Drug Interaction Report

Using voclosporin together with sirolimus protein-bound may increase the risk of serious infections and certain kinds of cancer, including skin cancer and cancer of the lymph glands (lymphoma). Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. Contact your doctor immediately if you develop 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. 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 sirolimus protein-bound. However, this has not been studied, and it is not known to what extent grapefruit juice may interact with sirolimus protein-bound. High blood levels of sirolimus protein-bound can increase side effects such as mouth sores and inflammation, nausea, diarrhea, vomiting, abdominal pain, decreased appetite, increased blood sugar, rash, hair loss, lung or breathing problems, 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. The manufacturer recommends avoiding grapefruit and grapefruit juice during treatment with sirolimus protein-bound. 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.