Drug Interaction Report

CycloSPORINE may increase the blood levels of nintedanib. This can increase the risk and/or severity of side effects such as liver problems, diarrhea, nausea, vomiting, stomach or intestinal wall perforation, bleeding, and cardiovascular problems such as heart attack, chest pain, or stroke. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. You should seek immediate medical attention if you develop 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/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. 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 and grapefruit juice can increase the levels of cycloSPORINE in your body and should generally not be consumed during treatment. High blood levels of cycloSPORINE can lead to increased risk of serious side effects on kidney, liver, and nervous system functions. If you regularly consume grapefruits or grapefruit juice, you should be monitored for side effects and/or changes in cycloSPORINE levels. However, do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor. You should also take cycloSPORINE on a consistent schedule with regard to time of day and relation to meals. Let your doctor know if you experience fever, rash, nausea, vomiting, abdominal pain, loss of appetite, dark urine, jaundice (yellowing of the skin or eyes), decreased urination, excessive thirst, swelling, weight gain, dizziness, fatigue, weakness, headache, blurred vision, numbness/burning/tingling in the hand and feet, tremors, or convulsions, as they may be symptoms caused by excessive effects of cycloSPORINE.

Grapefruit juice and Seville orange juice can increase the blood levels of nintedanib. This may increase the risk and/or severity of side effects such as liver problems, diarrhea, nausea, vomiting, stomach or intestinal wall perforation, bleeding, and cardiovascular problems such as heart attack, chest pain, or stroke. It is best to avoid or minimize the consumption of Seville oranges, Seville orange juice, grapefruit, and grapefruit juice during treatment. You should take nintedanib with food and swallow it whole with water. Taking nintedanib with food may help with absorption of the medication and reduce gastrointestinal side effects. Talk to your doctor or pharmacist if you have questions on how to take this or other medications you are prescribed. 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.