Ponatinib; Regorafenib/Strong CYP3A4 Inducers Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Apalutamide, carbamazepine, fosphenytoin, lumacaftor, mitotane, phenytoin, phenobarbital, primidone, rifabutin, rifampin, rifapentine and St John's Wort may change the way your liver processes ponatinib and regorafenib.

What might happen:

The amount of ponatinib may decrease and it may not work as well.The amount of regorafenib in your blood may increase. You could notice an increase in side effects such as high blood pressure, diarrhea, hand-foot skin reaction, or bleeding.

What you should do about this interaction:

Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. Your doctor may want you to stop taking St. John's Wort or may monitor you more closely while you are taking apalutamide, carbamazepine, fosphenytoin, lumacaftor, phenytoin, primidone, phenobarbital, rifabutin, rifampin, rifapentine or St. John's Wort with regorafenib.If you notice an increase in side effects from your regorafenib, contact your healthcare professional. Your doctor may want to decrease the dose or stop your regorafenib for some time.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

  • 1.Iclusig (ponatinib) US prescribing information. ARIAD Pharmaceuticals Inc. October 18, 2018.
  • 2.FDA. Drug Approval Package: Stivarga (regorafenib) Tablets, Application:203085, Clinical Pharmacology Review. accessed at: http://www.accessdata.fda.gov/drugsatfda_docs/nda/2012/203085Orig1s000Clin PharmR.pdf approval 09/27/2012.
  • 3.Stivarga (regorafenib) US prescribing information. Bayer HealthCare Pharmaceuticals, Inc. August, 2016.
  • 4.US Food and Drug Administration (FDA). Drug Development and Drug Interactions: Table of Substrates, Inhibitors and Inducers. Available at: https://www.fda.gov/drugs/drug-interactions-labeling/drug-development-and- drug-interactions-table-substrates-inhibitors-and-inducers. Updated 11/14/2017.
  • 5.This information is based on or an extract from the UW Metabolism and Transport Drug Interaction Database (DIDB) Platform, Copyright University of Washington 1999-2019..

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.