Drug Interaction Report

Nirogacestat may increase the blood levels of repaglinide. You may be more likely to experience side effects such as hypoglycemia, or low blood sugar, that can sometimes occur with the use of repaglinide. Symptoms of hypoglycemia include headache, dizziness, drowsiness, nervousness, weakness, tremor, nausea, hunger, sweating, and palpitation. The risk of other serious but uncommon side effects such as fluid retention, macular edema (swelling in the back of the eye), new or worsening heart failure, bone fractures, anemia, and liver problems may also be increased. You may need a dose adjustment or more frequent monitoring of your blood sugar and other tests to safely use both medications. Contact your doctor immediately if you experience blurred vision or other visual abnormalities; excessive or rapid weight gain; swelling in the ankles or legs; shortness of breath or difficulty breathing; unusual tiredness; chest pain or tightness; or worsening of existing heart problems. You should also seek prompt medical attention if you develop signs and symptoms of liver damage such as fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, light colored stools, and yellowing of the skin or eyes. 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, grapefruit juice, Seville oranges, or starfruit during treatment with nirogacestat. Doing so can significantly increase the blood levels of nirogacestat and increase the risk and/or severity of side effects such as diarrhea, liver problems, new non-melanoma skin cancers, electrolyte disturbances, and in women who can become pregnant, ovarian problems. 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.

Grapefruit juice may increase the blood levels of certain medications such as repaglinide. You may want to limit your consumption of grapefruit and grapefruit juice during treatment with repaglinide. 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.