Retevmo interactions: Alcohol, medications, and other factors

Before you start treatment with Retevmo, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Retevmo interacts with supplements, herbs, or vitamins, see the “Retevmo and other interactions” section below.)

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of drugs that can interact with Retevmo. Keep in mind that this table doesn’t include all drugs that may interact with Retevmo. Some of these interactions are described in detail just below in “Drug interactions in depth.”

There are no known interactions between Retevmo and alcohol. However, your doctor may advise you to avoid or limit alcohol consumption during Retevmo treatment.

This is because drinking alcohol while taking the drug may worsen some of Retevmo side effects. For example, you may experience:

• nausea
• vomiting
• headache
• diarrhea

In addition, consuming large amounts of alcohol can cause liver damage. Retevmo may also cause liver damage as a side effect. This means that drinking alcohol during Retevmo treatment may increase the risk of liver problems.

If you consume alcohol during Retevmo treatment, these side effects may be more likely to occur. If you have questions about drinking alcohol while taking Retevmo, talk with your doctor.

Here’s a closer look at certain drug interactions of Retevmo.

Drugs that reduce stomach acid

Drugs that reduce stomach acid are used to treat conditions such as indigestion, acid reflux, heartburn, and stomach ulcers. You can buy some of these drugs over the counter without a prescription. However, they can interact with Retevmo.

Interaction result:Taking Retevmo with drugs that reduce stomach acid can make Retevmo less effective at treating your cancer.

Interaction explained:Taking Retevmo with drugs that reduce stomach acid can reduce the amount of Retevmo that your bidy absorbs. Having a lower level of Retevmo in your body can make the medication less effective at treating your cancer.

Examples of stomach acid reducing drugs: Here are some stomach acid reducing drugs that may interact with Retevmo:

• antacids, such as:
  • aluminium hydroxide/magnesium hydroxide (Maalox)
  • calcium carbonate (Tums)
  • calcium carbonate/magnesium hydroxide (Rolaids, Mylanta)
  • sodium bicarbonate/potassium bicarbonate (Alka-Seltzer)
• H2 blockers, such as:
  • cimetidine (Tagamet HB)
  • famotidine (Pepcid AC)
  • ranitidine
• proton pump inhibitors, such as:
  • esomeprazole (Nexium)
  • omeprazole (Prilosec)
  • pantoprazole (Protonix)

Steps you or your doctor may take: Your doctor will likely avoid prescribing drugs that reduce stomach acid with Retevmo. You should avoid taking over-the-counter acid-reducing drugs with Retevmo unless you have talked with your doctor first.

If your doctor recommends taking acid-reducing medication with Retevmo, you can reduce the effect of the interaction in the following ways:

• If you take a proton pump inhibitor, you should take your dose of Retevmo with food.
• If you take an H2 blocker, you should take your dose of Retevmo 2 hours before or 10 hours after the H2 blocker.
• If you take an antacid, you should take your dose of Retevmo 2 hours before or 2 hours after the antacid.

If you have questions about taking Retevmo with an acid-reducing medication, talk with your doctor or pharmacist.

Certain antibiotics

Antibiotics are drugs used to treat bacterial infections. Your doctor may prescribe an antibiotic if you get a bacterial infection during your Retevmo treatment. However, certain antibiotics can interact with Retevmo.

Interaction result: Taking certain antibiotics with Retevmo can raise your risk of side effects from Retevmo.

Interaction explained: Some antibiotics slow the action of an enzyme (type of protein) called cytochrome p450 3A4 (CYP3A4). This enzyme helps clear Retevmo from your body. By slowing the action of CYP3A4, these antibiotics can make Retevmo build up in your body. This can raise your risk of Retevmo side effects. Examples include nausea, headache, liver problems, and QT prolongation (a type of abnormal heart rhythm).

Some other antibiotics can also cause QT prolongation (see just below). So taking these antibiotics with Retevmo can raise your risk of this side effect.

Examples of antibiotic drugs: Here are some antibiotics that may interact with Retevmo:

• azithromycin (Zithromax)
• ciprofloxacin (Cipro)
• clarithromycin
• erythromycin (Erytab, others)
• moxifloxacin (Avelox)

Steps you or your doctor may take: Your doctor will likely avoid prescribing the antibiotics listed above with Retevmo. If you need treatment for a bacterial infection while taking Retevmo, your doctor will typically prescribe an antibiotic that does not interact with Retevmo.

If your doctor prescribes one of these antibiotics with Retevmo, they may temporarily lower your Retevmo dosage. They may also monitor you more closely. For example, they may order electrocardiograms (ECGs) to check your heart rhythm.

If you have symptoms of QT prolongation while taking Retevmo with an antibiotic, tell your doctor right away. These symptoms can include dizziness, fainting, and heart palpitations.

If you have questions about taking Retevmo with antibiotics, talk with your doctor or pharmacist.

Drugs that can cause QT prolongation

QT prolongation is a type of abnormal heart rhythm. Certain medications can cause this problem. Examples include antiarrhythmics (drugs that treat irregular heartbeats), certain antipsychotics, and certain antibiotics (see just above). Retevmo can also cause this side effect.

Interaction result: Taking Retevmo with other drugs that can cause QT prolongation can raise your risk of this side effect. QT prolongation can cause dangerous and life threatening irregular heartbeats.

Interaction explained: Certain drugs can affect the electrical activity that controls your heartbeat. Doctors can see this change on an electrocardiogram (ECG) as a “prolonged QT interval”. The change can make the lower chambers of your heart take longer than usual to contract and relax.

Taking Retevmo with other drugs that can prolong your QT interval raises the risk of this interval becoming significantly longer. This raises your risk of dangerous irregular heartbeats.

Examples of QT prolonging drugs: Here are some QT prolonging drugs that may interact with Retevmo:

• antiarrhythmics, such as:
  • amiodarone (Pacerone)
  • dofetilide (Tikosyn)
  • disopyramide (Norpace)
• certain antipsychotics, such as:
  • chlorpromazine
  • risperidone (Risperdal)
• certain antidepressants, such as:
  • citalopram (Celexa)
  • escitalopram (Lexapro)
  • clomipramine (Anafranil)

Steps you or your doctor may take: If your doctor prescribes Retevmo with another drug that can cause QT prolongation, they will likely order frequent ECGs to check your heart rhythm.

Tell your doctor right away if you have symptoms of QT prolongation while taking Retevmo. These can include dizziness, fainting, and heart palpitations.

If you develop QT prolongation, your doctor may reduce your dosage of Retevmo or the other drug. If your QT interval does not return to previous levels, you may need to stop taking Retevmo.

If you have questions about taking Retevmo with other drugs that can affect your heart rhythm, talk with your doctor or pharmacist.

Retevmo may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Retevmo.

Retevmo interactions with supplements

Before you start treatment with Retevmo, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Retevmo interactions with herbs

Doctors will typically recommend you avoid taking St. John’s wort with Retevmo. St. John’s wort is an herbal supplement that may be used to treat depression and other conditions.

St. John’s wort may speed up the activity of an enzyme in your body called cytochrome P450 3A4 (CYP3A4). This enzyme helps break down Retevmo.

By speeding up this enzyme, St. John’s wort can cause Retevmo to break down more quickly. And this may lead to a low level of Retevmo in your system. If the level of Retevmo in your system is too low, the drug may not work to treat cancer.

Your doctor may be able to suggest a treatment option other than St. John’s wort.

Retevmo and vitamins

There are no specific reports of vitamins interacting with Retevmo. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Retevmo.

Retevmo interactions with food

Grapefruit and grapefruit juice can interact with Retevmo. Specifically, grapefruit products can stop your body from breaking down Retevmo. This raises the level of Retevmo in your body, which increases your risk of side effects from Retevmo. Examples include nausea, headache, liver problems, and QT prolongation (a type of abnormal heart rhythm). Due to this risk, your doctor may recommend not consuming grapefruit and grapefruit juice while taking the drug.

Retevmo and vaccines

There are no known interactions between Retevmo and vaccines. Talk with your doctor or pharmacist to see whether you’re due for any vaccines.

Retevmo and lab tests

Retevmo is not known to interact with any lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.

RETEVMO INTERACTION WITH CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Retevmo.

However, cannabis and cannabis products can affect the action of an enzyme (type of protein) that helps clear Retevmo from your body. So using cannabis with Retevmo may affect the level of Retevmo in your body.

As with any drug or supplement, talk with your doctor before using cannabis in combination with Retevmo. The impact of cannabis may also affect how well you stick to your Retevmo treatment plan.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Retevmo. Before you take this drug, be sure to talk with your doctor about your health history. Retevmo may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Retevmo include:

• Liver problems: If you have a liver problem, Retevmo could make it worse. Your doctor will likely monitor your liver function while you are taking Retevmo. If you have a severe liver problem, your doctor may prescribe a dosage of Retevmo that’s lower than usual.
• High blood pressure: If you have high blood pressure, Retevmo could make it worse. If your blood pressure is not well managed, your doctor may not prescribe Retevmo. Your doctor will likely monitor your blood pressure while you are taking Retevmo.
• Heart problems: If you have heart problems, such as a slow or irregular heartbeat or heart failure, you may have a raised risk of abnormal heart rhythms with Retevmo. Talk with your doctor about whether Retevmo is right for you.
• Electrolyte imbalance: If you have an electrolyte imbalance, such as a low potassium, magnesium, or calcium level, you may have a raised risk of abnormal heart rhythms with Retevmo. Your doctor will likely prescribe medication to correct any electrolyte imbalance before you start Retevmo.
• Hypothyroidism: If you have hypothyroidism (low levels of thyroid hormones), Retevmo could make this worse. Your doctor will likely monitor your thyroid hormone levels during treatment with Retevmo.
• Allergic reaction: If you’ve had an allergic reaction to Retevmo or any of its ingredients, your doctor will likely not prescribe Retevmo. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
• Breastfeeding: There isn’t enough information to determine whether the drug passes into breast milk or what effects Retevmo may have on a child who is breastfed. Due to the risk of side effects in a child who is breastfed, your doctor will likely recommend that you don’t breastfeed while taking Retevmo and for 1 week after your last dose. If you’re breastfeeding or planning to, talk with your doctor before taking Retevmo. They can talk with you about treatment options and ways to feed your child.
• Pregnancy: Retevmo is not safe to use while pregnant. Based on the way the drug works and studies in animals, the drug may cause congenital anomalies (commonly known as birth defects) or pregnancy loss. If you’re pregnant or planning to become pregnant, talk with your doctor about your treatment options. If you or your sexual partner are able to become pregnant, you should use birth control while taking Retevmo and for 1 week after your last dose.
• Recent or upcoming surgery: Retevmo can cause problems with wound healing. If you have recently had surgery or have any surgeries planned, talk with your doctor before taking Retevmo. Your doctor may recommend that you don’t start taking Retevmo until at least 2 weeks after having major surgery. And they may recommend stopping Retevmo 7 days before planned surgery.

You can take certain steps to help prevent interactions with Retevmo. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Retevmo label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If Retevmo does not come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Retevmo by taking it exactly as your doctor prescribes.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.