Drug Interaction Report

Neratinib may increase the blood levels and effects of lapatinib. You may need a dose adjustment or more frequent monitoring by your doctor 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.

Grapefruit juice can increase the blood levels of neratinib. This may increase the risk and/or severity of side effects such as diarrhea, nausea, vomiting, abdominal pain, mouth sores, loss of appetite, and liver problems. You should avoid the consumption of grapefruit and grapefruit juice during treatment with neratinib. Be sure to take the medication with food at the same time everyday to maintain consistent blood levels and effects. Talk to your doctor or pharmacist if you have questions on how to take this or other medications you are prescribed. 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.

Take lapatinib on an empty stomach 1 hour before or 1 hour after a meal unless otherwise directed by your doctor. This will make it easier for your body to absorb the medication. The lapatinib dose is administered once daily and should not be divided. The usual dose of lapatinib is equal to 5 tablets. You may swallow each tablet one at a time, but take the entire lapatinib dose at the same time each day. If you are receiving therapy with lapatinib you should be advised to avoid grapefruits and grapefruit juice. Grapefruit can raise the levels of lapatinib in your body and lead to dangerous side effects.

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

• neratinib
• Tykerb (lapatinib)

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.

The recommended maximum number of medicines in the 'HER2 inhibitors' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'HER2 inhibitors' category:

• neratinib
• Tykerb (lapatinib)

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.