Drug Interaction Report

Consumer information for this interaction is not currently available.

MONITOR: Coadministration with vadadustat, an inhibitor of breast cancer resistance protein (BCRP), may increase the plasma concentrations and pharmacologic effects of BCRP substrates. The proposed mechanism involves decreased clearance due to inhibition of BCRP by vadadustat. According to product labeling, when vadadustat was coadministered with the BCRP substrates sulfasalazine, simvastatin and rosuvastatin, systemic exposure (AUC) of the substrates increased 4.5-fold, 2-fold, and 2 to 3-fold, respectively. However, no substantial change in exposure to sulfasalazine's active metabolite was observed.

MANAGEMENT: Caution is advised when vadadustat is used concomitantly with drugs that are substrates of the breast cancer resistance protein (BCRP) transporter. Monitoring for signs and symptoms of increased exposure to the BCRP substrate should be considered whenever vadadustat is added to or withdrawn from therapy. The prescribing information for concomitant medications may be consulted to assess the benefits versus risks of coadministration, as well as any dosage adjustments that may be required during coadministration and/or following the discontinuation of a BCRP inhibitor.

Cladribine oral products can bind to other medications. This may increase your risk of experiencing side effects. To avoid or minimize the interaction, cladribine should be taken at least 3 hours before or after other medications. Talk to your doctor if you have any questions or concerns, or if you have trouble separating the dosing times. 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.

Consumer information for this interaction is not currently available.

MONITOR: Smoking and alcohol consumption during therapy with vadadustat may increase the risk of gastrointestinal erosions. Serious erosions, including gastrointestinal bleeding and the need for red blood cell transfusions, have been reported during vadadustat clinical trials. Patients with a history of gastrointestinal erosion, peptic ulcer disease, and current tobacco smokers and alcohol drinkers may be at higher risk of gastrointestinal injury.

MANAGEMENT: Caution is advised if vadadustat is prescribed to current tobacco smokers or alcohol drinkers. Patients should be advised to contact their physician if they develop potential signs and symptoms of gastrointestinal injury such as abdominal pain, hematemesis, trouble swallowing, chest or throat pain, and/or black, tarry stools.