Drug Interaction Report

The following interaction applies only if you are receiving the oral formulation of lefamulin (Xenleta), but not the intravenous formulation:

Lefamulin taken orally may increase the blood levels and effects of sonidegib. 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.

Sonidegib should be taken on an empty stomach, at least 1 hour before or 2 hours after a meal. The presence of food can significantly increase the absorption of sonidegib into the blood stream. This may increase side effects such as muscle spasms, muscle pain, muscle weakness, fatigue, nausea, vomiting, diarrhea, loss of appetite, weight loss, hair loss, itching, and taste abnormalities. You may also have an increased risk of developing a rare but serious condition called rhabdomyolysis that involves the breakdown of skeletal muscle tissue. In some cases, rhabdomyolysis can cause kidney damage and even death. Let your doctor know immediately if you have unexplained muscle pain, tenderness, or weakness during treatment with sonidegib, especially if these symptoms are accompanied by fever or dark colored urine. Grapefruit juice may also increase the blood levels of sonidegib and should be avoided. Talk to your doctor or pharmacist if you have any questions or concerns.

The following interaction applies only if you are taking lefamulin (Xenleta) orally:

Food may interfere with the absorption of lefamulin, which may lead to lower blood levels of the medication and possibly reduced effectiveness. You should take lefamulin at least 1 hour before or 2 hours after a meal. It is best to avoid or limit the consumption of grapefruit and grapefruit juice during treatment with lefamulin, as it may increase blood levels of the medication and increase side effects. Talk to your doctor or pharmacist if you have any questions or concerns.