Tagrisso interactions: Alcohol, medications, and other factors

Tagrisso 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 Tagrisso.

Tagrisso interactions with supplements

Before you start treatment with Tagrisso, tell your doctor and pharmacist about any 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.

Tagrisso interactions with herbs

Doctors will typically recommend you avoid taking St. John’s wort with Tagrisso. 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 Tagrisso.

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

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

Tagrisso and vitamins

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

Tagrisso and food

There were no reports of food interactions with Tagrisso. There are no foods to avoid while you’re taking Tagrisso. If you’d like to learn more about eating certain foods during treatment with Tagrisso, talk with your doctor.

Tagrisso and vaccines

There aren’t any known interactions between Tagrisso and vaccines. Talk with your doctor or pharmacist to see whether you’re due for any vaccines.

Tagrisso and lab tests

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

TAGRISSO INTERACTION WITH CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Tagrisso. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Tagrisso. The impact of cannabis may affect how well you stick to your Tagrisso treatment plan.

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

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

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

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

• nausea
• vomiting
• headache
• dizziness
• diarrhea

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

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

Certain antibiotics

Tagrisso can interact with certain antibiotics, which are drugs used to treat bacterial infections.

Interaction result: Taking certain antibiotics with Tagrisso can raise your risk of long QT syndrome (a type of abnormal heart rhythm). Long QT syndrome can cause life threatening irregular heartbeats.

Interaction explained: Tagrisso can cause long QT syndrome. Certain antibiotics can also cause this side effect. So taking Tagrisso and these antibiotics together can raise your risk of this side effect.

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

• azithromycin (Zithromax)
• clarithromycin
• erythromycin (Erytab, others)
• metronidazole (Flagyl)
• moxifloxacin (Avelox)

Steps you or your doctor may take: Your doctor will usually avoid prescribing antibiotics that can cause long QT syndrome with Tagrisso. But in some situations, they may need to prescribe these antibiotics.

If you need to take one of these antibiotics with Tagrisso, your doctor will likely monitor you more closely. For example, they may order blood tests to check your electrolyte levels. (Having electrolyte imbalances, such as low potassium or magnesium levels, can further increase your risk of long QT syndrome.) Your doctor may also order electrocardiograms (ECGs) to monitor your heart rhythm.

If you have symptoms of long QT syndrome while taking Tagrisso with one of these antibiotics, tell your doctor right away. These symptoms can include heart palpitations, noisy gasping when sleeping, dizziness, and fainting.

If you have questions about taking Tagrisso and antibiotics, talk with your doctor.

Certain seizure medications

Tagrisso can interact with certain seizure medications, which are used to treat seizure disorders such as epilepsy. Some of these drugs also have other uses, for example in treating bipolar disorder.

Interaction result: Taking Tagrisso with certain seizure medications can make Tagrisso less effective at treating lung cancer.

Interaction explained: Certain seizure medications can speed up the action of an enzyme (type of protein) in your body called cytochrome p450 3A4 (CYP3A4). This enzyme helps clear Tagrisso from your body. By speeding up CYP3A4, these seizure medications lower the level of Tagrisso in your body. This can make Tagrisso less effective.

Examples of seizure medications: Here are some seizure medications that may interact with Tagrisso:

• carbamazepine (Tegretol, others)
• phenobarbital
• phenytoin (Dilantin)

Steps you or your doctor may take: Your doctor will usually avoid prescribing Tagrisso with these seizure medications. But in some situations, they may need to prescribe these drugs together.

If your doctor prescribes Tagrisso with one of these seizure medications, they may prescribe a Tagrisso dosage that’s higher than usual.

If you have questions about taking Tagrisso with a seizure medication, talk with your doctor.

Loperamide (Imodium)

Tagrisso can interact with loperamide (Imodium), which is a drug used to treat diarrhea. You can buy loperamide over the counter without a prescription.

Interaction result: Taking loperamide with Tagrisso can raise your risk of loperamide side effects, including long QT syndrome (a type of abnormal heart rhythm). Long QT syndrome can cause life threatening irregular heartbeats.

Interaction explained: Tagrisso can reduce the action of a protein in your body called P-glycoprotein (P-gp). P-gp helps clear loperamide from your body. By reducing the action of P-gp, Tagrisso can cause loperamide to build up in your body.

Having a high level of loperamide in your body can raise your risk of side effects from loperamide, such as long QT syndrome. Tagrisso can also cause this side effect. So taking Tagrisso and loperamide together can raise your risk of this side effect.

Steps you or your doctor may take: While taking Tagrisso, you should talk with your doctor before taking loperamide to treat diarrhea.

If your doctor recommends taking loperamide with Tagrisso, they may also recommend taking a rehydration solution such as Pedialyte. Rehydration solutions contain electrolytes, such as sodium and potassium, which your body can lose with diarrhea. Having low electrolyte levels can raise your risk of long QT syndrome.

Your doctor will likely monitor you more closely if you take loperamide with Tagrisso. For example, they may order blood tests to check your electrolyte levels. They may also order electrocardiograms (ECGs) to monitor your heart rhythm.

If you have questions about taking loperamide with Tagrisso, talk with your doctor or pharmacist.

Certain medical conditions and other factors may increase the risk of interactions with Tagrisso. Before you take this drug, be sure to talk with your doctor about your health history. Tagrisso 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 Tagrisso include:

• Heart problems: Tagrisso can cause and worsen heart failure and long QT syndrome (a type of abnormal heart rhythm). If you already have these or other heart problems, talk with your doctor about whether Tagrisso is safe for you. If you take Tagrisso, your doctor may order frequent tests to monitor your heart. Tell your doctor right away if symptoms of your heart problem worsen while taking Tagrisso.
• Electrolyte imbalance: If you have high or low levels of electrolytes such as potassium or magnesium in your blood, you may have a raised risk of long QT syndrome with Tagrisso. Your doctor will likely order blood tests to monitor your electrolyte levels during your Tagrisso treatment. If needed, they may prescribe medication to correct any imbalances.
• Lung or breathing problems: Tagrisso can cause lung inflammation or scarring. If you have lung or breathing problems, including those unrelated to lung cancer, such as asthma, Tagrisso could worsen your symptoms. Tell your doctor right away if your lung or breathing symptoms worsen while taking Tagrisso.
• Low blood cell counts: Tagrisso can lower your red blood cell, white blood cell, and platelet counts. If you already have low blood cell counts, your doctor will likely monitor your blood cells during Tagrisso treatment.
• Allergic reaction: If you’ve had an allergic reaction to Tagrisso or any of its ingredients, your doctor will likely not prescribe Tagrisso. 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 Tagrisso while breastfeeding. Due to the possible risk, you should not breastfeed while taking Tagrisso and for 2 weeks after your last dose. If you’re breastfeeding or planning to, talk with your doctor before using Tagrisso. They can talk with you about treatment options and ways to feed your child.
• Pregnancy: Tagrisso is not safe to take during pregnancy. If you’re pregnant or planning to become pregnant, talk with your doctor about your treatment options. If you are able to become pregnant, you should use birth control while taking Tagrisso and for 6 weeks after your last dose. If you are male* and your sexual partner could become pregnant, you should use birth control while taking Tagrisso and for 4 months after your last dose.

* Sex and gender exist on spectrums. Use of the term “male” in this article refers to sex assigned at birth.

Here are some frequently asked questions about Tagrisso and possible interactions.

Is there an interaction between Tagrisso and dexamethasone?

No, there’s no direct interaction between Tagrisso and dexamethasone.

Tagrisso is used to treat certain types of lung cancer. Dexamethasone is used to treat inflammation in various parts of your body. It’s not uncommon for doctors to prescribe dexamethasone with Tagrisso.

However, dexamethasone can sometimes cause low potassium levels. And low potassium levels can raise the risk of long QT syndrome (a type of abnormal heart rhythm), which is a possible side effect of Tagrisso.

If your doctor prescribes Tagrisso and dexamethasone together, they may order blood tests to monitor your potassium levels.

Talk with your doctor if you have questions about taking Tagrisso with dexamethasone.

Can I take pain relievers with Tagrisso?

Yes, you can usually take pain relievers such as acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) with Tagrisso. There’s no known interaction between Tagrisso and pain relievers. However, Tagrisso can cause low blood platelet levels, which may increase your risk of side effects with ibuprofen, such as easy bruising or bleeding.

If you have questions about taking pain relievers with Tagrisso, talk with your doctor or pharmacist.

You can take certain steps to help prevent interactions with Tagrisso. 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 Tagrisso 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 Tagrisso 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 Tagrisso 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.