Rydapt (midostaurin) is a brand-name oral capsule prescribed for certain forms of leukemia and mastocytosis. Rydapt has interactions with some other drugs and certain supplements. Examples include itraconazole (Sporanox, Tolsura) and St. John’s wort.
Rydapt is prescribed for certain forms of the following conditions in adults:
- mast cell leukemia
- systemic mastocytosis that’s aggressive or associated with blood cancer
- a specific type of acute myeloid leukemia
An interaction occurs when one substance causes another substance to have a different effect than expected.
To learn more about Rydapt’s interactions, keep reading. For additional information, including details about its uses, see this article on Rydapt.
Before you start treatment with Rydapt, 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 Rydapt interacts with supplements, herbs, or vitamins, see the “Rydapt and other interactions” section.)
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 Rydapt. Keep in mind that this table doesn’t include all drugs that may interact with Rydapt. Some of these interactions are described in detail in “Drug interactions in depth.”
| Drug class or drug name | Drug examples | Interaction result with Rydapt |
| certain antibiotics | • azithromycin (Zithromax) • ciprofloxacin (Cipro) • clarithromycin • erythromycin (Ery-Tab, others) | can increase the risk of side effects of Rydapt and certain antibiotics |
| certain other antibiotics | • rifampin (Rifadin, Rimactane) • rifapentine (Priftin) | can make Rydapt less effective |
| certain antifungals | • fluconazole (Diflucan) • itraconazole (Sporanox) • ketoconazole • voriconazole (Vfend) | can increase the risk of side effects of Rydapt and certain antifungals |
| certain HIV medications | • atazanavir (Reyataz) • cobicistat (Tybost) • nelfinavir (Viracept) • ritonavir (Norvir) | can increase the risk of side effects of Rydapt |
| certain seizure medications | • carbamazepine (Tegretol, others) • phenytoin (Dilantin) • primidone (Mysoline) | can make Rydapt less effective |
| antiarrhythmics | • amiodarone (Pacerone) • dofetilide (Tikosyn) • disopyramide (Norpace) | may increase the risk of irregular heart rhythm |
| certain antipsychotics | • chlorpromazine • quetiapine (Seroquel) • risperidone (Risperdal) | may increase the risk of irregular heart rhythm |
| certain antidepressants | • bupropion (Wellbutrin, others) • clomipramine (Anafranil) • escitalopram (Lexapro) • nefazodone | can increase the risk of side effects of Rydapt or make certain antidepressants less effective |
| certain statins | • atorvastatin (Lipitor) • rosuvastatin (Crestor) • simvastatin (Zocor) | can increase the risk of side effects of certain statins |
| certain migraine medications | • atogepant (Qulipta) • ubrogepant (Ubrelvy) | can increase the risk of side effects of certain migraine drugs |
In some cases, factors or conditions could prevent your doctor from prescribing Rydapt due to the risk of harm. These are known as contraindications. Allergic reaction is the only contraindication of Rydapt.
If you have had an allergic reaction to Rydapt or any of its ingredients, your doctor will likely not prescribe Rydapt. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
Note: Before you start treatment with Rydapt, it’s important to tell your doctor if this contraindication applies to you. They can determine whether to prescribe Rydapt.
There aren’t any known interactions between Rydapt and alcohol. However, your doctor may advise you to avoid or limit alcohol consumption during Rydapt treatment.
This is because drinking alcohol while taking the drug may worsen some Rydapt side effects. For example, you may experience:
- nausea and vomiting
- headache
- diarrhea
- fatigue
- dizziness
If you consume alcohol during Rydapt treatment, these side effects may be more likely to occur. If you have questions about drinking alcohol while taking Rydapt, talk with your doctor.
Here’s a closer look at certain drug interactions of Rydapt.
Certain antibiotics
Antibiotics are used to treat infections caused by bacteria. Doctors commonly prescribe antibiotics for bacterial infections in people taking Rydapt.
Interaction result: Taking certain antibiotics with Rydapt can raise your risk of side effects from Rydapt. Examples include digestive side effects, lung problems, and QT prolongation (a type of abnormal heart rhythm). And taking Rydapt with certain other antibiotics can increase your risk of some antibiotic side effects.
Interaction explained: Some antibiotics slow the action of an enzyme (a type of protein) in your body called cytochrome p450 3A4 (CYP3A4). This enzyme helps break down Rydapt. Taking one of these antibiotics with Rydapt can make Rydapt build up in your body. This can raise your risk of Rydapt side effects.
Some other antibiotics can cause QT prolongation as a side effect. Taking one of these antibiotics with Rydapt can raise your risk of QT prolongation. Having electrolyte disturbances, such as low potassium levels, can further raise your risk of this side effect.
Examples of antibiotic drugs: Here are some antibiotics that may interact with Rydapt:
- azithromycin (Zithromax)
- ciprofloxacin (Cipro)
- clarithromycin
- erythromycin (Ery-Tab, others)
- levofloxacin
Steps you or your doctor may take: If you have a bacterial infection while taking Rydapt, your doctor will usually avoid treating it with antibiotics that can interact with Rydapt. Instead, they’ll likely prescribe an antibiotic that’s safer to take with this medication.
If your doctor prescribes one of the antibiotics listed above with Rydapt, they may monitor you more closely. For example, they may order blood tests to check your electrolyte levels or an electrocardiogram (ECG) to monitor your heart rhythm.
If you take Rydapt with one of these antibiotics, tell your doctor right away if you have new or worse Rydapt side effects. These may include:
- digestive side effects, such as nausea, vomiting, or diarrhea
- cough or shortness of breath
- heart palpitations
- dizziness or fainting
If you have questions about taking antibiotics with Rydapt, talk with your doctor or pharmacist.
Certain antidepressants
Antidepressants are used to treat mental health conditions such as depression and anxiety. It’s not uncommon for doctors to prescribe Rydapt with antidepressants.
Interaction result: Taking Rydapt with certain antidepressants can raise your risk of side effects from Rydapt. Taking Rydapt with certain other antidepressants can make the antidepressant less effective.
Interaction explained: Some antidepressants, such as nefazodone, slow the action of the enzyme CYP3A4. This enzyme helps break down Rydapt, so slowing it down can make Rydapt build up in your body. Having higher levels of Rydapt in your body can raise your risk of side effects.
Some other antidepressants (such as citalopram, escitalopram, and clomipramine) can cause QT prolongation as a side effect. Taking Rydapt with one of these antidepressants can raise your risk of QT prolongation. Having electrolyte disturbances, such as low potassium levels, can further raise your risk of this side effect.
As well, Rydapt can speed up the action of an enzyme in your body that helps break down certain antidepressants, such as bupropion. Taking Rydapt with one of these antidepressants can lower the amount of the antidepressant in your body. This can make the antidepressant less effective.
Examples of antidepressant drugs: Here are some antidepressants that may interact with Rydapt:
- bupropion (Wellbutrin, others)
- citalopram (Celexa)
- clomipramine (Anafranil)
- escitalopram (Lexapro)
- nefazodone
Steps you or your doctor may take: Your doctor will usually avoid prescribing Rydapt with antidepressants that can interact with Rydapt. If you take one of these antidepressants, your doctor may recommend switching to a different antidepressant that’s safer to take with Rydapt.
If your doctor prescribes Rydapt with one of the antidepressants listed above, they may monitor you more closely. For example, they may check your electrolyte levels or order ECGs to monitor your heart rhythm.
If you take Rydapt with one of these antidepressants, tell your doctor right away if you have new or worse Rydapt side effects.
If you take Rydapt with bupropion, your doctor will likely monitor you to make sure the antidepressant is still effective. Tell your doctor if you think your bupropion isn’t working as well as usual. If needed, your doctor may increase your dosage of bupropion.
If you have questions about taking Rydapt with antidepressants, talk with your doctor or pharmacist.
Certain statins
Statins are used to lower high cholesterol and reduce the risk of certain heart problems. It’s not uncommon for doctors to prescribe Rydapt with a statin.
Interaction result: Taking Rydapt with a statin can increase the risk of side effects from the statin. Examples include muscle pain and weakness.
Interaction explained: Rydapt blocks the action of certain transport proteins that help clear certain statins from your body. By blocking these proteins, Rydapt can make these statins build up in your body. This can raise your risk of side effects from the statin.
Examples of statin drugs: Here are some statins that may interact with Rydapt:
Steps you or your doctor may take: If your doctor prescribes Rydapt with a statin, they’ll likely monitor you more closely for side effects. Tell your doctor if you have any new or worse side effects from your statin. Examples can include headache, dizziness, and muscle pain or weakness. If needed, your doctor may lower your dosage of the statin.
If you have questions about taking Rydapt with a statin, talk with your doctor or pharmacist.
Rydapt 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 Rydapt.
Rydapt interactions with supplements
Before you start treatment with Rydapt, 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.
Rydapt interactions with herbs
Doctors will typically recommend you avoid taking St. John’s wort with Rydapt. 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 CYP3A4. This enzyme helps break down Rydapt.
By speeding up this enzyme, St. John’s wort can cause Rydapt to break down more quickly. And this may lead to a low level of Rydapt in your system. If the level of Rydapt in your system is too low, the drug may not work to treat your condition.
Your doctor may be able to suggest a treatment option other than St. John’s wort.
Rydapt and vitamins
There are no specific reports of vitamins interacting with Rydapt. 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 Rydapt.
Rydapt interactions with food
Grapefruit and grapefruit juice can interact with Rydapt. Specifically, grapefruit products can stop your body from breaking down Rydapt. This raises the level of Rydapt in your body, which increases your risk of side effects from Rydapt. Due to this risk, your doctor may recommend not consuming grapefruit and grapefruit juice while taking the drug.
If you have questions about consuming other foods with Rydapt, talk with your doctor or pharmacist.
Rydapt interactions with vaccines
Rydapt may interact with live vaccines. A live vaccine contains live but weakened pieces of the virus or bacterium it’s meant to defend against. When your immune system is healthy, live vaccines usually won’t cause infection.
But Rydapt can lower your white blood cell count, which can weaken your immune system. So if you get a live vaccine, your immune system may not be able to fight the virus or bacterium. This may cause you to become sick or develop symptoms of the illness the vaccine is meant to prevent.
Examples of live vaccines to avoid during Rydapt treatment include:
- measles, mumps, rubella (MMR)
- chickenpox
- flu vaccine (nasal spray form)
Before starting Rydapt, talk with your doctor or pharmacist about any vaccines you may need.
Rydapt and lab tests
Rydapt isn’t known to interact with any lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.
RYDAPT INTERACTION WITH CANNABIS OR CBDCannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Rydapt. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Rydapt. The impact of cannabis may affect how well you stick to your Rydapt 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 Rydapt. Before you take this drug, be sure to talk with your doctor about your health history. Rydapt 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 Rydapt include:
- Low white blood cell count: Rydapt can lower your white blood cell count, which can raise your risk of infections. Your doctor will likely monitor your white blood cell level during Rydapt treatment. If you have a low white blood cell count, your doctor may pause your Rydapt treatment.
- Lung conditions: Inflammation in your lungs is a possible side effect of Rydapt. If you have a lung condition such as asthma, this side effect could worsen your symptoms. Talk with your doctor about whether Rydapt is right for you.
- Heart conditions: Rydapt may cause QT prolongation (a type of abnormal heart rhythm). If you have certain heart conditions, this side effect could raise your risk of dangerous abnormal heartbeats. Talk with your doctor about whether Rydapt is right for you.
- Electrolyte disturbances: If you have electrolyte disturbances, such as low potassium levels, QT prolongation could raise your risk of dangerous abnormal heartbeats. Your doctor will likely monitor your electrolyte levels during Rydapt treatment. If needed, they may prescribe medication to correct any disturbances.
- Allergic reaction: If you’ve had an allergic reaction to Rydapt or any of its ingredients, your doctor will likely not prescribe Rydapt. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
- Breastfeeding: Your doctor will likely recommend that you do not breastfeed while taking Rydapt and for 4 months after stopping Rydapt. There isn’t enough information to determine whether the drug passes into breast milk. However, if it does, it could cause serious side effects in a child who is breastfed. If you’re breastfeeding or planning to, talk with your doctor before using Rydapt. They can talk with you about treatment options and ways to feed a child who is breastfed.
- Pregnancy: Rydapt may cause fetal harm if used during pregnancy. If you’re pregnant or planning to become pregnant, tell your doctor before starting Rydapt. They can advise you on the right treatment plan for you. If you’re able to become pregnant, you should use birth control during Rydapt treatment and for 4 months after stopping Rydapt. If you’re male* and have a sexual partner who’s able to become pregnant, you should use birth control during Rydapt treatment and for 4 months after stopping Rydapt.
* Note: Sex and gender exist on spectrums. Use of the term “male” in this article refers to sex assigned at birth.
You can take certain steps to help prevent interactions with Rydapt. 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 listTrusted Source , which your doctor and pharmacist can help you fill out.
It’s also important to read the Rydapt label and other
If Rydapt 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 Rydapt 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.
