Sutent interactions: Alcohol, medications, and other factors

Before you start treatment with Sutent, 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 Sutent interacts with supplements, herbs, or vitamins, see the “Sutent 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 Sutent. Keep in mind that this table doesn’t include all drugs that may interact with Sutent. Some of these interactions are described in detail just below in “Drug interactions in depth.”

There aren’t any known interactions between Sutent and alcohol. However, your doctor may advise you to avoid or limit alcohol consumption during Sutent treatment.

This is because drinking alcohol while taking the drug may worsen some of Sutent’s side effects. For example, you may have worsened diarrhea, vomiting, or fatigue.

In addition, Sutent may cause liver damage as a side effect. Consuming large amounts of alcohol can also cause liver damage and may increase this risk.

In fact, Sutent has a boxed warning about the risk of liver damage. A boxed warning is the most serious warning from the FDA. For details, see “Boxed warning” at the beginning of this article.

If you have questions about drinking alcohol during Sutent treatment, talk with your doctor.

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

Certain antiemetics

Antiemetics are prescribed to ease nausea and vomiting. This may include nausea and vomiting related to cancer treatments, such as Sutent.

Interaction result: Taking Sutent with certain antiemetics can increase the risk of an irregular heart rhythm. This includes specific irregular heart rhythms called long QT syndrome and torsades de pointes.

Interaction explained: Sutent and certain antiemetics may cause an irregular heart rhythm when taken individually. Taking these medications together can further increase this risk.

Examples of antiemetic drugs: Ondansetron and promethazine (Promethegan) are two antiemetics that may interact with Sutent.

Steps you or your doctor may take: Due to this risk, doctors may not prescribe an antiemetic that interacts with Sutent. They can recommend ways to help manage nausea and vomiting during Sutent treatment.

To learn more about Sutent and antiemetics, talk with your doctor or pharmacist.

Diabetes drugs

Diabetes drugs are prescribed to help manage blood sugar levels in people with type 1 or type 2 diabetes.

Interaction result: Taking Sutent with diabetes drugs can increase the risk of low blood sugar.

Interaction explained: Sutent and diabetes drugs may lower blood sugar levels. Taking these drugs together increases the risk of this effect. If your blood sugar becomes too low, you may have symptoms such as headache, dizziness, shaking, and sweating.

Examples of diabetes drugs: Here are some diabetes drugs that may interact with Sutent:

• metformin (Fortamet, Glumetza)
• glipizide (Glucotrol XL)
• glimepiride (Amaryl)

Steps you or your doctor may take: Before starting Sutent treatment, tell your doctor if you take any diabetes drugs. They may prescribe a lower dosage of the diabetes drug to help reduce the risk of low blood sugar.

Your doctor can advise you on how to manage low blood sugar symptoms. For example, they may recommend eating at least 15 grams (g) of carbohydrates. This may include hard candies, fruit juices, non-diet sodas, or glucose tablets.

Having severely low blood sugar may be life threatening or lead to loss of consciousness. If you have severely low blood sugar, you or a bystander should call 911 or a local emergency number right away.

To learn more about Sutent and diabetes drugs, talk with your doctor or pharmacist.

Bisphosphonates

Bisphosphonates are prescribed for osteoporosis and other bone conditions.

Interaction result: Taking Sutent with a bisphosphonate may increase the risk of osteonecrosis of the jaw (death of jawbone tissue).

Interaction explained: When taken individually, Sutent and bisphosphonates may cause jaw osteonecrosis. This risk may be increased by taking these drugs together.

Examples of bisphosphonate drugs: Here are some bisphosphonates that may interact with Sutent:

• alendronate (Binosto, Fosamax)
• ibandronate
• risedronate (Actonel, Atelvia)

Steps you or your doctor may take: Before starting Sutent treatment, tell your doctor if you take a bisphosphonate. They can recommend whether it’s safe to take these drugs together.

If your doctor prescribes Sutent with a bisphosphonate, watch for symptoms of jaw osteonecrosis. Examples include swollen gums, loose teeth, and jaw or mouth pain. Tell your doctor right away if you have these symptoms. Your doctor may also recommend having regular dental visits while you’re taking Sutent alone or with these drugs.

To learn more about Sutent and bisphosphonates, talk with your doctor or pharmacist.

Sutent 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 Sutent.

Sutent interactions with supplements

Before you start treatment with Sutent, 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.

Sutent interactions with herbs

Sutent may interact with St. John’s wort. This is an herbal supplement used for depression and other conditions.

St. John’s wort may speed up the activity of an enzyme in your body that helps break down Sutent. Taking this herb may cause Sutent to break down too quickly, leading to a low level of Sutent in your system. If the level of Sutent in your system is too low, the drug may not work to treat your condition.

If your doctor prescribes Sutent with St. John’s wort, they may prescribe a higher Sutent dosage than usual. Doing so can help keep the level of Sutent high enough in your body for it to be effective.

Your doctor may also suggest a treatment option other than St. John’s wort.

Sutent and vitamins

There are no specific reports of vitamins interacting with Sutent. 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 Sutent.

Sutent interactions with food

Sutent may interact with grapefruit and grapefruit juice. Grapefruit products can slow the breakdown of Sutent in your body. This can lead to a high level of Sutent in your system, increasing your risk of side effects from the drug.

For this reason, your doctor may recommend that you avoid grapefruit products during treatment with Sutent.

Sutent and vaccines

Sutent’s prescribing information doesn’t note any interactions with vaccines.

However, Sutent can cause your immune system to be less active. So if you get a vaccine while taking Sutent, your immune system may not have a strong response to it. This may cause you to become sick or develop symptoms of the illness the vaccine is meant to prevent.

For more information about this, you can talk with your doctor or pharmacist. You can also ask them whether you’re due for any vaccines.

Sutent and lab tests

Sutent isn’t known to interact with any lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.

SUTENT AND CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been reported to interact with Sutent. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Sutent. The impact of cannabis may affect how well you stick to your Sutent 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 Sutent. Before you take this drug, be sure to talk with your doctor about your health history. Sutent 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 Sutent include:

• Diabetes: Sutent may cause low blood sugar. People with type 1 or type 2 diabetes may have an increased risk of this side effect. If you have diabetes, your doctor may advise you to check your blood sugar levels more often than usual while taking Sutent.
• Heart-related problems: Before taking Sutent, tell your doctor if you’ve ever had a heart-related problem. Examples include heart failure, heart attack, and a blood clot in the lung. Sutent may cause heart problems as a side effect. It isn’t known for certain whether the drug is safe for people who’ve had heart-related problems in the past. Your doctor can recommend whether to prescribe Sutent or an alternative treatment.
• Dental problems or procedures: Certain dental issues may increase the risk of osteonecrosis of the jaw with Sutent. Examples include a lack of dental hygiene (clean teeth and gums) and having a serious dental procedure, such as a tooth extraction. Your doctor may advise you to have regular dental visits during Sutent treatment.
• Planned surgery: Before having surgery, be sure the surgeon knows you’re taking Sutent. This drug may slow the healing process after surgery. For this reason, your doctor may advise you to stop taking Sutent at least 3 weeks before and for 2 weeks after surgery. Your doctor can tell you more about temporarily stopping Sutent before and after surgery.
• Allergic reaction: If you’ve had an allergic reaction to Sutent or any of its ingredients, your doctor will likely not prescribe Sutent. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
• Breastfeeding: It’s not known whether it’s safe to use Sutent while breastfeeding. There isn’t enough information to determine whether the drug passes into breast milk or what effects Sutent may have on a child who is breastfed. To be safe, your doctor may advise you not to breastfeed during Sutent treatment or for at least 4 weeks after your last dose. If you’re breastfeeding or planning to, talk with your doctor before starting Sutent. They can talk with you about treatment options and ways to feed your child.
• Pregnancy: Sutent is likely not safe to take while pregnant. Animal studies show that the drug may cause congenital anomalies (commonly known as birth defects). However, it’s important to note that animal studies don’t always indicate what may happen in humans. If you’re pregnant or planning to become pregnant, tell your doctor before starting Sutent. They can advise you on the right treatment plan.
• Risk of liver damage: Sutent has a boxed warning about the risk of liver damage. This is the most serious warning from the FDA. A boxed warning alerts doctors and patients about drug effects that may be dangerous. For details, see “Boxed warning” at the top of this article.

You can take certain steps to help prevent interactions with Sutent. 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 Sutent 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 Sutent doesn’t 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 Sutent 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.