Koselugo

Overview

selumetinib

kinase inhibitor

• CYP3A4 substrate
• antiplatelet/anticoagulant effects
• cardiotoxic effects
• rhabdomyolysis

• avoid supplemental vitamin E if daily vitamin E intake greater than recommended or safe limits; combo may incr. risk of bleeding; additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules

Avoid/Use Alternative

• adagrasib
Koselugo (selumetinib)

+

adagrasib

1 interaction

Avoid/Use Alternative

selumetinib + adagrasib

use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• apalutamide
Koselugo (selumetinib)

+

apalutamide

1 interaction

Avoid/Use Alternative

selumetinib + apalutamide

avoid combo: combo may decr. selumetinib levels, efficacy (hepatic metab. induced)

• aprepitant
Koselugo (selumetinib)

+

aprepitant

1 interaction

Avoid/Use Alternative

selumetinib + aprepitant

if aprepitant 3-day regimen, use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments; aprepitant single dose-regimen OK: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• atazanavir
Koselugo (selumetinib)

+

atazanavir

1 interaction

Avoid/Use Alternative

selumetinib + atazanavir

use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• avacopan
Koselugo (selumetinib)

+

avacopan

1 interaction

Avoid/Use Alternative

selumetinib + avacopan

use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• berotralstat
Koselugo (selumetinib)

+

berotralstat

1 interaction

Avoid/Use Alternative

selumetinib + berotralstat

use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• bosentan
Koselugo (selumetinib)

+

bosentan

1 interaction

Avoid/Use Alternative

selumetinib + bosentan

avoid combo: combo may decr. selumetinib levels, efficacy (hepatic metab. induced)

• butalbital
Koselugo (selumetinib)

+

butalbital

1 interaction

Avoid/Use Alternative

selumetinib + butalbital

avoid combo: combo may decr. selumetinib levels, efficacy (hepatic metab. induced)

• carbamazepine
Koselugo (selumetinib)

+

carbamazepine

1 interaction

Avoid/Use Alternative

selumetinib + carbamazepine

avoid combo: combo may decr. selumetinib levels, efficacy (hepatic metab. induced)

• cenobamate
Koselugo (selumetinib)

+

cenobamate

1 interaction

Avoid/Use Alternative

selumetinib + cenobamate

avoid combo: combo may decr. selumetinib levels, efficacy (hepatic metab. induced)

• ceritinib
Koselugo (selumetinib)

+

ceritinib

1 interaction

Avoid/Use Alternative

selumetinib + ceritinib

use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• chloramphenicol
Koselugo (selumetinib)

+

chloramphenicol

1 interaction

Avoid/Use Alternative

selumetinib + chloramphenicol

use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• ciprofloxacin
Koselugo (selumetinib)

+

ciprofloxacin

1 interaction

Avoid/Use Alternative

selumetinib + ciprofloxacin

use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• clarithromycin
Koselugo (selumetinib)

+

clarithromycin

1 interaction

Avoid/Use Alternative

selumetinib + clarithromycin

use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• clofazimine
Koselugo (selumetinib)

+

clofazimine

1 interaction

Avoid/Use Alternative

selumetinib + clofazimine

use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• cobicistat
Koselugo (selumetinib)

+

cobicistat

1 interaction

Avoid/Use Alternative

selumetinib + cobicistat

use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• colchicine
Koselugo (selumetinib)

+

colchicine

1 interaction

Avoid/Use Alternative

selumetinib + colchicine

use alternative or monitor CK, myotoxicity sx, especially during initiation/titration: combo may incr. risk of myopathy, rhabdomyolysis (additive effects)

• conivaptan
Koselugo (selumetinib)

+

conivaptan

1 interaction

Avoid/Use Alternative

selumetinib + conivaptan

use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• crizotinib
Koselugo (selumetinib)

+

crizotinib

1 interaction

Avoid/Use Alternative

selumetinib + crizotinib

use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• cyclosporine
Koselugo (selumetinib)

+

cyclosporine

1 interaction

Avoid/Use Alternative

selumetinib + cyclosporine

use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• dabrafenib
Koselugo (selumetinib)

+

dabrafenib

1 interaction

Avoid/Use Alternative

selumetinib + dabrafenib

avoid combo: combo may decr. selumetinib levels, efficacy; may incr. risk of cardiotoxicity (hepatic metab. induced; additive effects)

• danazol
Koselugo (selumetinib)

+

danazol

1 interaction

Avoid/Use Alternative

selumetinib + danazol

use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• darunavir
Koselugo (selumetinib)

+

darunavir

1 interaction

Avoid/Use Alternative

selumetinib + darunavir

use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• diltiazem
Koselugo (selumetinib)

+

diltiazem

1 interaction

Avoid/Use Alternative

selumetinib + diltiazem

use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• dronedarone
Koselugo (selumetinib)

+

dronedarone

1 interaction

Avoid/Use Alternative

selumetinib + dronedarone

use alternative or monitor cardiac fxn (incl. LVEF), CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited, additive effects)

• duvelisib
Koselugo (selumetinib)

+

duvelisib

1 interaction

Avoid/Use Alternative

selumetinib + duvelisib

use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• efavirenz
Koselugo (selumetinib)

+

efavirenz

1 interaction

Avoid/Use Alternative

selumetinib + efavirenz

avoid combo: combo may decr. selumetinib levels, efficacy (hepatic metab. induced)

• encorafenib
Koselugo (selumetinib)

+

encorafenib

1 interaction

Avoid/Use Alternative

selumetinib + encorafenib

avoid combo: combo may decr. selumetinib levels, efficacy; may incr. risk of cardiotoxicity, GI or other bleeding, incl. life-threatening (hepatic metab. induced; additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• enzalutamide
Koselugo (selumetinib)

+

enzalutamide

1 interaction

Avoid/Use Alternative

selumetinib + enzalutamide

avoid combo: combo may decr. selumetinib levels, efficacy (hepatic metab. induced)

• epirubicin
Koselugo (selumetinib)

+

epirubicin

1 interaction

Avoid/Use Alternative

selumetinib + epirubicin

use alternative or monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• erythromycin
Koselugo (selumetinib)

+

erythromycin

1 interaction

Avoid/Use Alternative

selumetinib + erythromycin

use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• etravirine
Koselugo (selumetinib)

+

etravirine

1 interaction

Avoid/Use Alternative

selumetinib + etravirine

avoid combo: combo may decr. selumetinib levels, efficacy (hepatic metab. induced)

• fedratinib
Koselugo (selumetinib)

+

fedratinib

1 interaction

Avoid/Use Alternative

selumetinib + fedratinib

use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• fexinidazole
Koselugo (selumetinib)

+

fexinidazole

1 interaction

Avoid/Use Alternative

selumetinib + fexinidazole

avoid combo: combo may decr. selumetinib levels, efficacy (hepatic metab. induced)

• fluconazole
Koselugo (selumetinib)

+

fluconazole

1 interaction

Avoid/Use Alternative

selumetinib + fluconazole

use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• fosamprenavir
Koselugo (selumetinib)

+

fosamprenavir

1 interaction

Avoid/Use Alternative

selumetinib + fosamprenavir

consider alternative: combo may incr. or decr. selumetinib levels, incr. risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects or decr. efficacy (hepatic metab. altered)

• fosphenytoin
Koselugo (selumetinib)

+

fosphenytoin

1 interaction

Avoid/Use Alternative

selumetinib + fosphenytoin

avoid combo: combo may decr. selumetinib levels, efficacy (hepatic metab. induced)

• ginkgo
Koselugo (selumetinib)

+

ginkgo

1 interaction

Avoid/Use Alternative

selumetinib + ginkgo

consider alternative: combo may incr. or decr. selumetinib levels, incr. risk of cardiotoxicity, myopathy, rhabdomyolysis, bleeding (incl. life-threatening) or decr. efficacy (hepatic metab. altered, additive effects)

• grapefruit
Koselugo (selumetinib)

+

grapefruit

1 interaction

Avoid/Use Alternative

selumetinib + grapefruit

avoid grapefruit juice: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (GI metab. inhibited)

• idarubicin
Koselugo (selumetinib)

+

idarubicin

1 interaction

Avoid/Use Alternative

selumetinib + idarubicin

use alternative at least 5 half-lives after selumetinib D/C; otherwise, monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• idelalisib
Koselugo (selumetinib)

+

idelalisib

1 interaction

Avoid/Use Alternative

selumetinib + idelalisib

use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• imatinib
Koselugo (selumetinib)

+

imatinib

1 interaction

Avoid/Use Alternative

selumetinib + imatinib

use alternative or monitor cardiac fxn (incl. LVEF), bleeding s/sx, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, GI or other bleeding, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited, additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• isavuconazonium
Koselugo (selumetinib)

+

isavuconazonium

1 interaction

Avoid/Use Alternative

selumetinib + isavuconazonium

use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• itraconazole
Koselugo (selumetinib)

+

itraconazole

1 interaction

Avoid/Use Alternative

selumetinib + itraconazole

use alternative or monitor cardiac fxn (incl. LVEF), CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited, additive effects)

• ivosidenib
Koselugo (selumetinib)

+

ivosidenib

1 interaction

Avoid/Use Alternative

selumetinib + ivosidenib

avoid combo: combo may decr. selumetinib levels, efficacy (hepatic metab. induced)

• ketoconazole
Koselugo (selumetinib)

+

ketoconazole

1 interaction

Avoid/Use Alternative

selumetinib + ketoconazole

use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• lefamulin
Koselugo (selumetinib)

+

lefamulin

1 interaction

Avoid/Use Alternative

selumetinib + lefamulin

ORAL LEFAMULIN: use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments; IV lefamulin use OK: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• lenacapavir
Koselugo (selumetinib)

+

lenacapavir

1 interaction

Avoid/Use Alternative

selumetinib + lenacapavir

during and x9mo after lenacapavir tx, use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• letermovir
Koselugo (selumetinib)

+

letermovir

1 interaction

Avoid/Use Alternative

selumetinib + letermovir

use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• levoketoconazole
Koselugo (selumetinib)

+

levoketoconazole

1 interaction

Avoid/Use Alternative

selumetinib + levoketoconazole

use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• lonafarnib
Koselugo (selumetinib)

+

lonafarnib

1 interaction

Avoid/Use Alternative

selumetinib + lonafarnib

use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• lopinavir/ritonavir
Koselugo (selumetinib)

+

lopinavir/ ritonavir

1 interaction

Avoid/Use Alternative

selumetinib + lopinavir/ ritonavir

avoid combo: combo may incr. or decr. selumetinib levels, incr. risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects or decr. efficacy (hepatic metab. altered)

• lorlatinib
Koselugo (selumetinib)

+

lorlatinib

1 interaction

Avoid/Use Alternative

selumetinib + lorlatinib

avoid combo: combo may decr. selumetinib levels, efficacy (hepatic metab. induced)

• lumacaftor/ivacaftor
Koselugo (selumetinib)

+

lumacaftor/ ivacaftor

1 interaction

Avoid/Use Alternative

selumetinib + lumacaftor/ ivacaftor

avoid combo: combo may decr. selumetinib levels, efficacy (hepatic metab. induced)

• mavacamten
Koselugo (selumetinib)

+

mavacamten

1 interaction

Avoid/Use Alternative

selumetinib + mavacamten

avoid combo: combo may decr. selumetinib levels, efficacy; may incr. risk of cardiotoxicity (hepatic metab. induced; additive effects)

• mifepristone
Koselugo (selumetinib)

+

mifepristone

1 interaction

Avoid/Use Alternative

selumetinib + mifepristone

use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• mitapivat
Koselugo (selumetinib)

+

mitapivat

1 interaction

Avoid/Use Alternative

selumetinib + mitapivat

avoid combo: combo may decr. selumetinib levels, efficacy (hepatic metab. induced)

• mitotane
Koselugo (selumetinib)

+

mitotane

1 interaction

Avoid/Use Alternative

selumetinib + mitotane

avoid combo: combo may decr. selumetinib levels, efficacy; may incr. risk of bleeding (hepatic metab. induced; additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• modafinil
Koselugo (selumetinib)

+

modafinil

1 interaction

Avoid/Use Alternative

selumetinib + modafinil

avoid combo: combo may decr. selumetinib levels, efficacy (hepatic metab. induced)

• nafcillin
Koselugo (selumetinib)

+

nafcillin

1 interaction

Avoid/Use Alternative

selumetinib + nafcillin

avoid combo: combo may decr. selumetinib levels, efficacy (hepatic metab. induced)

• nefazodone
Koselugo (selumetinib)

+

nefazodone

1 interaction

Avoid/Use Alternative

selumetinib + nefazodone

use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• nelfinavir
Koselugo (selumetinib)

+

nelfinavir

1 interaction

Avoid/Use Alternative

selumetinib + nelfinavir

use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• netupitant
Koselugo (selumetinib)

+

netupitant

1 interaction

Avoid/Use Alternative

selumetinib + netupitant

use alternative or monitor LVEF, CK, myopathy sx and decr. selumetinib dose as follows during and x1wk after (fos)netupitant tx: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• nilotinib
Koselugo (selumetinib)

+

nilotinib

1 interaction

Avoid/Use Alternative

selumetinib + nilotinib

use alternative or monitor LVEF, CK, myopathy sx, bleeding s/sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, GI or other bleeding (incl. life-threatening), other adverse effects (hepatic metab. inhibited, additive effects)

• nirogacestat
Koselugo (selumetinib)

+

nirogacestat

1 interaction

Avoid/Use Alternative

selumetinib + nirogacestat

use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• pacritinib
Koselugo (selumetinib)

+

pacritinib

1 interaction

Avoid/Use Alternative

selumetinib + pacritinib

avoid combo: combo may decr. selumetinib levels, efficacy; may incr. risk of bleeding, incl. life-threatening (hepatic metab. induced; additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• pentobarbital
Koselugo (selumetinib)

+

pentobarbital

1 interaction

Avoid/Use Alternative

selumetinib + pentobarbital

avoid combo: combo may decr. selumetinib levels, efficacy (hepatic metab. induced)

• pexidartinib
Koselugo (selumetinib)

+

pexidartinib

1 interaction

Avoid/Use Alternative

selumetinib + pexidartinib

avoid combo: combo may decr. selumetinib levels, efficacy (hepatic metab. induced)

• phenobarbital
Koselugo (selumetinib)

+

phenobarbital

1 interaction

Avoid/Use Alternative

selumetinib + phenobarbital

avoid combo: combo may decr. selumetinib levels, efficacy (hepatic metab. induced)

• phenytoin
Koselugo (selumetinib)

+

phenytoin

1 interaction

Avoid/Use Alternative

selumetinib + phenytoin

avoid combo: combo may decr. selumetinib levels, efficacy (hepatic metab. induced)

• posaconazole
Koselugo (selumetinib)

+

posaconazole

1 interaction

Avoid/Use Alternative

selumetinib + posaconazole

use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• primidone
Koselugo (selumetinib)

+

primidone

1 interaction

Avoid/Use Alternative

selumetinib + primidone

avoid combo: combo may decr. selumetinib levels, efficacy (hepatic metab. induced)

• red yeast rice
Koselugo (selumetinib)

+

red yeast rice

1 interaction

Avoid/Use Alternative

selumetinib + red yeast rice

use alternative or monitor CK, myopathy sx: combo may incr. risk of myopathy, rhabdomyolysis (additive effects, red yeast rice contains varying amounts of lovastatin)

• repotrectinib
Koselugo (selumetinib)

+

repotrectinib

1 interaction

Avoid/Use Alternative

selumetinib + repotrectinib

avoid combo: combo may decr. selumetinib levels, efficacy (hepatic metab. induced)

• ribociclib
Koselugo (selumetinib)

+

ribociclib

1 interaction

Avoid/Use Alternative

selumetinib + ribociclib

use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• rifabutin
Koselugo (selumetinib)

+

rifabutin

1 interaction

Avoid/Use Alternative

selumetinib + rifabutin

avoid combo: combo may decr. selumetinib levels, efficacy (hepatic metab. induced)

• rifampin
Koselugo (selumetinib)

+

rifampin

1 interaction

Avoid/Use Alternative

selumetinib + rifampin

avoid combo: combo may decr. selumetinib levels, efficacy (hepatic metab. induced)

• rifapentine
Koselugo (selumetinib)

+

rifapentine

1 interaction

Avoid/Use Alternative

selumetinib + rifapentine

avoid combo: combo may decr. selumetinib levels, efficacy (hepatic metab. induced)

• rilzabrutinib
Koselugo (selumetinib)

+

rilzabrutinib

1 interaction

Avoid/Use Alternative

selumetinib + rilzabrutinib

use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• ritonavir
Koselugo (selumetinib)

+

ritonavir

1 interaction

Avoid/Use Alternative

selumetinib + ritonavir

consider alternative: combo may incr. or decr. selumetinib levels, incr. risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects or decr. efficacy (hepatic metab. altered)

• sotorasib
Koselugo (selumetinib)

+

sotorasib

1 interaction

Avoid/Use Alternative

selumetinib + sotorasib

avoid combo: combo may decr. selumetinib levels, efficacy (hepatic metab. induced)

• St. John's wort
Koselugo (selumetinib)

+

St. John's wort

1 interaction

Avoid/Use Alternative

selumetinib + St. John's wort

avoid combo: combo may decr. selumetinib levels, efficacy (hepatic metab. induced)

• tipranavir
Koselugo (selumetinib)

+

tipranavir

1 interaction

Avoid/Use Alternative

selumetinib + tipranavir

use alternative or monitor LVEF, CK, myopathy sx, bleeding s/sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, bleeding (incl. life-threatening), other adverse effects (hepatic metab. inhibited; additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• tucatinib
Koselugo (selumetinib)

+

tucatinib

1 interaction

Avoid/Use Alternative

selumetinib + tucatinib

use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• verapamil
Koselugo (selumetinib)

+

verapamil

1 interaction

Avoid/Use Alternative

selumetinib + verapamil

use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• voriconazole
Koselugo (selumetinib)

+

voriconazole

1 interaction

Avoid/Use Alternative

selumetinib + voriconazole

use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

Monitor/Modify Tx

• acalabrutinib
Koselugo (selumetinib)

+

acalabrutinib

1 interaction

Monitor/Modify Tx

selumetinib + acalabrutinib

monitor bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• adalimumab
Koselugo (selumetinib)

+

adalimumab

1 interaction

Monitor/Modify Tx

selumetinib + adalimumab

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• ado-trastuzumab emtansine
Koselugo (selumetinib)

+

ado-trastuzumab emtansine

1 interaction

Monitor/Modify Tx

selumetinib + ado-trastuzumab emtansine

monitor bleeding s/sx, cardiac fxn, incl. LVEF: combo may incr. risk of GI or other bleeding (incl. life-threatening), cardiotoxicity (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• afatinib
Koselugo (selumetinib)

+

afatinib

1 interaction

Monitor/Modify Tx

selumetinib + afatinib

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• aldesleukin
Koselugo (selumetinib)

+

aldesleukin

1 interaction

Monitor/Modify Tx

selumetinib + aldesleukin

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• alogliptin
Koselugo (selumetinib)

+

alogliptin

1 interaction

Monitor/Modify Tx

selumetinib + alogliptin

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• alpha-tocopherol (vitamin E)
Koselugo (selumetinib)

+

alpha-tocopherol (vitamin E)

1 interaction

Monitor/Modify Tx

selumetinib + alpha-tocopherol (vitamin E)

monitor bleeding s/sx: combo may incr. risk of bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• alprazolam
Koselugo (selumetinib)

+

alprazolam

1 interaction

Monitor/Modify Tx

selumetinib + alprazolam

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• alteplase
Koselugo (selumetinib)

+

alteplase

1 interaction

Monitor/Modify Tx

selumetinib + alteplase

monitor bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• amiodarone
Koselugo (selumetinib)

+

amiodarone

1 interaction

Monitor/Modify Tx

selumetinib + amiodarone

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• amlodipine
Koselugo (selumetinib)

+

amlodipine

1 interaction

Monitor/Modify Tx

selumetinib + amlodipine

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• anacaulase topical
Koselugo (selumetinib)

+

anacaulase topical

1 interaction

Monitor/Modify Tx

selumetinib + anacaulase topical

monitor bleeding s/sx: combo may incr. risk of bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• anagrelide
Koselugo (selumetinib)

+

anagrelide

1 interaction

Monitor/Modify Tx

selumetinib + anagrelide

monitor cardiac fxn (incl. LVEF), bleeding s/sx: combo may incr. risk of cardiotoxicity, bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• antithrombin
Koselugo (selumetinib)

+

antithrombin

1 interaction

Monitor/Modify Tx

selumetinib + antithrombin

monitor bleeding s/sx: combo may incr. risk of bleeding, incl. severe (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• apixaban
Koselugo (selumetinib)

+

apixaban

1 interaction

Monitor/Modify Tx

selumetinib + apixaban

monitor bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• argatroban
Koselugo (selumetinib)

+

argatroban

1 interaction

Monitor/Modify Tx

selumetinib + argatroban

monitor bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• asciminib
Koselugo (selumetinib)

+

asciminib

1 interaction

Monitor/Modify Tx

selumetinib + asciminib

monitor CK, myopathy sx, cardiac fxn, incl. LVEF: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited, additive effects)

• asparaginase
Koselugo (selumetinib)

+

asparaginase

1 interaction

Monitor/Modify Tx

selumetinib + asparaginase

monitor bleeding s/sx: combo may incr. risk of bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• aspirin
Koselugo (selumetinib)

+

aspirin

1 interaction

Monitor/Modify Tx

selumetinib + aspirin

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• atorvastatin
Koselugo (selumetinib)

+

atorvastatin

1 interaction

Monitor/Modify Tx

selumetinib + atorvastatin

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited, additive effects)

• avapritinib
Koselugo (selumetinib)

+

avapritinib

1 interaction

Monitor/Modify Tx

selumetinib + avapritinib

monitor bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• avelumab
Koselugo (selumetinib)

+

avelumab

1 interaction

Monitor/Modify Tx

selumetinib + avelumab

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• axitinib
Koselugo (selumetinib)

+

axitinib

1 interaction

Monitor/Modify Tx

selumetinib + axitinib

monitor cardiac fxn (incl. LVEF), bleeding s/sx: combo may incr. risk of cardiotoxicity, GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• belumosudil
Koselugo (selumetinib)

+

belumosudil

1 interaction

Monitor/Modify Tx

selumetinib + belumosudil

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• berberine
Koselugo (selumetinib)

+

berberine

1 interaction

Monitor/Modify Tx

selumetinib + berberine

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• bevacizumab
Koselugo (selumetinib)

+

bevacizumab

1 interaction

Monitor/Modify Tx

selumetinib + bevacizumab

monitor cardiac fxn (incl. LVEF), bleeding s/sx: combo may incr. risk of cardiotoxicity, GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• bezlotoxumab
Koselugo (selumetinib)

+

bezlotoxumab

1 interaction

Monitor/Modify Tx

selumetinib + bezlotoxumab

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• bicalutamide
Koselugo (selumetinib)

+

bicalutamide

1 interaction

Monitor/Modify Tx

selumetinib + bicalutamide

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• binimetinib
Koselugo (selumetinib)

+

binimetinib

1 interaction

Monitor/Modify Tx

selumetinib + binimetinib

monitor bleeding s/sx, cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity, GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• bivalirudin
Koselugo (selumetinib)

+

bivalirudin

1 interaction

Monitor/Modify Tx

selumetinib + bivalirudin

monitor bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• bortezomib
Koselugo (selumetinib)

+

bortezomib

1 interaction

Monitor/Modify Tx

selumetinib + bortezomib

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• bosutinib
Koselugo (selumetinib)

+

bosutinib

1 interaction

Monitor/Modify Tx

selumetinib + bosutinib

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• brentuximab vedotin
Koselugo (selumetinib)

+

brentuximab vedotin

1 interaction

Monitor/Modify Tx

selumetinib + brentuximab vedotin

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• bromelain
Koselugo (selumetinib)

+

bromelain

1 interaction

Monitor/Modify Tx

selumetinib + bromelain

monitor bleeding s/sx: combo may incr. risk of bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• bromfenac ophthalmic
Koselugo (selumetinib)

+

bromfenac ophthalmic

1 interaction

Monitor/Modify Tx

selumetinib + bromfenac ophthalmic

monitor bleeding s/sx: combo may incr. risk of postop ocular bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• cabazitaxel
Koselugo (selumetinib)

+

cabazitaxel

1 interaction

Monitor/Modify Tx

selumetinib + cabazitaxel

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• cabozantinib
Koselugo (selumetinib)

+

cabozantinib

1 interaction

Monitor/Modify Tx

selumetinib + cabozantinib

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• calaspargase
Koselugo (selumetinib)

+

calaspargase

1 interaction

Monitor/Modify Tx

selumetinib + calaspargase

monitor bleeding s/sx: combo may incr. risk of bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• cangrelor
Koselugo (selumetinib)

+

cangrelor

1 interaction

Monitor/Modify Tx

selumetinib + cangrelor

monitor bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• capecitabine
Koselugo (selumetinib)

+

capecitabine

1 interaction

Monitor/Modify Tx

selumetinib + capecitabine

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• capivasertib
Koselugo (selumetinib)

+

capivasertib

1 interaction

Monitor/Modify Tx

selumetinib + capivasertib

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• caplacizumab
Koselugo (selumetinib)

+

caplacizumab

1 interaction

Monitor/Modify Tx

selumetinib + caplacizumab

monitor bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• carfilzomib
Koselugo (selumetinib)

+

carfilzomib

1 interaction

Monitor/Modify Tx

selumetinib + carfilzomib

monitor cardiac fxn (incl. LVEF), bleeding s/sx: combo may incr. risk of cardiotoxicity, GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• celecoxib
Koselugo (selumetinib)

+

celecoxib

1 interaction

Monitor/Modify Tx

selumetinib + celecoxib

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• certolizumab pegol
Koselugo (selumetinib)

+

certolizumab pegol

1 interaction

Monitor/Modify Tx

selumetinib + certolizumab pegol

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• chlorzoxazone
Koselugo (selumetinib)

+

chlorzoxazone

1 interaction

Monitor/Modify Tx

selumetinib + chlorzoxazone

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• cilostazol
Koselugo (selumetinib)

+

cilostazol

1 interaction

Monitor/Modify Tx

selumetinib + cilostazol

monitor cardiac fxn (incl. LVEF), CK, myopathy sx, bleeding s/sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, bleeding, other adverse effects (hepatic metab. inhibited; additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• cimetidine
Koselugo (selumetinib)

+

cimetidine

1 interaction

Monitor/Modify Tx

selumetinib + cimetidine

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• citalopram
Koselugo (selumetinib)

+

citalopram

1 interaction

Monitor/Modify Tx

selumetinib + citalopram

monitor bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by SSRI inhibition of platelet serotonin uptake and vitamin E content in selumetinib capsules)

• clopidogrel
Koselugo (selumetinib)

+

clopidogrel

1 interaction

Monitor/Modify Tx

selumetinib + clopidogrel

monitor bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• clotrimazole oropharyngeal
Koselugo (selumetinib)

+

clotrimazole oropharyngeal

1 interaction

Monitor/Modify Tx

selumetinib + clotrimazole oropharyngeal

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• clozapine
Koselugo (selumetinib)

+

clozapine

1 interaction

Monitor/Modify Tx

selumetinib + clozapine

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• cobimetinib
Koselugo (selumetinib)

+

cobimetinib

1 interaction

Monitor/Modify Tx

selumetinib + cobimetinib

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• collagenase clostridium histolyticum
Koselugo (selumetinib)

+

collagenase clostridium histolyticum

1 interaction

Monitor/Modify Tx

selumetinib + collagenase clostridium histolyticum

monitor injection site bleeding s/sx: combo may incr. risk of localized bleeding, incl. severe (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• cranberry
Koselugo (selumetinib)

+

cranberry

1 interaction

Monitor/Modify Tx

selumetinib + cranberry

monitor LVEF, CK, myopathy sx, especially w/ large amounts of cranberry: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (GI metab. inhibited)

• cyclophosphamide
Koselugo (selumetinib)

+

cyclophosphamide

1 interaction

Monitor/Modify Tx

selumetinib + cyclophosphamide

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• cysteamine
Koselugo (selumetinib)

+

cysteamine

1 interaction

Monitor/Modify Tx

selumetinib + cysteamine

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• dabigatran
Koselugo (selumetinib)

+

dabigatran

1 interaction

Monitor/Modify Tx

selumetinib + dabigatran

monitor bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• dalteparin
Koselugo (selumetinib)

+

dalteparin

1 interaction

Monitor/Modify Tx

selumetinib + dalteparin

monitor bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• danshen
Koselugo (selumetinib)

+

danshen

1 interaction

Monitor/Modify Tx

selumetinib + danshen

monitor bleeding s/sx: combo may decr. selumetinib levels, efficacy; may incr. risk of bleeding (hepatic metab. induced; additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• daptomycin
Koselugo (selumetinib)

+

daptomycin

1 interaction

Monitor/Modify Tx

selumetinib + daptomycin

monitor CK, myopathy sx: combo may incr. risk of myopathy, rhabdomyolysis (additive effects)

• daridorexant
Koselugo (selumetinib)

+

daridorexant

1 interaction

Monitor/Modify Tx

selumetinib + daridorexant

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• dasatinib
Koselugo (selumetinib)

+

dasatinib

1 interaction

Monitor/Modify Tx

selumetinib + dasatinib

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• daunorubicin
Koselugo (selumetinib)

+

daunorubicin

1 interaction

Monitor/Modify Tx

selumetinib + daunorubicin

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• deferasirox
Koselugo (selumetinib)

+

deferasirox

1 interaction

Monitor/Modify Tx

selumetinib + deferasirox

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• defibrotide
Koselugo (selumetinib)

+

defibrotide

1 interaction

Monitor/Modify Tx

selumetinib + defibrotide

monitor bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• desvenlafaxine
Koselugo (selumetinib)

+

desvenlafaxine

1 interaction

Monitor/Modify Tx

selumetinib + desvenlafaxine

monitor bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by SNRI inhibition of platelet serotonin uptake and vitamin E content in selumetinib capsules)

• deuruxolitinib
Koselugo (selumetinib)

+

deuruxolitinib

1 interaction

Monitor/Modify Tx

selumetinib + deuruxolitinib

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• diclofenac
Koselugo (selumetinib)

+

diclofenac

1 interaction

Monitor/Modify Tx

selumetinib + diclofenac

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• diclofenac ophthalmic
Koselugo (selumetinib)

+

diclofenac ophthalmic

1 interaction

Monitor/Modify Tx

selumetinib + diclofenac ophthalmic

monitor bleeding s/sx: combo may incr. risk of postop ocular bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• diclofenac topical
Koselugo (selumetinib)

+

diclofenac topical

1 interaction

Monitor/Modify Tx

selumetinib + diclofenac topical

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• diflunisal
Koselugo (selumetinib)

+

diflunisal

1 interaction

Monitor/Modify Tx

selumetinib + diflunisal

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• dimethyl fumarate
Koselugo (selumetinib)

+

dimethyl fumarate

1 interaction

Monitor/Modify Tx

selumetinib + dimethyl fumarate

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• diosmin
Koselugo (selumetinib)

+

diosmin

1 interaction

Monitor/Modify Tx

selumetinib + diosmin

monitor LVEF, CK, myopathy sx, bleeding s/sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, bleeding, other adverse effects (hepatic metab. inhibited; additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• dipyridamole
Koselugo (selumetinib)

+

dipyridamole

1 interaction

Monitor/Modify Tx

selumetinib + dipyridamole

monitor bleeding s/sx: combo may incr. risk of bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• diroximel fumarate
Koselugo (selumetinib)

+

diroximel fumarate

1 interaction

Monitor/Modify Tx

selumetinib + diroximel fumarate

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• doxorubicin
Koselugo (selumetinib)

+

doxorubicin

1 interaction

Monitor/Modify Tx

selumetinib + doxorubicin

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• duloxetine
Koselugo (selumetinib)

+

duloxetine

1 interaction

Monitor/Modify Tx

selumetinib + duloxetine

monitor bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by SNRI inhibition of platelet serotonin uptake and vitamin E content in selumetinib capsules)

• edoxaban
Koselugo (selumetinib)

+

edoxaban

1 interaction

Monitor/Modify Tx

selumetinib + edoxaban

monitor bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• elafibranor
Koselugo (selumetinib)

+

elafibranor

1 interaction

Monitor/Modify Tx

selumetinib + elafibranor

monitor CK, myopathy sx: combo may decr. selumetinib levels, efficacy; may incr. risk of myopathy, rhabdomyolysis (hepatic metab. induced; additive effects)

• enoxaparin
Koselugo (selumetinib)

+

enoxaparin

1 interaction

Monitor/Modify Tx

selumetinib + enoxaparin

monitor bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• entrectinib
Koselugo (selumetinib)

+

entrectinib

1 interaction

Monitor/Modify Tx

selumetinib + entrectinib

monitor cardiac fxn (incl. LVEF), CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited, additive effects)

• epoprostenol
Koselugo (selumetinib)

+

epoprostenol

1 interaction

Monitor/Modify Tx

selumetinib + epoprostenol

monitor bleeding s/sx: combo may incr. risk of bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• eptifibatide
Koselugo (selumetinib)

+

eptifibatide

1 interaction

Monitor/Modify Tx

selumetinib + eptifibatide

monitor bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• erlotinib
Koselugo (selumetinib)

+

erlotinib

1 interaction

Monitor/Modify Tx

selumetinib + erlotinib

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• escitalopram
Koselugo (selumetinib)

+

escitalopram

1 interaction

Monitor/Modify Tx

selumetinib + escitalopram

monitor bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by SSRI inhibition of platelet serotonin uptake and vitamin E content in selumetinib capsules)

• etanercept
Koselugo (selumetinib)

+

etanercept

1 interaction

Monitor/Modify Tx

selumetinib + etanercept

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• ethanol
Koselugo (selumetinib)

+

ethanol

1 interaction

Monitor/Modify Tx

selumetinib + ethanol

monitor bleeding s/sx w/ orally ingested alcohol: combo may incr. risk of GI or other bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• ethinyl estradiol (contraceptive)
Koselugo (selumetinib)

+

ethinyl estradiol (contraceptive)

1 interaction

Monitor/Modify Tx

selumetinib + ethinyl estradiol (contraceptive)

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• etodolac
Koselugo (selumetinib)

+

etodolac

1 interaction

Monitor/Modify Tx

selumetinib + etodolac

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• evening primrose oil
Koselugo (selumetinib)

+

evening primrose oil

1 interaction

Monitor/Modify Tx

selumetinib + evening primrose oil

monitor bleeding s/sx: combo may incr. risk of bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• everolimus
Koselugo (selumetinib)

+

everolimus

1 interaction

Monitor/Modify Tx

selumetinib + everolimus

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• fam-trastuzumab deruxtecan
Koselugo (selumetinib)

+

fam-trastuzumab deruxtecan

1 interaction

Monitor/Modify Tx

selumetinib + fam-trastuzumab deruxtecan

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• fenofibrate
Koselugo (selumetinib)

+

fenofibrate

1 interaction

Monitor/Modify Tx

selumetinib + fenofibrate

monitor CK, myopathy sx: combo may incr. risk of myopathy, rhabdomyolysis (additive effects)

• fenofibric acid
Koselugo (selumetinib)

+

fenofibric acid

1 interaction

Monitor/Modify Tx

selumetinib + fenofibric acid

monitor CK, myopathy sx: combo may incr. risk of myopathy, rhabdomyolysis (additive effects)

• fenoprofen
Koselugo (selumetinib)

+

fenoprofen

1 interaction

Monitor/Modify Tx

selumetinib + fenoprofen

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• fenugreek
Koselugo (selumetinib)

+

fenugreek

1 interaction

Monitor/Modify Tx

selumetinib + fenugreek

monitor bleeding s/sx: combo may incr. risk of bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• finerenone
Koselugo (selumetinib)

+

finerenone

1 interaction

Monitor/Modify Tx

selumetinib + finerenone

monitor LVEF, CK, myopathy sx if on finerenone 40 mg/day: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• flibanserin
Koselugo (selumetinib)

+

flibanserin

1 interaction

Monitor/Modify Tx

selumetinib + flibanserin

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• fluorouracil
Koselugo (selumetinib)

+

fluorouracil

1 interaction

Monitor/Modify Tx

selumetinib + fluorouracil

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• fluoxetine
Koselugo (selumetinib)

+

fluoxetine

1 interaction

Monitor/Modify Tx

selumetinib + fluoxetine

monitor bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by SSRI inhibition of platelet serotonin uptake and vitamin E content in selumetinib capsules)

• flurbiprofen
Koselugo (selumetinib)

+

flurbiprofen

1 interaction

Monitor/Modify Tx

selumetinib + flurbiprofen

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• flurbiprofen ophthalmic
Koselugo (selumetinib)

+

flurbiprofen ophthalmic

1 interaction

Monitor/Modify Tx

selumetinib + flurbiprofen ophthalmic

monitor bleeding s/sx: combo may incr. risk of postop ocular bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• fluvastatin
Koselugo (selumetinib)

+

fluvastatin

1 interaction

Monitor/Modify Tx

selumetinib + fluvastatin

monitor CK, myopathy sx: combo may incr. risk of myopathy, rhabdomyolysis (additive effects)

• fluvoxamine
Koselugo (selumetinib)

+

fluvoxamine

1 interaction

Monitor/Modify Tx

selumetinib + fluvoxamine

monitor LVEF, CK, myopathy sx, bleeding s/sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, bleeding (incl. life-threatening), other adverse effects (hepatic metab. inhibited, additive effects, antiplatelet and anticoagulant effects augmented by SSRI inhibition of platelet serotonin uptake and vitamin E content in selumetinib capsules)

• fondaparinux
Koselugo (selumetinib)

+

fondaparinux

1 interaction

Monitor/Modify Tx

selumetinib + fondaparinux

monitor bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• fosaprepitant
Koselugo (selumetinib)

+

fosaprepitant

1 interaction

Monitor/Modify Tx

selumetinib + fosaprepitant

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• fostamatinib
Koselugo (selumetinib)

+

fostamatinib

1 interaction

Monitor/Modify Tx

selumetinib + fostamatinib

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• fruquintinib
Koselugo (selumetinib)

+

fruquintinib

1 interaction

Monitor/Modify Tx

selumetinib + fruquintinib

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• garlic
Koselugo (selumetinib)

+

garlic

1 interaction

Monitor/Modify Tx

selumetinib + garlic

monitor bleeding s/sx, especially w/ supplemental garlic; dietary intake OK: combo may decr. selumetinib levels, efficacy; may incr. risk of bleeding (hepatic metab. induced; additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• gefitinib
Koselugo (selumetinib)

+

gefitinib

1 interaction

Monitor/Modify Tx

selumetinib + gefitinib

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• gemfibrozil
Koselugo (selumetinib)

+

gemfibrozil

1 interaction

Monitor/Modify Tx

selumetinib + gemfibrozil

monitor CK, myopathy sx: combo may incr. risk of myopathy, rhabdomyolysis (additive effects)

• gemtuzumab ozogamicin
Koselugo (selumetinib)

+

gemtuzumab ozogamicin

1 interaction

Monitor/Modify Tx

selumetinib + gemtuzumab ozogamicin

monitor platelets, bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• gepotidacin
Koselugo (selumetinib)

+

gepotidacin

1 interaction

Monitor/Modify Tx

selumetinib + gepotidacin

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• givinostat
Koselugo (selumetinib)

+

givinostat

1 interaction

Monitor/Modify Tx

selumetinib + givinostat

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (GI metab. inhibited)

• givosiran
Koselugo (selumetinib)

+

givosiran

1 interaction

Monitor/Modify Tx

selumetinib + givosiran

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited; givosiran effects on hepatic heme biosynthesis may reduce CYP450 enzyme activity)

• glecaprevir
Koselugo (selumetinib)

+

glecaprevir

1 interaction

Monitor/Modify Tx

selumetinib + glecaprevir

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• goldenseal
Koselugo (selumetinib)

+

goldenseal

1 interaction

Monitor/Modify Tx

selumetinib + goldenseal

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• golimumab
Koselugo (selumetinib)

+

golimumab

1 interaction

Monitor/Modify Tx

selumetinib + golimumab

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• grazoprevir
Koselugo (selumetinib)

+

grazoprevir

1 interaction

Monitor/Modify Tx

selumetinib + grazoprevir

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• heparin
Koselugo (selumetinib)

+

heparin

1 interaction

Monitor/Modify Tx

selumetinib + heparin

monitor bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• hydrocortisone
Koselugo (selumetinib)

+

hydrocortisone

1 interaction

Monitor/Modify Tx

selumetinib + hydrocortisone

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• hydroxychloroquine
Koselugo (selumetinib)

+

hydroxychloroquine

1 interaction

Monitor/Modify Tx

selumetinib + hydroxychloroquine

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• ibrutinib
Koselugo (selumetinib)

+

ibrutinib

1 interaction

Monitor/Modify Tx

selumetinib + ibrutinib

monitor cardiac fxn (incl. LVEF), bleeding s/sx: combo may incr. risk of cardiotoxicity, bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• ibuprofen
Koselugo (selumetinib)

+

ibuprofen

1 interaction

Monitor/Modify Tx

selumetinib + ibuprofen

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• ibuprofen lysine
Koselugo (selumetinib)

+

ibuprofen lysine

1 interaction

Monitor/Modify Tx

selumetinib + ibuprofen lysine

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• icosapent ethyl
Koselugo (selumetinib)

+

icosapent ethyl

1 interaction

Monitor/Modify Tx

selumetinib + icosapent ethyl

monitor bleeding s/sx: combo may incr. risk of bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• ifosfamide
Koselugo (selumetinib)

+

ifosfamide

1 interaction

Monitor/Modify Tx

selumetinib + ifosfamide

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• iloprost inhaled
Koselugo (selumetinib)

+

iloprost inhaled

1 interaction

Monitor/Modify Tx

selumetinib + iloprost inhaled

monitor bleeding s/sx: combo may incr. risk of bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• indomethacin
Koselugo (selumetinib)

+

indomethacin

1 interaction

Monitor/Modify Tx

selumetinib + indomethacin

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• infliximab
Koselugo (selumetinib)

+

infliximab

1 interaction

Monitor/Modify Tx

selumetinib + infliximab

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• interferon beta 1a
Koselugo (selumetinib)

+

interferon beta 1a

1 interaction

Monitor/Modify Tx

selumetinib + interferon beta 1a

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• interferon beta 1b
Koselugo (selumetinib)

+

interferon beta 1b

1 interaction

Monitor/Modify Tx

selumetinib + interferon beta 1b

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• interferon gamma 1b
Koselugo (selumetinib)

+

interferon gamma 1b

1 interaction

Monitor/Modify Tx

selumetinib + interferon gamma 1b

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• isoniazid
Koselugo (selumetinib)

+

isoniazid

1 interaction

Monitor/Modify Tx

selumetinib + isoniazid

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• istradefylline
Koselugo (selumetinib)

+

istradefylline

1 interaction

Monitor/Modify Tx

selumetinib + istradefylline

monitor LVEF, CK, myopathy sx, especially w/ istradefylline 40 mg dose: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• ivacaftor
Koselugo (selumetinib)

+

ivacaftor

1 interaction

Monitor/Modify Tx

selumetinib + ivacaftor

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• ketoprofen
Koselugo (selumetinib)

+

ketoprofen

1 interaction

Monitor/Modify Tx

selumetinib + ketoprofen

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• ketorolac
Koselugo (selumetinib)

+

ketorolac

1 interaction

Monitor/Modify Tx

selumetinib + ketorolac

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• ketorolac ophthalmic
Koselugo (selumetinib)

+

ketorolac ophthalmic

1 interaction

Monitor/Modify Tx

selumetinib + ketorolac ophthalmic

monitor bleeding s/sx: combo may incr. risk of postop ocular bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• kratom
Koselugo (selumetinib)

+

kratom

1 interaction

Monitor/Modify Tx

selumetinib + kratom

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• lapatinib
Koselugo (selumetinib)

+

lapatinib

1 interaction

Monitor/Modify Tx

selumetinib + lapatinib

monitor cardiac fxn (incl. LVEF), CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited, additive effects)

• larotrectinib
Koselugo (selumetinib)

+

larotrectinib

1 interaction

Monitor/Modify Tx

selumetinib + larotrectinib

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• lazertinib
Koselugo (selumetinib)

+

lazertinib

1 interaction

Monitor/Modify Tx

selumetinib + lazertinib

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• lenvatinib
Koselugo (selumetinib)

+

lenvatinib

1 interaction

Monitor/Modify Tx

selumetinib + lenvatinib

monitor cardiac fxn (incl. LVEF), bleeding s/sx: combo may incr. risk of cardiotoxicity, GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• levomilnacipran
Koselugo (selumetinib)

+

levomilnacipran

1 interaction

Monitor/Modify Tx

selumetinib + levomilnacipran

monitor bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by SNRI inhibition of platelet serotonin uptake and vitamin E content in selumetinib capsules)

• lifileucel
Koselugo (selumetinib)

+

lifileucel

1 interaction

Monitor/Modify Tx

selumetinib + lifileucel

monitor bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• linagliptin
Koselugo (selumetinib)

+

linagliptin

1 interaction

Monitor/Modify Tx

selumetinib + linagliptin

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• lomitapide
Koselugo (selumetinib)

+

lomitapide

1 interaction

Monitor/Modify Tx

selumetinib + lomitapide

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• lovastatin
Koselugo (selumetinib)

+

lovastatin

1 interaction

Monitor/Modify Tx

selumetinib + lovastatin

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited, additive effects)

• lurasidone
Koselugo (selumetinib)

+

lurasidone

1 interaction

Monitor/Modify Tx

selumetinib + lurasidone

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• magnesium salicylate
Koselugo (selumetinib)

+

magnesium salicylate

1 interaction

Monitor/Modify Tx

selumetinib + magnesium salicylate

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• margetuximab
Koselugo (selumetinib)

+

margetuximab

1 interaction

Monitor/Modify Tx

selumetinib + margetuximab

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• maribavir
Koselugo (selumetinib)

+

maribavir

1 interaction

Monitor/Modify Tx

selumetinib + maribavir

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• mavorixafor
Koselugo (selumetinib)

+

mavorixafor

1 interaction

Monitor/Modify Tx

selumetinib + mavorixafor

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• meclofenamate
Koselugo (selumetinib)

+

meclofenamate

1 interaction

Monitor/Modify Tx

selumetinib + meclofenamate

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• mefenamic acid
Koselugo (selumetinib)

+

mefenamic acid

1 interaction

Monitor/Modify Tx

selumetinib + mefenamic acid

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• meloxicam
Koselugo (selumetinib)

+

meloxicam

1 interaction

Monitor/Modify Tx

selumetinib + meloxicam

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• methotrexate
Koselugo (selumetinib)

+

methotrexate

1 interaction

Monitor/Modify Tx

selumetinib + methotrexate

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• methyl salicylate topical
Koselugo (selumetinib)

+

methyl salicylate topical

1 interaction

Monitor/Modify Tx

selumetinib + methyl salicylate topical

monitor bleeding s/sx: combo may incr. risk of bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules; systemic salicylate absorption may occur from topical use)

• milnacipran
Koselugo (selumetinib)

+

milnacipran

1 interaction

Monitor/Modify Tx

selumetinib + milnacipran

monitor bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by SNRI inhibition of platelet serotonin uptake and vitamin E content in selumetinib capsules)

• mirdametinib
Koselugo (selumetinib)

+

mirdametinib

1 interaction

Monitor/Modify Tx

selumetinib + mirdametinib

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• mitoxantrone
Koselugo (selumetinib)

+

mitoxantrone

1 interaction

Monitor/Modify Tx

selumetinib + mitoxantrone

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• mobocertinib
Koselugo (selumetinib)

+

mobocertinib

1 interaction

Monitor/Modify Tx

selumetinib + mobocertinib

monitor cardiac fxn, incl. LVEF: combo may decr. selumetinib levels, efficacy; may incr. risk of cardiotoxicity (hepatic metab. induced; additive effects)

• monomethyl fumarate
Koselugo (selumetinib)

+

monomethyl fumarate

1 interaction

Monitor/Modify Tx

selumetinib + monomethyl fumarate

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• mycophenolate mofetil
Koselugo (selumetinib)

+

mycophenolate mofetil

1 interaction

Monitor/Modify Tx

selumetinib + mycophenolate mofetil

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• mycophenolic acid
Koselugo (selumetinib)

+

mycophenolic acid

1 interaction

Monitor/Modify Tx

selumetinib + mycophenolic acid

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• nabumetone
Koselugo (selumetinib)

+

nabumetone

1 interaction

Monitor/Modify Tx

selumetinib + nabumetone

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• naproxen
Koselugo (selumetinib)

+

naproxen

1 interaction

Monitor/Modify Tx

selumetinib + naproxen

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• nattokinase
Koselugo (selumetinib)

+

nattokinase

1 interaction

Monitor/Modify Tx

selumetinib + nattokinase

monitor bleeding s/sx: combo may incr. risk of bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• nepafenac ophthalmic
Koselugo (selumetinib)

+

nepafenac ophthalmic

1 interaction

Monitor/Modify Tx

selumetinib + nepafenac ophthalmic

monitor bleeding s/sx: combo may incr. risk of postop ocular bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• niacin (vitamin B3)
Koselugo (selumetinib)

+

niacin (vitamin B3)

1 interaction

Monitor/Modify Tx

selumetinib + niacin (vitamin B3)

monitor CK, myopathy sx, platelets, bleeding s/sx: combo may incr. risk of myopathy, rhabdomyolysis, bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• nicardipine
Koselugo (selumetinib)

+

nicardipine

1 interaction

Monitor/Modify Tx

selumetinib + nicardipine

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• nintedanib
Koselugo (selumetinib)

+

nintedanib

1 interaction

Monitor/Modify Tx

selumetinib + nintedanib

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• nusinersen
Koselugo (selumetinib)

+

nusinersen

1 interaction

Monitor/Modify Tx

selumetinib + nusinersen

monitor platelets, bleeding s/sx: combo may incr. risk of bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• omega-3-acid
Koselugo (selumetinib)

+

omega-3-acid

1 interaction

Monitor/Modify Tx

selumetinib + omega-3-acid

monitor bleeding s/sx: combo may incr. risk of bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• osilodrostat
Koselugo (selumetinib)

+

osilodrostat

1 interaction

Monitor/Modify Tx

selumetinib + osilodrostat

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• osimertinib
Koselugo (selumetinib)

+

osimertinib

1 interaction

Monitor/Modify Tx

selumetinib + osimertinib

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• oxaliplatin
Koselugo (selumetinib)

+

oxaliplatin

1 interaction

Monitor/Modify Tx

selumetinib + oxaliplatin

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• oxaprozin
Koselugo (selumetinib)

+

oxaprozin

1 interaction

Monitor/Modify Tx

selumetinib + oxaprozin

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• palbociclib
Koselugo (selumetinib)

+

palbociclib

1 interaction

Monitor/Modify Tx

selumetinib + palbociclib

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• paroxetine
Koselugo (selumetinib)

+

paroxetine

1 interaction

Monitor/Modify Tx

selumetinib + paroxetine

monitor bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by SSRI inhibition of platelet serotonin uptake and vitamin E content in selumetinib capsules)

• pazopanib
Koselugo (selumetinib)

+

pazopanib

1 interaction

Monitor/Modify Tx

selumetinib + pazopanib

monitor cardiac fxn (incl. LVEF), CK, myopathy sx, bleeding s/sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, GI or other bleeding (incl. life-threatening), other adverse effects (hepatic metab. inhibited; additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• pegaspargase
Koselugo (selumetinib)

+

pegaspargase

1 interaction

Monitor/Modify Tx

selumetinib + pegaspargase

monitor bleeding s/sx: combo may incr. risk of bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• peginterferon beta 1a
Koselugo (selumetinib)

+

peginterferon beta 1a

1 interaction

Monitor/Modify Tx

selumetinib + peginterferon beta 1a

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• penicillin G
Koselugo (selumetinib)

+

penicillin G

1 interaction

Monitor/Modify Tx

selumetinib + penicillin G

monitor bleeding s/sx, especially w/ large penicillin G doses and/or concomitant renal impairment: combo may incr. risk of bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• pentosan polysulfate sodium
Koselugo (selumetinib)

+

pentosan polysulfate sodium

1 interaction

Monitor/Modify Tx

selumetinib + pentosan polysulfate sodium

monitor bleeding s/sx: combo may incr. risk of bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• pentoxifylline
Koselugo (selumetinib)

+

pentoxifylline

1 interaction

Monitor/Modify Tx

selumetinib + pentoxifylline

monitor bleeding s/sx: combo may incr. risk of bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• peppermint
Koselugo (selumetinib)

+

peppermint

1 interaction

Monitor/Modify Tx

selumetinib + peppermint

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• pertuzumab
Koselugo (selumetinib)

+

pertuzumab

1 interaction

Monitor/Modify Tx

selumetinib + pertuzumab

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• pibrentasvir
Koselugo (selumetinib)

+

pibrentasvir

1 interaction

Monitor/Modify Tx

selumetinib + pibrentasvir

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• pioglitazone
Koselugo (selumetinib)

+

pioglitazone

1 interaction

Monitor/Modify Tx

selumetinib + pioglitazone

monitor cardiac fxn, incl. LVEF: combo may decr. selumetinib levels, efficacy; may incr. risk of cardiotoxicity (hepatic metab. induced; additive effects)

• piperacillin
Koselugo (selumetinib)

+

piperacillin

1 interaction

Monitor/Modify Tx

selumetinib + piperacillin

monitor bleeding s/sx, especially w/ prolonged piperacillin tx and/or concomitant renal impairment: combo may incr. risk of bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• piroxicam
Koselugo (selumetinib)

+

piroxicam

1 interaction

Monitor/Modify Tx

selumetinib + piroxicam

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• pirtobrutinib
Koselugo (selumetinib)

+

pirtobrutinib

1 interaction

Monitor/Modify Tx

selumetinib + pirtobrutinib

monitor LVEF, CK, myopathy sx, bleeding s/sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, GI or other bleeding (incl. life-threatening), other adverse effects (hepatic metab. inhibited, additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• pitavastatin
Koselugo (selumetinib)

+

pitavastatin

1 interaction

Monitor/Modify Tx

selumetinib + pitavastatin

monitor CK, myopathy sx: combo may incr. risk of myopathy, rhabdomyolysis (additive effects)

• plasminogen, human
Koselugo (selumetinib)

+

plasminogen, human

1 interaction

Monitor/Modify Tx

selumetinib + plasminogen, human

monitor bleeding s/sx, especially during and x4h after plasminogen infusion: combo may incr. risk of GI or other bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• ponatinib
Koselugo (selumetinib)

+

ponatinib

1 interaction

Monitor/Modify Tx

selumetinib + ponatinib

monitor cardiac fxn (incl. LVEF), bleeding s/sx: combo may incr. risk of cardiotoxicity, GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• porfimer
Koselugo (selumetinib)

+

porfimer

1 interaction

Monitor/Modify Tx

selumetinib + porfimer

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• pralsetinib
Koselugo (selumetinib)

+

pralsetinib

1 interaction

Monitor/Modify Tx

selumetinib + pralsetinib

monitor bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• prasugrel
Koselugo (selumetinib)

+

prasugrel

1 interaction

Monitor/Modify Tx

selumetinib + prasugrel

monitor bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• pravastatin
Koselugo (selumetinib)

+

pravastatin

1 interaction

Monitor/Modify Tx

selumetinib + pravastatin

monitor CK, myopathy sx: combo may incr. risk of myopathy, rhabdomyolysis (additive effects)

• propafenone
Koselugo (selumetinib)

+

propafenone

1 interaction

Monitor/Modify Tx

selumetinib + propafenone

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• quercetin
Koselugo (selumetinib)

+

quercetin

1 interaction

Monitor/Modify Tx

selumetinib + quercetin

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• raltegravir
Koselugo (selumetinib)

+

raltegravir

1 interaction

Monitor/Modify Tx

selumetinib + raltegravir

monitor CK, myopathy sx: combo may incr. risk of myopathy, rhabdomyolysis (additive effects)

• ramucirumab
Koselugo (selumetinib)

+

ramucirumab

1 interaction

Monitor/Modify Tx

selumetinib + ramucirumab

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• ranibizumab
Koselugo (selumetinib)

+

ranibizumab

1 interaction

Monitor/Modify Tx

selumetinib + ranibizumab

monitor bleeding s/sx: combo may incr. risk of ocular hemorrhage (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• ranolazine
Koselugo (selumetinib)

+

ranolazine

1 interaction

Monitor/Modify Tx

selumetinib + ranolazine

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• regorafenib
Koselugo (selumetinib)

+

regorafenib

1 interaction

Monitor/Modify Tx

selumetinib + regorafenib

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• remdesivir
Koselugo (selumetinib)

+

remdesivir

1 interaction

Monitor/Modify Tx

selumetinib + remdesivir

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• remibrutinib
Koselugo (selumetinib)

+

remibrutinib

1 interaction

Monitor/Modify Tx

selumetinib + remibrutinib

monitor bleeding s/sx: combo may incr. risk of bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• resveratrol
Koselugo (selumetinib)

+

resveratrol

1 interaction

Monitor/Modify Tx

selumetinib + resveratrol

monitor LVEF, CK, myopathy sx, bleeding s/sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, bleeding, other adverse effects (hepatic metab. inhibited, additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• reteplase
Koselugo (selumetinib)

+

reteplase

1 interaction

Monitor/Modify Tx

selumetinib + reteplase

monitor bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• revakinagene taroretcel
Koselugo (selumetinib)

+

revakinagene taroretcel

1 interaction

Monitor/Modify Tx

selumetinib + revakinagene taroretcel

monitor bleeding s/sx: combo may incr. risk of ocular hemorrhage (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• ripretinib
Koselugo (selumetinib)

+

ripretinib

1 interaction

Monitor/Modify Tx

selumetinib + ripretinib

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• ritlecitinib
Koselugo (selumetinib)

+

ritlecitinib

1 interaction

Monitor/Modify Tx

selumetinib + ritlecitinib

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• rivaroxaban
Koselugo (selumetinib)

+

rivaroxaban

1 interaction

Monitor/Modify Tx

selumetinib + rivaroxaban

monitor bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• ropeginterferon alfa-2b
Koselugo (selumetinib)

+

ropeginterferon alfa-2b

1 interaction

Monitor/Modify Tx

selumetinib + ropeginterferon alfa-2b

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• rosiglitazone
Koselugo (selumetinib)

+

rosiglitazone

1 interaction

Monitor/Modify Tx

selumetinib + rosiglitazone

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• rosuvastatin
Koselugo (selumetinib)

+

rosuvastatin

1 interaction

Monitor/Modify Tx

selumetinib + rosuvastatin

monitor CK, myopathy sx: combo may incr. risk of myopathy, rhabdomyolysis (additive effects)

• rucaparib
Koselugo (selumetinib)

+

rucaparib

1 interaction

Monitor/Modify Tx

selumetinib + rucaparib

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• salsalate
Koselugo (selumetinib)

+

salsalate

1 interaction

Monitor/Modify Tx

selumetinib + salsalate

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• saw palmetto
Koselugo (selumetinib)

+

saw palmetto

1 interaction

Monitor/Modify Tx

selumetinib + saw palmetto

monitor bleeding s/sx: combo may incr. risk of bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• saxagliptin
Koselugo (selumetinib)

+

saxagliptin

1 interaction

Monitor/Modify Tx

selumetinib + saxagliptin

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• selpercatinib
Koselugo (selumetinib)

+

selpercatinib

1 interaction

Monitor/Modify Tx

selumetinib + selpercatinib

monitor LVEF, CK, myopathy sx, bleeding s/sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, bleeding (incl. life-threatening), other adverse effects (hepatic metab. inhibited, additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• sepiapterin
Koselugo (selumetinib)

+

sepiapterin

1 interaction

Monitor/Modify Tx

selumetinib + sepiapterin

monitor bleeding s/sx: combo may incr. risk of bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• sertraline
Koselugo (selumetinib)

+

sertraline

1 interaction

Monitor/Modify Tx

selumetinib + sertraline

monitor bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by SSRI inhibition of platelet serotonin uptake and vitamin E content in selumetinib capsules)

• simvastatin
Koselugo (selumetinib)

+

simvastatin

1 interaction

Monitor/Modify Tx

selumetinib + simvastatin

monitor CK, myopathy sx: combo may incr. risk of myopathy, rhabdomyolysis (additive effects)

• sirolimus albumin-bound
Koselugo (selumetinib)

+

sirolimus albumin-bound

1 interaction

Monitor/Modify Tx

selumetinib + sirolimus albumin-bound

monitor bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• sitagliptin
Koselugo (selumetinib)

+

sitagliptin

1 interaction

Monitor/Modify Tx

selumetinib + sitagliptin

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• sorafenib
Koselugo (selumetinib)

+

sorafenib

1 interaction

Monitor/Modify Tx

selumetinib + sorafenib

monitor bleeding s/sx, cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity, GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• sotatercept
Koselugo (selumetinib)

+

sotatercept

1 interaction

Monitor/Modify Tx

selumetinib + sotatercept

monitor platelets, bleeding s/sx: combo may incr. risk of bleeding, incl. severe (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• spironolactone
Koselugo (selumetinib)

+

spironolactone

1 interaction

Monitor/Modify Tx

selumetinib + spironolactone

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. possibly inhibited)

• stiripentol
Koselugo (selumetinib)

+

stiripentol

1 interaction

Monitor/Modify Tx

selumetinib + stiripentol

monitor LVEF, CK, myopathy sx: combo may incr. or decr. selumetinib levels, incr. risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects or decr. efficacy (hepatic metab. inhibited, hepatic metab. possibly induced)

• sulindac
Koselugo (selumetinib)

+

sulindac

1 interaction

Monitor/Modify Tx

selumetinib + sulindac

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• sunitinib
Koselugo (selumetinib)

+

sunitinib

1 interaction

Monitor/Modify Tx

selumetinib + sunitinib

monitor bleeding s/sx, cardiac fxn, incl. LVEF: combo may incr. risk of GI or other bleeding (incl. life-threatening), cardiotoxicity (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• tenecteplase
Koselugo (selumetinib)

+

tenecteplase

1 interaction

Monitor/Modify Tx

selumetinib + tenecteplase

monitor bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• ticagrelor
Koselugo (selumetinib)

+

ticagrelor

1 interaction

Monitor/Modify Tx

selumetinib + ticagrelor

monitor LVEF, CK, myopathy sx, bleeding s/sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, bleeding (incl. life-threatening), other adverse effects (hepatic metab. inhibited; additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• tirofiban
Koselugo (selumetinib)

+

tirofiban

1 interaction

Monitor/Modify Tx

selumetinib + tirofiban

monitor bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• tisotumab vedotin
Koselugo (selumetinib)

+

tisotumab vedotin

1 interaction

Monitor/Modify Tx

selumetinib + tisotumab vedotin

monitor bleeding s/sx: combo may incr. risk of bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• tivozanib
Koselugo (selumetinib)

+

tivozanib

1 interaction

Monitor/Modify Tx

selumetinib + tivozanib

monitor bleeding s/sx, cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity, GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• tolmetin
Koselugo (selumetinib)

+

tolmetin

1 interaction

Monitor/Modify Tx

selumetinib + tolmetin

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• tolvaptan
Koselugo (selumetinib)

+

tolvaptan

1 interaction

Monitor/Modify Tx

selumetinib + tolvaptan

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• tovorafenib
Koselugo (selumetinib)

+

tovorafenib

1 interaction

Monitor/Modify Tx

selumetinib + tovorafenib

monitor bleeding s/sx: combo may decr. selumetinib levels, efficacy; may incr. risk of bleeding, incl. life-threatening (hepatic metab. induced; additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• trabectedin
Koselugo (selumetinib)

+

trabectedin

1 interaction

Monitor/Modify Tx

selumetinib + trabectedin

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• trametinib
Koselugo (selumetinib)

+

trametinib

1 interaction

Monitor/Modify Tx

selumetinib + trametinib

monitor cardiac fxn (incl. LVEF), bleeding s/sx: combo may incr. risk of cardiotoxicity, GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• trastuzumab
Koselugo (selumetinib)

+

trastuzumab

1 interaction

Monitor/Modify Tx

selumetinib + trastuzumab

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• trazodone
Koselugo (selumetinib)

+

trazodone

1 interaction

Monitor/Modify Tx

selumetinib + trazodone

monitor bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by trazodone inhibition of platelet serotonin uptake and vitamin E content in selumetinib capsules)

• treosulfan
Koselugo (selumetinib)

+

treosulfan

1 interaction

Monitor/Modify Tx

selumetinib + treosulfan

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. possibly inhibited)

• treprostinil
Koselugo (selumetinib)

+

treprostinil

1 interaction

Monitor/Modify Tx

selumetinib + treprostinil

monitor bleeding s/sx: combo may incr. risk of bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• trofinetide
Koselugo (selumetinib)

+

trofinetide

1 interaction

Monitor/Modify Tx

selumetinib + trofinetide

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (GI metab. inhibited)

• upadacitinib
Koselugo (selumetinib)

+

upadacitinib

1 interaction

Monitor/Modify Tx

selumetinib + upadacitinib

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• vadadustat
Koselugo (selumetinib)

+

vadadustat

1 interaction

Monitor/Modify Tx

selumetinib + vadadustat

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• valproic acid
Koselugo (selumetinib)

+

valproic acid

1 interaction

Monitor/Modify Tx

selumetinib + valproic acid

monitor bleeding s/sx: combo may incr. risk of bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• vandetanib
Koselugo (selumetinib)

+

vandetanib

1 interaction

Monitor/Modify Tx

selumetinib + vandetanib

monitor cardiac fxn (incl. LVEF), bleeding s/sx: combo may incr. risk of cardiotoxicity, bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• venlafaxine
Koselugo (selumetinib)

+

venlafaxine

1 interaction

Monitor/Modify Tx

selumetinib + venlafaxine

monitor bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by SNRI inhibition of platelet serotonin uptake and vitamin E content in selumetinib capsules)

• vilazodone
Koselugo (selumetinib)

+

vilazodone

1 interaction

Monitor/Modify Tx

selumetinib + vilazodone

monitor bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vilazodone inhibition of platelet serotonin uptake and vitamin E content in selumetinib capsules)

• viloxazine
Koselugo (selumetinib)

+

viloxazine

1 interaction

Monitor/Modify Tx

selumetinib + viloxazine

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• vinpocetine
Koselugo (selumetinib)

+

vinpocetine

1 interaction

Monitor/Modify Tx

selumetinib + vinpocetine

monitor bleeding s/sx: combo may incr. risk of bleeding (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• vonoprazan
Koselugo (selumetinib)

+

vonoprazan

1 interaction

Monitor/Modify Tx

selumetinib + vonoprazan

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• vorapaxar
Koselugo (selumetinib)

+

vorapaxar

1 interaction

Monitor/Modify Tx

selumetinib + vorapaxar

monitor bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• vortioxetine
Koselugo (selumetinib)

+

vortioxetine

1 interaction

Monitor/Modify Tx

selumetinib + vortioxetine

monitor bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vortioxetine inhibition of platelet serotonin uptake and vitamin E content in selumetinib capsules)

• warfarin
Koselugo (selumetinib)

+

warfarin

1 interaction

Monitor/Modify Tx

selumetinib + warfarin

monitor INR, bleeding s/sx: combo may incr. risk of bleeding, incl. life-threatening (synergistic effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• willow bark
Koselugo (selumetinib)

+

willow bark

1 interaction

Monitor/Modify Tx

selumetinib + willow bark

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects; antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules, willow bark may contain salicylates)

• xanomeline
Koselugo (selumetinib)

+

xanomeline

1 interaction

Monitor/Modify Tx

selumetinib + xanomeline

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (GI metab. possibly inhibited)

• zanidatamab
Koselugo (selumetinib)

+

zanidatamab

1 interaction

Monitor/Modify Tx

selumetinib + zanidatamab

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• zanubrutinib
Koselugo (selumetinib)

+

zanubrutinib

1 interaction

Monitor/Modify Tx

selumetinib + zanubrutinib

monitor bleeding s/sx: combo may decr. selumetinib levels, efficacy; may incr. risk of bleeding, incl. life-threatening (hepatic metab. induced; additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• zenocutuzumab
Koselugo (selumetinib)

+

zenocutuzumab

1 interaction

Monitor/Modify Tx

selumetinib + zenocutuzumab

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)

• zileuton
Koselugo (selumetinib)

+

zileuton

1 interaction

Monitor/Modify Tx

selumetinib + zileuton

monitor LVEF, CK, myopathy sx: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metab. inhibited)

• ziv-aflibercept
Koselugo (selumetinib)

+

ziv-aflibercept

1 interaction

Monitor/Modify Tx

selumetinib + ziv-aflibercept

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by vitamin E content in selumetinib capsules)

• zongertinib
Koselugo (selumetinib)

+

zongertinib

1 interaction

Monitor/Modify Tx

selumetinib + zongertinib

monitor cardiac fxn, incl. LVEF: combo may incr. risk of cardiotoxicity (additive effects)