Drug Interaction Report

Asciminib may increase the blood levels of nilotinib. High blood levels of nilotinib can increase the risk and/or severity of side effects such as anemia, bleeding problems, infections, and irregular heart rhythm. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if you develop paleness, fatigue, dizziness, unusual bleeding or bruising, or signs and symptoms of infection such as fever, chills, diarrhea, sore throat, muscle aches, shortness of breath, blood in phlegm, weight loss, red or inflamed skin, body sores, and pain or burning during urination. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations. 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.

Do not consume grapefruit or grapefruit juice during treatment with nilotinib unless directed otherwise by your doctor. Grapefruit juice can increase the blood levels of nilotinib to dangerous levels, increasing the risk of an irregular heart rhythm that may be serious. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with nilotinib. Food may also increase the blood levels of nilotinib. Therefore, you should take nilotinib on an empty stomach, meaning no food should be eaten for at least two hours before or one hour after taking nilotinib. 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 reduce the absorption of asciminib, which may lead to lower blood levels of the medication and possibly reduced effectiveness. You should avoid eating for at least 2 hours before and 1 hour after taking asciminib. 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.

The recommended maximum number of medicines in the 'BCR-ABL tyrosine kinase inhibitors' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'BCR-ABL tyrosine kinase inhibitors' category:

• asciminib
• nilotinib

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.