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Drug Interaction Report

5 potential interactions and/or warnings found for the following 2 drugs:

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Interactions between your drugs

Major

verapamil encorafenib

Applies to: verapamil, encorafenib

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Coadministration of encorafenib with a drug that is both a substrate as well as a moderate inhibitor of CYP450 3A4 may result in increased plasma concentrations of encorafenib and significantly decreased plasma concentrations of the other drug. Encorafenib itself is a substrate and a potent inducer of CYP450 3A4. When a single 50 mg dose of encorafenib (equivalent to 0.1 times the recommended dose) was administered with diltiazem, a moderate CYP450 3A4 inhibitor, encorafenib peak plasma concentration (Cmax) increased by 45% and systemic exposure (AUC) increased by 2-fold. Increased exposure to encorafenib may increase the risk of serious and life-threatening adverse effects such as hemorrhage, uveitis, QT prolongation, hepatotoxicity, dermatologic reactions, and new malignancies. Conversely, administration of a single 2 mg dose of the sensitive CYP450 3A4 substrate midazolam after repeated administration of encorafenib 450 mg once daily and binimetinib 45 mg twice daily resulted in decreased systemic exposure (AUC) and peak plasma concentration (Cmax) of midazolam by approximately 82% and 74%, respectively, compared to midazolam alone. Reduced plasma concentrations may potentially lead to decreased efficacy of the CYP450 3A4 substrate.

MANAGEMENT: Concomitant use of encorafenib with moderate CYP450 3A4 inhibitors that are also sensitive CYP450 3A4 substrates should generally be avoided. If coadministration is required, the manufacturer recommends reducing the encorafenib dose to one-half of the dose used prior to addition of the moderate CYP450 3A4 inhibitor. After the inhibitor has been discontinued for 3 to 5 elimination half-lives, the encorafenib dose that was taken prior to initiating the inhibitor may be resumed. If the concomitant medication also carries a risk of prolonging the QT interval, then obtaining more frequent electrocardiograms (ECGs) to monitor the QT interval may be advisable. Patients should be counseled to seek immediate medical attention if they experience symptoms that could indicate the occurrence of torsade de pointes such as dizziness, lightheadedness, syncope, palpitations, irregular heartbeat, and/or shortness of breath. The prescribing information for any concomitant medication should be consulted for further guidance and assessment of benefits versus risks of coadministration, as well as any dosage adjustments that may be required during coadministration and/or following the discontinuation of the potent CYP450 3A4 inducer.

Drug and food interactions

Major

encorafenib food

Applies to: encorafenib

You should preferably avoid consumption of grapefruit and grapefruit juice while taking encorafenib. Grapefruit and grapefruit juice can significantly increase the blood levels of encorafenib. This may increase the risk of serious side effects such as bleeding complications, eye and vision problems, liver problems, irregular heart rhythm, and development of new skin cancers. Talk to your doctor if you have any questions or concerns. 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.

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Moderate

verapamil food

Applies to: verapamil

You may take verapamil with or without food, but take it the same way every time. You should avoid consuming grapefruit or grapefruit juice as much as possible during treatment with verapamil. If you have been regularly consuming grapefruit or grapefruit juice with verapamil, do not increase or decrease the amounts of these products in your diet without first talking to your doctor. Grapefruit juice can increase the blood levels and effects of verapamil. Contact your doctor if you experience sudden, unexplained weight gain; swelling of the hands, ankles, or feet; chest pain; or difficulty breathing. Avoid driving or operating hazardous machinery until you know how the medication affects you, and use caution when getting up from a sitting or lying position. 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.

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Moderate

verapamil food

Applies to: verapamil

Ask your doctor before using verapamil together with ethanol. Verapamil may increase the blood levels and intoxicating effects of ethanol. This can cause symptoms of extreme drowsiness, confusion, and nausea. If you experience any of these side effect you should avoid activities requiring mental alertness. 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.

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Moderate

verapamil food

Applies to: verapamil

Using verapamil together with multivitamin with minerals can decrease the effects of verapamil. Talk with your doctor before using verapamil and multivitamin with minerals together. You may need a dose adjustment or need your blood pressure checked more often if you take both medications. 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.

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Therapeutic duplication warnings

No duplication warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor 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.
Unknown No interaction information available.

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.