Pemazyre Interactions: Alcohol, Medications, and Others

Before you start taking Pemazyre, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Pemazyre interacts with supplements, herbs, and vitamins, see the “Are there other interactions with Pemazyre?” section below.)

If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.

The table below lists drugs that may interact with Pemazyre. Keep in mind that this table does not include all drugs that may interact with Pemazyre. For more information about some of these interactions, see the “Drug interactions explained” section below.

Pemazyre is not known to interact with alcohol. But Pemazyre and alcohol can cause some similar side effects, such as nausea, diarrhea, headache, and dehydration (low fluid level). So you may be more likely to experience these side effects if you drink alcohol during your Pemazyre treatment.

If you have questions about consuming alcohol while taking Pemazyre, talk with your doctor or pharmacist.

Learn more about certain drug interactions that can occur with Pemazyre.

Interaction with certain seizure medications

Pemazyre can interact with certain seizure medications, which are prescribed to treat seizure disorders such as epilepsy.

Examples of seizure medications that can interact with Pemazyre include:

• carbamazepine (Tegretol, others)
• cenobamate (Xcopri)
• phenobarbital (Sezaby)
• phenytoin (Dilantin)

What could happen

Taking Pemazyre with these seizure medications can make your body break down Pemazyre faster than usual. This can make Pemazyre less effective.

What you can do

Your doctor will likely avoid prescribing Pemazyre with certain seizure medications.

If you take a seizure medication that interacts with Pemazyre, your doctor may have you switch to a different seizure medication before prescribing Pemazyre.

If you have questions about taking Pemazyre with a seizure medication, talk with your doctor or pharmacist.

Interaction with certain antifungals

Pemazyre can interact with certain antifungal medications, which are prescribed to treat and help prevent fungal infections.

Examples of antifungal medications that can interact with Pemazyre include:

• fluconazole (Diflucan)
• itraconazole (Sporanox, Tolsura)
• ketoconazole
• posaconazole (Noxafil)
• voriconazole (Vfend)

What could happen

Taking these antifungals with Pemazyre can prevent your body from breaking down Pemazyre effectively. As a result, the level of Pemazyre can build up in your body. This can raise your risk of side effects from Pemazyre, such as hair loss, diarrhea, and eye problems.

What you can do

Your doctor will likely avoid prescribing certain antifungals with Pemazyre. But if they do prescribe one of these antifungals with Pemazyre, they may lower your dosage of Pemazyre. You should not take a higher dose of either medication than your doctor prescribes. Your doctor will likely increase your Pemazyre dosage again after you’ve finished the course of the antifungal medication.

If you have questions about taking Pemazyre with an antifungal drug, talk with your doctor or pharmacist.

Interaction with certain antibiotics

Pemazyre can interact with certain antibiotic drugs, which are prescribed to treat and help prevent bacterial infections.

Examples of antibiotic medications that can interact with Pemazyre include:

• ciprofloxacin (Cipro)
• clarithromycin
• erythromycin (Ery-Tab, others)

What could happen

Taking these antibiotics with Pemazyre can prevent your body from breaking down Pemazyre effectively. As a result, the level of Pemazyre can build up in your body. This can raise your risk of side effects from Pemazyre, such as eye problems, diarrhea, and hair loss.

What you can do

Your doctor will likely avoid prescribing certain antibiotics with Pemazyre. But they do prescribe Pemazyre with one of these antibiotics, they may lower your dosage of Pemazyre. You should not take a higher dose of either medication than your doctor prescribes. Your doctor will likely increase your Pemazyre dosage again after you’ve finished the course of the antibiotic medication.

If you have questions about taking Pemazyre with an antibiotic, talk with your doctor or pharmacist.

Pemazyre may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See below for details. Note that the information below does not include all other possible interactions with Pemazyre.

Does Pemazyre interact with supplements?

Before you start taking Pemazyre, talk with your doctor and pharmacist about any supplements, herbs, and vitamins you take. Sharing this information with them may help you avoid possible interactions.

If you have questions about interactions that may affect you, talk with your doctor or pharmacist.

Pemazyre interactions with herbs

Pemazyre can interact with St. John’s wort, an herbal supplement taken to ease symptoms of depression and other conditions. You should not take St John’s wort with Pemazyre. It could make Pemazyre less effective.

It’s important to check with your doctor or pharmacist before taking any other herbal products while taking Pemazyre.

Pemazyre interactions with vitamins

There are currently no reports of Pemazyre interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.

For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while taking Pemazyre.

Does Pemazyre interact with food?

Pemazyre can interact with grapefruit and grapefruit juice.

You should not consume grapefruit while taking Pemazyre because it could cause the level of the drug to build up in your body. This can raise your risk of side effects from Pemazyre.

If you have questions about consuming certain foods with Pemazyre, talk with your doctor.

Does Pemazyre interact with vaccines?

There are currently no reports of Pemazyre interacting with vaccines. If you have questions about getting certain vaccines during your Pemazyre treatment, talk with your doctor.

Does Pemazyre interact with lab tests?

There are currently no reports of Pemazyre interacting with lab tests. If you have questions about having certain lab tests during your treatment with Pemazyre, talk with the healthcare professional ordering the test.

Does Pemazyre interact with cannabis or CBD?

There are currently no reports of Pemazyre interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But CBD has been shown to block the activity of the enzyme that breaks down Pemazyre in your body. More research is needed to determine how CBD may interact with Pemazyre.

As with any drug or supplement, talk with your doctor before using cannabis with Pemazyre.

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

Certain medical conditions or other health factors may raise the risk of interactions with Pemazyre. Before taking Pemazyre, talk with your doctor about your health history. They’ll determine whether Pemazyre is right for you.

Health conditions or other factors that might interact with Pemazyre include:

Eye disorders: If you have dry eye syndrome or an eye disorder affecting your retina, taking Pemazyre could worsen your condition. Talk with your doctor about whether Pemazyre is right for you.

Severe kidney or liver problems: If you have a severe kidney or liver problem, the level of Pemazyre can build up in your body. This can raise your risk of side effects from the drug. Because of this, your doctor will likely prescribe a lower dosage of Pemazyre for you.

Pregnancy: Pemazyre is not safe to take during pregnancy. If you’re pregnant or planning a pregnancy, talk with your doctor about your treatment options. If you’re sexually active and you or your partner can become pregnant, you should use birth control while taking Pemazyre and for 1 week after your last dose.

Breastfeeding: It’s not known whether Pemazyre passes into breast milk, and if so, what effects it may have on a child who is breastfed. But because of the risk of harm, you should not breastfeed while taking Pemazyre or for 1 week after your last dose. If you’re breastfeeding or planning to breastfeed, talk with your doctor about your options.

Allergic reaction: If you’ve had an allergic reaction to Pemazyre or any of its ingredients, your doctor will likely not prescribe Pemazyre. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.

Taking certain steps can help you avoid interactions with Pemazyre. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:

• Whether you drink alcohol or use cannabis.
• Other medications you take, as well as any vitamins, supplements, and herbs. Your doctor or pharmacist can help you fill out a medication list.
• What to do if you start taking a new drug during your Pemazyre treatment.

It’s also important to understand Pemazyre’s label and other paperwork that may come with the drug. Colored stickers that describe interactions may be on the label. And the paperwork (sometimes called the patient package insert or medication guide) may have other details about interactions. If you did not get paperwork with Pemazyre, ask your pharmacist to print a copy for you.

If you have difficulty reading or understanding this information, your doctor or pharmacist can help.

Taking Pemazyre exactly as prescribed can also help prevent interactions.

If you still have questions about Pemazyre and its possible interactions, talk with your doctor.

Questions you may want to ask your doctor include:

• Do I need to check with you before taking over-the-counter medications with Pemazyre?
• If I take a drug that interacts with Pemazyre, will you adjust my Pemazyre dosage?
• If I have an eye disorder, will I need extra monitoring while taking Pemazyre?

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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.