Drug Interaction Report

Consumer information for this interaction is not currently available.

MONITOR CLOSELY: Coadministration of zanubrutinib with drugs that interfere with platelet function or coagulation may potentiate the risk of bleeding complications. Serious and fatal hemorrhagic events have been reported during zanubrutinib monotherapy. Grade 3 or higher bleeding events including intracranial and gastrointestinal hemorrhage, hematuria, and hemothorax have been reported in up to 4.6% of patients treated with zanubrutinib monotherapy, with fatalities occurring in up to 0.3% of patients. Overall, bleeding events of any grade, including purpura and petechiae, have occurred in patients both with and without concomitant antiplatelet or anticoagulation therapy. Coadministration of zanubrutinib with antiplatelet or anticoagulant medications may potentiate the risk of hemorrhage. The mechanism for the bleeding events is not well understood, although treatment with zanubrutinib commonly causes thrombocytopenia. Grade 3 or 4 cytopenias including neutropenia, thrombocytopaenia, and anemia have been reported during treatment with zanubrutinib monotherapy.

MANAGEMENT: Use of zanubrutinib, either alone or concomitantly with other medications that interfere with platelet function or coagulation may potentiate risk of bleeding complications. Concomitant use should be done with caution. Close clinical and laboratory monitoring for bleeding complications is recommended during therapy. Patients should be advised to promptly report any signs and symptoms of bleeding to their physician. Discontinue zanubrutinib if intracranial hemorrhage of any grade occurs. Refer to the product labeling further dosage adjustment, and/or withholding treatment is advised if Grade 3 or higher adverse reactions occur. Additional consultation with individual package labeling, as well as relevant institutional protocols, may be advisable for further guidance.

Drinking large amounts of grapefruit juice can increase your blood levels of colchicine to dangerous levels. You should avoid the consumption of grapefruit or grapefruit juice during treatment with colchicine. Let your doctor know if you experience abdominal pain, nausea, vomiting, diarrhea, fever, muscle pain, weakness, fatigue, and/or numbness or tingling in your hands and feet, as these may be early symptoms of colchicine toxicity.

Grapefruit juice and Seville orange juice can increase the blood levels of zanubrutinib. This may increase side effects such as rash, diarrhea, constipation, cough, hemorrhage, development of other cancers, abnormal heart rhythm, and impaired bone marrow function resulting in low numbers of different types of blood cells. You may also be more likely to develop anemia, bleeding problems, or infections due to low blood cell counts. You should avoid the consumption of Seville oranges, Seville orange juice, grapefruit and grapefruit juice during treatment with zanubrutinib. Be sure to take the medication at approximately the same time(s) everyday to maintain consistent blood levels and effects. 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.