Drug Interaction Report

The following interaction applies only to products containing sodium biphosphate that are used for bowel cleansing. It does not apply to products containing sodium biphosphate that are used for other, non-laxative related purposes.

Bowel cleansing with sodium biphosphate can cause kidney failure, in some cases up to several months after the procedure. Although it rarely occurs, the risk is increased in individuals receiving treatment with phenyl salicylate, especially if they are also elderly or frail. You may need a dose adjustment or special tests to safely use both medications. Combining these medications may also increase the risk of dehydration and electrolyte abnormalities. In severe cases, dehydration and electrolyte abnormalities can lead to irregular heart rhythm, seizures, and kidney problems. You should use sodium biphosphate exactly as prescribed by your doctor, and drink plenty of clear fluids before, during, and after the cleansing process to keep yourself hydrated. Your doctor may also recommend an electrolyte rehydration solution that you can use. Talk to your doctor if you have any 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.

Using sodium biphosphate together with pemigatinib may increase the levels of phosphate in the blood, which may increase your risk of high phosphate levels (hyperphosphatemia), and a buildup of minerals such as calcium in different tissues in your body. Your doctor will check your blood phosphate level regularly when your first start treatment with pemigatinib and regularly throughout treatment. They may recommend changes in your diet, phosphate-lowering therapy, and/or change your dose of pemigatinib if necessary. Talk to your doctor if you have any questions or concerns. Contact your doctor as soon as possible if you develop signs and symptoms of high phosphate levels in the blood (hyperphosphatemia) such as muscle cramps, convulsions, tingling or numbness around the mouth, and bone pain. 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.

Pemigatinib may be taken with or without food. Do not consume grapefruit, grapefruit juice, or any supplements that contain grapefruit extract during treatment with pemigatinib unless directed otherwise by your doctor. Grapefruit juice can increase the blood levels of pemigatinib. This may increase the frequency and severity of serious side effects such as elevated phosphate levels in the blood (which can eventually lead to low blood calcium levels; calcium deposits in the skin, muscles, and other tissues; anemia; muscle cramps; seizures; and irregular heart rhythm), eye and vision problems, joint pain, mouth sores and inflammation, hair loss, diarrhea, nausea, vomiting, and constipation. 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.

Oral medications may not be properly absorbed when they are taken within one hour before starting sodium biphosphate for bowel cleansing. Talk to your doctor or pharmacist to see if you should adjust the dosing schedule of your other medications before you begin bowel cleansing treatment. 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.

Ask your doctor before using hyoscyamine together with ethanol (alcohol). Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking hyoscyamine. You should be warned not to exceed recommended dosages and to avoid activities requiring mental alertness. If your doctor prescribes these medications together, you may need a dose adjustment to safely take this combination. 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.