Drug Interaction Report

Consumer information for this interaction is not currently available.

MONITOR: Coadministration with potent inhibitors of CYP450 3A4 may increase the plasma concentrations of atrasentan, which is primarily metabolized by CYP450 3A4. When a single dose of atrasentan 10 mg was administered with ketoconazole, a potent CYP450 3A4 inhibitor, atrasentan systemic exposure (AUC) increased by 90%. The risk of adverse effects such as edema, hepatotoxicity and anemia may be increased with this combination. The interaction has not been studied with other, less potent CYP450 3A4 inhibitors.

MANAGEMENT: Caution is advised when atrasentan is used with potent CYP450 3A4 inhibitors. Patients should be monitored for edema, anemia and signs of hepatotoxicity such as nausea, vomiting, abdominal pain, dark urine, loss of appetite, itching and/or yellowing of the skin or eyes.

Do not consume grapefruit or grapefruit juice during treatment with ceritinib unless directed otherwise by your doctor. Grapefruit juice can increase the blood levels of ceritinib to dangerous levels, increasing the risk of an irregular heart rhythm that may be serious. Other, more common side effects such as diarrhea, nausea, vomiting, abdominal pain, and hyperglycemia (high blood sugar) may also increase. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with ceritinib. Food may also increase the blood levels of ceritinib. Therefore, you should take ceritinib on an empty stomach, meaning no food should be eaten for at least two hours before or after taking ceritinib. 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.