Drug Interaction Report

Gilteritinib may increase the blood levels of ripretinib in some patients. This may increase the risk and/or severity of side effects such as nausea, vomiting, constipation, diarrhea, hair loss, muscle pain, high blood pressure, heart failure, skin reactions, and skin cancers. 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. Let your doctor know if you develop redness, pain, blisters, rash, bleeding, or swelling on the palms of your hands or soles of your feet, as these may be signs and symptoms of a potentially severe and painful condition known as Palmar-Plantar Erythrodysesthesia Syndrome (PPES), or hand-foot syndrome. Also seek medical attention if you experience signs and symptoms of heart failure such as fatigue, shortness of breath, protruding neck veins, water retention, and swelling in the abdomen, legs or ankles. 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 may increase the blood levels of certain medications such as ripretinib. You may want to limit your consumption of grapefruit and grapefruit juice during treatment with ripretinib. However, if you have been regularly consuming grapefruit or grapefruit juice with the medication, then it is advisable for you to talk with your doctor before changing the amounts of these products in your diet, as this may alter the effects of your medication. Contact your doctor if your condition changes or you experience increased side effects. Orange juice is not expected to interact.

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

• gilteritinib
• ripretinib

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.