Drug Interaction Report

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Coadministration with moderate inhibitors of CYP450 3A4 may increase the plasma concentrations and adverse effects of palovarotene, which is primarily metabolized by the isoenzyme. Concomitant use of erythromycin, a moderate CYP450 3A4 inhibitor, with palovarotene at steady-state plasma levels increased its peak plasma concentration (Cmax) and systemic exposure (AUC) by 1.6 and 2.5-fold, respectively. Increased concentrations of palovarotene may increase the risk of adverse effects such as dry skin, dry lips, alopecia, pruritus, erythema, paronychia, cellulitis, decubitus ulcer, xerophthalmia, night blindness, depression, mood alterations, and pseudotumor cerebri (benign intracranial hypertension).

MANAGEMENT: Concomitant use of palovarotene with moderate CYP450 3A4 inhibitors should generally be avoided. If coadministration is required, the manufacturer recommends reducing the dosage of palovarotene by one-half. The manufacturer's product labeling should be consulted for further information. Patients should be monitored closely for increased palovarotene-related side effects such as dry skin, dry lips, alopecia, pruritus, erythema, paronychia, cellulitis, decubitus ulcer, xerophthalmia, night blindness, depression, mood alterations, and pseudotumor cerebri.

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.

Grapefruit, pomelo, and juices or supplements containing these fruits may increase the blood levels of palovarotene, which may increase the risk and/or severity of side effects such as dry skin, dry lips, hair loss, skin rash, itching, skin and nail infection, dry eyes, night blindness, depression, and mood changes. It may also increase the risk of a rare, but potentially serious, condition called pseudotumor cerebri caused by increased pressure in the brain. Palovarotene should be taken with food at approximately the same time each day. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact. 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.