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Drug Interactions With Sunitinib
Grapefruit juice, echinacea, silodosin, and other products may cause reactions with sunitinib. Drug interactions with this chemotherapy medication can lead to serious side effects, such as bleeding, high blood pressure, and anemia. Some interactions can also alter the effectiveness of your medications. To reduce your risk, let your healthcare provider know about any other medications, vitamins, or supplements you are taking before beginning treatment with sunitinib.
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Sunitinib (SUTENT®) can potentially react with a number of other medications. Some of the drugs that may react with sunitinib include but are not limited to:
- Bevacizumab (Avastin®)
- CYP 3A4 inducer medications, such as:
- Aminoglutethimide (Cytadren®)
- Bosentan (Tracleer®)
- Carbamazepine (Carbatrol®, Epitol®, Equetro®, Tegretol®)
- Dexamethasone (Decadron®, Dexpak®, Maxidex®)
- Efavirenz (Sustiva®)
- Efavirenz, emtricitabine, and tenofovir (Atripla®)
- Etravirine (Intelence™)
- Fosphenytoin (Cerebyx®)
- Nafcillin
- Nevirapine (Viramune®)
- Oxcarbazepine (Trileptal®)
- Pentobarbital (Nembutal®)
- Phenobarbital (Luminal®)
- Phenytoin (Dilantin®, Phenytek®)
- Primidone (Mysoline®)
- Rifabutin (Mycobutin®)
- Rifampin (Rifadin®)
- Rifapentine (Priftin®)
- St. John's wort
- CYP 3A4 inhibitor medications, such as:
- Amprenavir (Agenerase®)
- Atazanavir (Reyataz®)
- Clarithromycin (Biaxin®)
- Conivaptan (Vaprisol®)
- Crizotinib (Xalkori®)
- Darunavir (Prezista®)
- Delavirdine (Rescriptor®)
- Erythromycin
- Fluconazole (Diflucan®)
- Fosamprenavir (Lexiva®)
- Imatinib (Gleevec®)
- Indinavir (Crixivan®)
- Isoniazid
- Itraconazole (Sporanox®)
- Ketoconazole (Nizoral®)
- Lopinavir and ritonavir (Kaletra®)
- Miconazole
- Nefazodone (Serzone®)
- Nelfinavir (Viracept®)
- Nicardipine (Cardene®)
- Posaconazole (Noxafil®)
- Quinidine
- Ritonavir (Norvir®)
- Saquinavir (Fortovase®, Invirase®)
- Telaprevir (INCIVEK™)
- Telithromycin (Ketek®)
- Voriconazole (VFEND®)
- Dabigatran (Pradaxa®)
- Denosumab (Prolia®)
- Echinacea
- Everolimus (Afinitor®, Zortress®)
- Grapefruit or grapefruit juice
- Leflunomide (Arava®)
- "Live" vaccinations, such as:
- Chickenpox vaccine (varicella vaccine)
- FluMist® (the nasal vaccine for influenza; the injected vaccine is not live)
- MMR vaccine (measles, mumps, rubella vaccine)
- Polio vaccine
- Rotavirus vaccine
- Smallpox vaccine
- Yellow fever vaccine
- BCG vaccine (used in some countries for tuberculosis)
- Medications that cause a certain change in the heart rhythm known as QT prolongation (see QT-Prolonging Medications for a list of such drugs)
- Natalizumab (Tysabri®)
- Pimecrolimus (Elidel®)
- Silodosin (Rapaflo®)
- Sipuleucel-T (PROVENGE®)
- Tacrolimus ointment (Protopic®)
- Temsirolimus (TORISEL®)
- Topotecan (Hycamtin®)
- Trastuzumab (Herceptin®).
Written by/reviewed by: Susan Lakey, PharmD, MPH, BCPP
Last reviewed by: Kristi Monson, PharmD