Drug Interaction Report

Consumer information for this interaction is not currently available.

MONITOR: Acetylcholinesterase inhibitors may have vagotonic effects on the sinoatrial and atrioventricular nodes, which occasionally manifest as bradycardia or heart block (<2%). Because bradycardia is a risk factor for torsade de pointes, a theoretical risk exists when combined with agents that prolong the QT interval. In general, the risk of an individual agent or a combination of agents causing ventricular arrhythmia in association with QT prolongation is largely unpredictable but may be increased by certain underlying risk factors including, but not limited to congenital long QT syndrome, cardiac disease, and electrolyte disturbances (e.g., hypokalemia, hypomagnesemia). In addition, the extent of drug-induced QT prolongation may vary depending on the dosage(s) and specific drug(s) involved.

MANAGEMENT: Caution is advised when acetylcholinesterase inhibitors are used with drugs that can prolong the QT interval. Patients should be monitored for bradycardia, atrioventricular block and syncope, and advised to seek medical attention if they experience dizziness, lightheadedness, fainting, shortness of breath, or slow or irregular heartbeat.

Do not consume grapefruit, grapefruit juice, or Seville oranges during treatment with entrectinib. Doing so can significantly increase the blood levels of entrectinib and increase the risk and/or severity of side effects such as dizziness; confusion; hallucinations; problems with concentration, attention, thinking, and memory; mood changes; insomnia; drowsiness; liver problems; increased uric acid levels in the blood (hyperuricemia); congestive heart failure; fluid retention and swelling; changes in electrical activity of the heart (a condition known as QT prolongation, which may lead to irregular heart rhythm that can be life-threatening); vision problems; and low red or white blood cell counts. 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.