Selpercatinib/Vonoprazan-Clarithromycin Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

The pH of your GI tract needs to be acidic for selpercatinib to dissolve and be absorbed. Proton pump inhibitors, like vonoprazan, change the pH (acidity) in your GI tract.Also, selpercatinib may affect your heart's rhythm. Clarithromycin can have the same effect and can also slow down how quickly your body processes selpercatinib.

What might happen:

The amount of selpercatinib in your blood may decrease and it may not work as well.However, if selpercatinib is absorbed, the amount of selpercatinib in your blood may increase and cause more side effects than normal. You may have a higher risk of developing liver problems, high blood pressure, bleeding, or an irregular heart beat which can be life-threatening.

What you should do about this interaction:

Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. Your doctor may want to change your medicine.If you need to take vonoprazan with selpercatinib, take selpercatinib with food.If your doctor changes vonoprazan to an H2 blocker, take selpercatinib at least 2 hours before or 10 hours after the H2 blocker.If your doctor changes vonoprazan to an antacid, take selpercatinib at least 2 hours before or 2 hours after the antacid.If you have questions about how to schedule your medicines, ask your pharmacist.Let your doctor know right away if you notice an irregular heartbeat, have dizziness or fainting episodes, or signs of liver problems such as yellowing of the skin or eyes, dark urine or abdominal pain.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

  • 1.Retevmo (selpercatinib) US prescribing information. Eli Lilly April, 2024.
  • 2.Voquezna (vonoprazan-amoxicillin and vonoprazan-amoxicillin-clarithromycin) US prescribing information. Phathom Pharmaceuticals, Inc. November, 2023.
  • 3.Drew BJ, Ackerman MJ, Funk M, Gibler WB, Kligfield P, Menon V, Philippides GJ, Roden DM, Zareba W. Prevention of torsade de pointes in hospital settings: a scientific statement from the American Heart Association and the American College of Cardiology Foundation. J Am Coll Cardiol 2010 Mar 2;55(9):934-47.
  • 4.USDepartment of Health and Human Services Food and Drug Administration. ICH E14 Clinical Evaluation of QT/QTc Interval Prolongation and Proarrhythmic Potential for Non-Antiarrhythmic Drugs. Available at: https://www.fda.gov/media/71372/download October, 2005.

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.