Key takeaways
- Brukinsa may interact with medications like warfarin, certain antibiotics, antifungals, and calcium channel blockers, possibly increasing side effects or reducing the effectiveness of other drugs. Inform your doctor of all medications you take before starting Brukinsa.
- While there are no known direct interactions between Brukinsa and alcohol, drinking alcohol while taking Brukinsa may worsen some of the drug’s side effects, such as headache or diarrhea.
- Health conditions like infections, liver problems, heart rhythm issues, and bleeding problems may increase the risk of interactions with Brukinsa. Discuss your health history with your doctor before starting treatment.
Brukinsa has possible interactions with some other drugs and certain supplements. Examples include warfarin (Jantoven) and ciprofloxacin (Cipro). Talk with your doctor to avoid potentially harmful effects from Brukinsa interactions.
Brukinsa is available as an oral capsule. It’s prescribed for the following conditions in adults in certain situations:
An interaction occurs when one substance causes another substance to have a different effect than expected.
By learning about possible Brukinsa interactions, you can work with your doctor to ensure that Brukinsa will be safe and effective for you to take. For additional information about Brukinsa, including details about its uses, see this Brukinsa overview article.
Before you start treatment with Brukinsa, 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 Brukinsa interacts with supplements, herbs, or vitamins, see the “Brukinsa 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 Brukinsa. Keep in mind that this table doesn’t include all drugs that may interact with Brukinsa. Some of these interactions are described in detail in “Drug interactions in depth.”
| Drug class or drug name | Drug examples | Interaction result with Brukinsa |
|---|---|---|
| warfarin (Jantoven) | — | can make warfarin less effective |
| mavacamten (Camzyos) | — | can make Brukinsa less effective |
| nefazodone | — | can increase the risk of side effects of Brukinsa |
| certain antiarrhythmics | • amiodarone (Nexterone, Pacerone) • dronedarone (Multaq) | can increase the risk of side effects of Brukinsa |
| certain antifungals | • fluconazole (Diflucan) • itraconazole (Sporanox, Tolsura) • ketoconazole | can increase the risk of side effects of Brukinsa |
| certain seizure drugs | • carbamazepine (Epitol, Tegretol, others) • phenytoin (Dilantin, Phenytek) • phenobarbital (Sezaby) | can make Brukinsa less effective |
| certain antibiotics | • ciprofloxacin (Cipro) • clarithromycin • erythromycin (Eryc, Ery-Tab, others) | can increase the risk of side effects of Brukinsa |
| certain immunosuppressants | • cyclosporine (Gengraf, Neoral, others) • sirolimus (Fyarro, Rapamune, others) • tacrolimus (Astagraf XL, Prograf, others) | can increase the risk of side effects of Brukinsa or make certain immunosuppressants less effective |
| certain calcium channel blockers | • diltiazem (Cardizem, Tiazac, others) • verapamil (Verelan, Verelan PM) | can increase the risk of side effects of Brukinsa |
| certain other cancer drugs | • adagrasib (Krazati) • nilotinib (Danziten, Tasigna) • ribociclib (Kisqali) | can increase the risk of side effects of Brukinsa |
Some medications, such as antibiotics and antifungals, can increase Brukinsa levels, leading to increased side effects. Your doctor may need to lower your dose if you take these medications. Stronger medications, such as ketoconazole, require a larger dose reduction than moderate ones, such as diltiazem. Always talk with your doctor before starting a new medication.
There are no known interactions between Brukinsa and alcohol. However, drinking alcohol while taking the drug may worsen some of Brukinsa’s side effects. For example, you may have worsened headache or diarrhea.
If you have questions about drinking alcohol while taking Brukinsa, talk with your doctor.
Here’s a closer look at certain drug interactions of Brukinsa.
Warfarin
Warfarin (Jantoven) is prescribed to treat and help prevent blood clots.
Taking Brukinsa during warfarin treatment may make warfarin less effective. So, you may be at a higher risk of blood clots.
Brukinsa does not change how your body processes warfarin, but it may increase your risk of bleeding if you take the two drugs together. Your doctor may need to monitor you more closely or adjust your warfarin dosage.
Steps you or your doctor may take
Before starting Brukinsa treatment, tell your doctor if you’re taking warfarin. They can advise you on whether it’s safe to take these medications together.
If you’re prescribed warfarin with Brukinsa, your doctor may recommend certain blood tests to check the effects of warfarin. They may use these blood test results to adjust your warfarin dosage and help the drug to be more effective.
To learn more about Brukinsa and warfarin, talk with your doctor or pharmacist.
Certain antibiotics
Antibiotics are prescribed to treat bacterial infections.
Taking Brukinsa with certain antibiotics may increase the risk of side effects from Brukinsa.
This is because certain antibiotics could slow the breakdown of Brukinsa in your body. As a result, taking these drugs together could raise the level of Brukinsa in your system and increase your risk of side effects.
Here are some antibiotics that may interact with Brukinsa:
- ciprofloxacin (Cipro)
- clarithromycin
- erythromycin (Eryc, Ery-Tab, others)
Steps you or your doctor may take
If you need an antibiotic during Brukinsa treatment, be sure the doctor prescribing it knows that you’re taking Brukinsa. They’ll advise you on whether the specific antibiotic you need can be taken with Brukinsa. Your doctor can recommend which antibiotic may be best for your infection.
In some cases, your doctor may prescribe an antibiotic that interacts with Brukinsa. If so, they may temporarily lower your Brukinsa dosage while you’re taking the antibiotic. Doing so can help reduce your risk of side effects.
To learn more about Brukinsa and antibiotics, talk with your doctor or pharmacist.
Certain calcium channel blockers
Calcium channel blockers (CCBs) are prescribed for high blood pressure and other heart-related problems.
Taking Brukinsa with certain CCBs may increase the risk of side effects from Brukinsa.
This is because certain CCBs could slow the breakdown of Brukinsa and raise the level of the drug in your system. Having a high level of Brukinsa in your body could increase your risk of side effects.
CCBs that may interact with Brukinsa include diltiazem (Cardizem, Tiazac, others) and verapamil (Verelan, Verelan PM).
Steps you or your doctor may take
Before starting Brukinsa treatment, tell your doctor if you’re taking a CCB. They can advise you on whether it’s safe to take Brukinsa with the CCB you’re prescribed.
If your doctor prescribes Brukinsa with a CCB that it interacts with, they may give you a lower Brukinsa dosage than is typical. Doing so can help reduce your risk of side effects from the drug.
To learn more about Brukinsa and CCBs, talk with your doctor or pharmacist.
Brukinsa may have other interactions, such as with supplements, foods, vaccines, or lab tests.
Here are some potential interactions with Brukinsa. Keep in mind that the following information does not include all possible Brukinsa interactions.
Brukinsa interactions with supplements
Before you start treatment with Brukinsa, 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.
Brukinsa interactions with herbs
Doctors will typically recommend avoiding St. John’s wort while taking Brukinsa. St. John’s wort is an herbal supplement used to treat depression and other conditions.
St. John’s wort may speed up the activity of an enzyme (protein) in your body that helps break down Brukinsa. Taking them together may lead to a low level of Brukinsa in your system. If the level of Brukinsa in your system is too low, the drug may not work to treat your condition.
Your doctor can suggest treatment options other than St. John’s wort.
Brukinsa and vitamins
There are no specific reports of vitamins interacting with Brukinsa. 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 Brukinsa.
Brukinsa interactions with food
Brukinsa may interact with grapefruit products.
This is because grapefruit or grapefruit juice may slow the activity of an enzyme in your body that helps break down Brukinsa. This may lead to a high level of Brukinsa in your system, increasing your risk of side effects.
Due to this risk, your doctor may recommend avoiding grapefruit and grapefruit juice while taking Brukinsa.
Brukinsa and vaccines
Brukinsa’s prescribing information doesn’t include any interactions with vaccines.
However, Brukinsa may lower the activity of your immune system. Certain vaccines rely on your immune system to be effective. For this reason, vaccines may not work as well if you receive them during Brukinsa treatment.
To learn more about this, talk with your doctor or pharmacist. They can check whether you’re due for any vaccines and recommend when it’s safe to receive them.
Brukinsa and lab tests
Brukinsa is not known to interact with lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.
BRUKINSA AND CANNABIS OR CBDCannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Brukinsa. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Brukinsa. The impact of cannabis may affect how well you stick to your Brukinsa 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 Brukinsa. Before you take this drug, be sure to talk with your doctor about your health history. Brukinsa 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 Brukinsa include:
- Infection: Before starting Brukinsa treatment, tell your doctor if you have an infection. Also tell them about past infections you’ve had, including hepatitis B. Taking Brukinsa may worsen infections or activate symptoms of certain infections you’ve had in the past. Your doctor may treat your infection and can recommend when it’s safe to start Brukinsa treatment.
- Liver problems: Before taking Brukinsa, tell your doctor if you have a liver problem, such as liver failure. They may prescribe a lower Brukinsa dosage than is typical. Brukinsa may also cause liver damage as a side effect, which could worsen your liver problem. Your doctor can recommend whether Brukinsa is a safe treatment option.
- Heart rhythm problems or related factors: Treatment with Brukinsa may increase the risk of heart rhythm problems. This risk may be greater in people with certain risk factors, including high blood pressure or infection. Your doctor can tell you whether Brukinsa is a safe treatment option for you.
- Bleeding problems: Before taking Brukinsa, tell your doctor if you have a bleeding problem. Brukinsa may also cause bleeding as a side effect, which could worsen your condition. Your doctor can recommend whether Brukinsa is a safe treatment option.
- Planned surgery: Before having surgery, be sure the surgeon knows that you’re taking Brukinsa. This drug may increase the risk of bleeding with surgery. For this reason, your doctor may advise you to stop taking Brukinsa for 3 to 7 days before and after surgery. Your doctor can tell you more about temporarily stopping Brukinsa during this time.
- Allergic reaction: If you’ve had an allergic reaction to Brukinsa or any of its ingredients, your doctor will likely not prescribe Brukinsa. 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 take Brukinsa while breastfeeding. There is not enough information to determine whether the drug passes into breast milk or what effects Brukinsa may have on a child who is breastfed. To be safe, your doctor may advise you not to breastfeed during Brukinsa treatment or for at least 2 weeks after your final dose. If you’re breastfeeding or planning to, talk with your doctor before taking Brukinsa. They can talk with you about treatment options and ways to feed a child other than breastfeeding.
- Pregnancy: There have not been enough clinical trials to determine whether Brukinsa is safe to take while pregnant. Animal studies show that the drug may cause congenital anomalies (commonly known as birth defects). However, 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 Brukinsa. They can advise you on the right treatment plan for you.
You can take certain steps to help prevent interactions with Brukinsa. Your doctor and pharmacist are key resources, so reaching out to them before starting treatment is a helpful first step. For example, it’s important that you 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 Brukinsa label and other
If Brukinsa 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 Brukinsa 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.