Drug Interaction Report

Using inotersen together with regorafenib may cause serious and potentially life-threatening bleeding complications. Treatment with inotersen can cause significant and sudden reductions in platelet count, which can lead to bleeding in some cases. The risk of bleeding may be further increased when combined with blood thinners or other medications that can also affect platelet count or function. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. You should seek immediate medical attention if you experience any unusual bleeding or bruising, or have other signs and symptoms of bleeding such as dizziness; lightheadedness; red or black, tarry stools; coughing up or vomiting fresh or dried blood that looks like coffee grounds; severe headache; and weakness. 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.

Depending on the amount of fat, food may help the absorption of regorafenib. You should take it with a low-fat breakfast at the same time everyday to maintain consistent blood levels and effects. Examples of a low-fat breakfast include: 2 slices of white toast with 1 tablespoon of low-fat margarine and 1 tablespoon of jelly, plus 8 ounces of skim milk (319 calories; 8.2 g fat); or 1 cup of cereal, 8 ounces of skim milk, 1 slice of toast with jam, apple juice, and 1 cup of coffee or tea (520 calories; 2 g fat). Avoid consuming grapefruit or grapefruit juice during treatment, as it may alter the blood levels and effects of the medication. 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.