Drug Interaction Report

Voclosporin may increase the blood levels of ripretinib in some patients. This may increase the risk and/or severity of side effects such as nausea, vomiting, constipation, diarrhea, hair loss, muscle pain, high blood pressure, heart failure, skin reactions, and skin cancers. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. Let your doctor know if you develop redness, pain, blisters, rash, bleeding, or swelling on the palms of your hands or soles of your feet, as these may be signs and symptoms of a potentially severe and painful condition known as Palmar-Plantar Erythrodysesthesia Syndrome (PPES), or hand-foot syndrome. Also seek medical attention if you experience signs and symptoms of heart failure such as fatigue, shortness of breath, protruding neck veins, water retention, and swelling in the abdomen, legs or ankles. 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 may delay and reduce the absorption of voclosporin, which may lead to lower blood levels of the medication and possibly reduced effectiveness. Voclosporin should be taken on an empty stomach at least 1 hour before or 2 hours after food. This will make it easier for your body to absorb the medication. Also, while taking voclosporin, you should avoid grapefruits and grapefruit juice. Grapefruit can raise the blood levels of voclosporin in your body and lead to increased adverse effects. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor. Also, if you are taking voclosporin you should avoid potassium-containing salt substitutes or over-the-counter potassium supplements without first talking to your doctor. Taking voclosporin together with these salt substitutes or supplements may cause high levels of potassium in your blood. High levels of potassium can cause weakness, irregular heartbeat, confusion, tingling of the extremities, or feelings of heaviness in the legs. Call your doctor at once if you have any of these symptoms. 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.

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.