Drug Interaction Report

Ivosidenib may decrease the blood levels and effects of pirfenidone. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. Contact your doctor if your condition changes. 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.

Do not consume grapefruit or grapefruit juice during treatment with ivosidenib unless directed otherwise by your doctor. Grapefruit juice can increase the blood levels of ivosidenib. This may increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). Talk to your doctor if you have any questions or concerns. You may take ivosidenib with or without food, but avoid taking it with a high-fat meal, as this can also increase blood levels of the medication. An example of a high-fat meal includes 2 eggs fried in butter, 2 strips of bacon, 2 slices of white bread with butter, 1 croissant with 1 slice of cheese, and 8 ounces of whole milk (approximately 1,000 calories and 58 grams of fat). You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment. 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.

Pirfenidone should be taken with food to help reduce dizziness and gastrointestinal side effects such as diarrhea, nausea, vomiting, and upset stomach. Avoid smoking during treatment, as cigarette smoking can reduce the blood levels and effects of pirfenidone. If you are a smoker, you should try to quit smoking before starting treatment. Talk to your doctor or pharmacist if you have any questions or concerns, or need help in finding a smoking cessation program. You should also avoid consuming grapefruit or grapefruit juice while taking pirfenidone, as it may increase blood levels of the medication and lead to more 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.