Monitor patients who are at significant risk of developing QTc prolongation, including patients with known long QT syndromes, clinically significant bradyarrhythmias, and severe or uncontrolled heart failure. This drug has not been studied in patients with clinically significant active cardiovascular disease or recent myocardial infarction. Assess QT interval, electrolytes, and TSH at baseline and periodically during treatment, adjusting frequency based upon risk factors, including diarrhea or drug interactions. Correct hypokalemia, hypomagnesemia, and hypocalcemia prior to initiating therapy.
Heart Failure
Moderate:selpercatinib
Selpercatinib has a moderate potential interaction with Heart Failure.
Selpercatinib can cause concentration-dependent QT interval prolongation. Monitor patients who are at significant risk of developing QTc prolongation, including patients with known long QT syndromes, clinically significant bradyarrhythmias, and severe or uncontrolled heart failure. This drug has not been studied in patients with clinically significant active cardiovascular disease or recent myocardial infarction. Assess QT interval, electrolytes, and TSH at baseline and periodically during treatment, adjusting frequency based upon risk factors, including diarrhea or drug interactions. Correct hypokalemia, hypomagnesemia, and hypocalcemia prior to initiating therapy.
High Blood Pressure
Moderate:selpercatinib
Selpercatinib has a moderate potential interaction with High Blood Pressure.
Selpercatinib may cause hypertension and therapy should not be initiated in patients with uncontrolled hypertension. Care should be exercised when using this agent in hypertensive patients. Optimize blood pressure before starting treatment. It is recommended to monitor blood pressure after 1 week, and regularly as clinically indicated. Initiate or adjust anti-hypertensive therapy as appropriate. Withhold, reduce dose, or permanently discontinue treatment based on the severity.
History - Myocardial Infarction
Moderate:selpercatinib
Selpercatinib has a moderate potential interaction with History - Myocardial Infarction.
Selpercatinib can cause concentration-dependent QT interval prolongation. Monitor patients who are at significant risk of developing QTc prolongation, including patients with known long QT syndromes, clinically significant bradyarrhythmias, and severe or uncontrolled heart failure. This drug has not been studied in patients with clinically significant active cardiovascular disease or recent myocardial infarction. Assess QT interval, electrolytes, and TSH at baseline and periodically during treatment, adjusting frequency based upon risk factors, including diarrhea or drug interactions. Correct hypokalemia, hypomagnesemia, and hypocalcemia prior to initiating therapy.
Hypocalcemia
Moderate:selpercatinib
Selpercatinib has a moderate potential interaction with Hypocalcemia.
Selpercatinib can cause concentration-dependent QT interval prolongation. Monitor patients who are at significant risk of developing QTc prolongation, including patients with known long QT syndromes, clinically significant bradyarrhythmias, and severe or uncontrolled heart failure. This drug has not been studied in patients with clinically significant active cardiovascular disease or recent myocardial infarction. Assess QT interval, electrolytes, and TSH at baseline and periodically during treatment, adjusting frequency based upon risk factors, including diarrhea or drug interactions. Correct hypokalemia, hypomagnesemia, and hypocalcemia prior to initiating therapy.
Hypokalemia
Moderate:selpercatinib
Selpercatinib has a moderate potential interaction with Hypokalemia.
Selpercatinib can cause concentration-dependent QT interval prolongation. Monitor patients who are at significant risk of developing QTc prolongation, including patients with known long QT syndromes, clinically significant bradyarrhythmias, and severe or uncontrolled heart failure. This drug has not been studied in patients with clinically significant active cardiovascular disease or recent myocardial infarction. Assess QT interval, electrolytes, and TSH at baseline and periodically during treatment, adjusting frequency based upon risk factors, including diarrhea or drug interactions. Correct hypokalemia, hypomagnesemia, and hypocalcemia prior to initiating therapy.
Interstitial Lung Disease
Moderate:selpercatinib
Selpercatinib has a moderate potential interaction with Interstitial Lung Disease.
Selpercatinib may cause severe, life-threatening, or fatal interstitial lung disease (ILD)/pneumonitis. Monitor for new or worsening pulmonary symptoms. Withhold therapy and promptly investigate acute or worsening respiratory symptoms suggestive of ILD/pneumonitis (e.g., dyspnea, cough, and fever).
Liver Disease
Moderate:selpercatinib
Selpercatinib has a moderate potential interaction with Liver Disease.
Selpercatinib is metabolized predominantly by CYP450 3A4. The dose of selpercatinib should be reduced in patients with severe hepatic impairment. No dosage modification is recommended for patients with mild or moderate hepatic impairment. Serious hepatic adverse reactions have been reported in patients treated with selpercatinib. Monitor ALT and AST before starting therapy with selpercatinib, every two weeks during the first three months, then monthly thereafter and as clinically indicated. It is recommended to withhold, reduce dose or permanently discontinue treatment based on the severity of selpercatinib-related adverse reactions in patients with hepatic impairment.
Long QT Syndrome
Moderate:selpercatinib
Selpercatinib has a moderate potential interaction with Long QT Syndrome.
Selpercatinib can cause concentration-dependent QT interval prolongation. Monitor patients who are at significant risk of developing QTc prolongation, including patients with known long QT syndromes, clinically significant bradyarrhythmias, and severe or uncontrolled heart failure. This drug has not been studied in patients with clinically significant active cardiovascular disease or recent myocardial infarction. Assess QT interval, electrolytes, and TSH at baseline and periodically during treatment, adjusting frequency based upon risk factors, including diarrhea or drug interactions. Correct hypokalemia, hypomagnesemia, and hypocalcemia prior to initiating therapy.
Magnesium Imbalance
Moderate:selpercatinib
Selpercatinib has a moderate potential interaction with Magnesium Imbalance.
Selpercatinib can cause concentration-dependent QT interval prolongation. Monitor patients who are at significant risk of developing QTc prolongation, including patients with known long QT syndromes, clinically significant bradyarrhythmias, and severe or uncontrolled heart failure. This drug has not been studied in patients with clinically significant active cardiovascular disease or recent myocardial infarction. Assess QT interval, electrolytes, and TSH at baseline and periodically during treatment, adjusting frequency based upon risk factors, including diarrhea or drug interactions. Correct hypokalemia, hypomagnesemia, and hypocalcemia prior to initiating therapy.
Renal Dysfunction
Moderate:selpercatinib
Selpercatinib has a moderate potential interaction with Renal Dysfunction.
Tumor lysis syndrome has been reported with use of selpercatinib in patients with medullary thyroid carcinoma. Patients with rapidly growing tumors, a high tumor burden, renal dysfunction, or dehydration who take selpercatinib may be at increased risk. Closely monitor at-risk patients and consider appropriate prophylaxis, including hydration.
Moderate:selpercatinib
Selpercatinib has a moderate potential interaction with Renal Dysfunction.
A recommended dose of selpercatinib has not been established for patients with end-stage renal disease. No dosage modification is recommended for patients with mild to severe renal impairment. The use of selpercatinib may increase serum creatinine. It is recommended to consider alternative markers of renal function if persistent elevations in serum creatinine are observed.
Thyroid Disease
Moderate:selpercatinib
Selpercatinib has a moderate potential interaction with Thyroid Disease.
Selpercatinib can cause concentration-dependent QT interval prolongation. Monitor patients who are at significant risk of developing QTc prolongation, including patients with known long QT syndromes, clinically significant bradyarrhythmias, and severe or uncontrolled heart failure. This drug has not been studied in patients with clinically significant active cardiovascular disease or recent myocardial infarction. Assess QT interval, electrolytes, and TSH at baseline and periodically during treatment, adjusting frequency based upon risk factors, including diarrhea or drug interactions. Correct hypokalemia, hypomagnesemia, and hypocalcemia prior to initiating therapy.
Tumor Lysis Syndrome
Moderate:selpercatinib
Selpercatinib has a moderate potential interaction with Tumor Lysis Syndrome.
Tumor lysis syndrome has been reported with use of selpercatinib in patients with medullary thyroid carcinoma. Patients with rapidly growing tumors, a high tumor burden, renal dysfunction, or dehydration who take selpercatinib may be at increased risk. Closely monitor at-risk patients and consider appropriate prophylaxis, including hydration.
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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