Drug Interaction Report

Ripretinib may increase the blood levels of aliskiren in some patients. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. High blood levels of aliskiren can cause an excessive fall in blood pressure and increase the risk of developing a condition known as hyperkalemia, or high blood potassium. In severe cases, hyperkalemia can lead to kidney failure, muscle paralysis, irregular heart rhythm, and cardiac arrest. You may be more likely to develop hyperkalemia while taking aliskiren if you are elderly, dehydrated, or have kidney disease, diabetes, or advanced heart failure. Regular or long-term use of nonsteroidal anti-inflammatory drugs such as ibuprofen or naproxen (Aleve) may also increase your risk. It is important that you maintain adequate fluid intake during treatment with aliskiren. In addition, talk to your doctor to see if you should limit consumption of potassium-rich foods such as tomatoes, raisins, figs, potatoes, lima beans, bananas, plantains, papayas, pears, cantaloupes, mangoes, and potassium-containing salt substitutes. You should seek medical attention if you experience nausea, vomiting, weakness, confusion, tingling of the hands and feet, a weak pulse, or a slow or irregular heartbeat, as these may be symptoms of hyperkalemia. 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.

Food can affect the absorption of aliskiren from the intestine. Therefore, you should take aliskiren at the same time each day exactly as prescribed by your doctor. You may take aliskiren with or without food, but take it the same way every time. This will help keep blood levels and effects of the medication steady. You should avoid drinking orange, apple, or grapefruit juice as much as possible during treatment with aliskiren. Studies have shown that drinking these juices regularly or within a short period before or after a dose of aliskiren can interfere with the absorption of the medication.

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.

HydroCHLOROthiazide and ethanol (alcohol) may have additive effects in lowering your blood pressure. You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate. These side effects are most likely to be seen at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. 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.