Verzenio interactions: Alcohol, medications, and other factors

Before you start treatment with Verzenio, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Verzenio interacts with supplements, herbs, or vitamins, see the “Verzenio and other interactions” section below.)

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

Here’s a table of drugs that can interact with Verzenio. Keep in mind that this table doesn’t include all drugs that may interact with Verzenio. Some of these interactions are described in detail just below in “Drug interactions in depth.”

There are no known interactions between Verzenio and alcohol. However, your doctor may advise you to avoid or limit alcohol consumption during Verzenio treatment.

This is because drinking alcohol while taking the drug may worsen some of Verzenio’s side effects.* For example, you may experience:

• diarrhea
• nausea
• vomiting
• headache
• dizziness
• fatigue
• decreased appetite

In addition, consuming large amounts of alcohol can cause liver damage. Verzenio may also cause liver damage as a side effect. This means that drinking alcohol during Verzenio treatment may increase the risk of liver problems.

If you consume alcohol during Verzenio treatment, these side effects may be more likely to occur. If you have questions about drinking alcohol while taking Verzenio, talk with your doctor.

* For details about Verzenio’s side effects, see this article.

Here’s a closer look at certain drug interactions of Verzenio.

Certain antifungals

Verzenio can interact with certain antifungals, which are drugs that treat fungal infections.

Interaction result:Taking certain antifungals with Verzenio can raise your risk of side effects from Verzenio.

Interaction explained: Certain antifungals slow the activity of an enzyme (type of protein) that helps clear Verzenio from your body. This enzyme is called cytochrome p450 3A4 (CYP3A4). By slowing CYP3A4, these antifungals can cause Verzenio to build up in your body. This can increase your risk of its side effects.

Examples of antifungal drugs: Here are some antifungal drugs that may interact with Verzenio:

• fluconazole (Diflucan)
• itraconazole (Sporanox)
• ketoconazole
• voriconazole (Vfend)

Steps you or your doctor may take:If you need treatment with an antifungal while taking Verzenio, your doctor will likely avoid prescribing ketoconazole. This antifungal can cause the level of Verzenio in your body to get very high. Instead, they will likely prescribe a different antifungal.

If your doctor prescribes another antifungal that can interact with Verzenio, they may temporarily lower your dosage of Verzenio. Don’t take a higher dosage of either medication than your doctor prescribes.

If you have new or increased Verzenio side effects while taking it with an antifungal, tell your doctor right away. For details about Verzenio’s side effects, see this article.

After you finish the course of antifungals, your doctor will usually increase your Verzenio dosage again. Don’t increase your Verzenio dosage until your doctor instructs you to do so.

If you have questions about taking Verzenio with antifungals, talk with your doctor.

Certain antibiotics

Verzenio can interact with certain antibiotics, which are drugs that treat bacterial infections.

Interaction result:Taking certain antibiotics with Verzenio can raise your risk of side effects from Verzenio.

Interaction explained:Certain antibiotics slow the activity of an enzyme (type of protein) that helps clear Verzenio from your body. This enzyme is called cytochrome p450 3A4 (CYP3A4). By slowing CYP3A4, these antibiotics cause Verzenio to build up in your body. This can raise your risk of its side effects.

Examples of antibiotic drugs: Here are some antibiotics that may interact with Verzenio:

• ciprofloxacin (Cipro)
• clarithromycin
• erythromycin (Erytab, others)

Steps you or your doctor may take:If you take one of these antibiotics with Verzenio, your doctor may temporarily lower your dosage of Verzenio. Don’t take a higher dosage of either medication than your doctor prescribes.

If you have new or increased Verzenio side effects while taking it with an antibiotic, tell your doctor right away. For details about Verzenio’s side effects, see this article.

After you finish the course of antibiotics, your doctor will usually increase your Verzenio dosage again. Don’t increase your Verzenio dosage until your doctor tells you to.

If you have questions about taking Verzenio with antibiotics, talk with your doctor.

Certain seizure medications

Verzenio can interact with certain seizure medications, which treat seizure disorders such as epilepsy.

Interaction result:Taking Verzenio with certain seizure medications can make Verzenio less effective at treating breast cancer.

Interaction explained:Certain seizure medications speed up the activity of an enzyme (type of protein) that helps clear Verzenio from your body. This enzyme is called cytochrome p450 3A4 (CYP3A4). By speeding up CYP3A4, these medications cause your body to clear Verzenio faster than usual. This lowers the level of Verzenio in your body, which can make it less effective.

Examples of seizure medications: Here are some seizure medications that may interact with Verzenio:

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

Steps you or your doctor may take:Your doctor will likely avoid prescribing Verzenio with these seizure medications. They may recommend switching to a different seizure medication. Or they may recommend a treatment other than Verzenio for your breast cancer.

If you have questions about taking Verzenio with a seizure medication, talk with your doctor.

Verzenio may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Verzenio.

Verzenio interactions with supplements

Before you start treatment with Verzenio, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

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

Verzenio interactions with herbs

Doctors will typically recommend that you avoid taking St. John’s wort with Verzenio. St. John’s wort is an herbal supplement that some people use to treat depression and other conditions.

St. John’s wort may speed up the activity of an enzyme in your body called cytochrome P450 3A4 (CYP3A4). This enzyme helps break down Verzenio.

By speeding up this enzyme, St. John’s wort can cause Verzenio to break down more quickly. And this may lead to a low level of Verzenio in your system. If the level of Verzenio in your system is too low, the drug may not work to treat breast cancer.

Your doctor may be able to suggest a treatment option other than St. John’s wort.

Verzenio and vitamins

There are no specific reports of vitamins interacting with Verzenio. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Verzenio.

Verzenio interactions with food

Grapefruit and grapefruit juice can interact with Verzenio. Specifically, grapefruit products can stop your body from breaking down Verzenio. This raises the level of Verzenio in your body, which increases your risk of side effects from Verzenio.* Due to this risk, your doctor may recommend that you do not consume grapefruit and grapefruit juice while taking the drug.

* For details about Verzenio’s side effects, see this article.

Verzenio and vaccines

There are no known interactions between Verzenio and vaccines. However, Verzenio can lower your white blood cell count. If you have a low white blood cell count with Verzenio, your immune system may not respond to vaccines as well as usual. So if you get a vaccine during treatment, it may not work as well as usual.

Before starting Verzenio, talk with your doctor or pharmacist about any vaccines you may need.

Verzenio and lab tests

Verzenio is not known to interact with any lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.

VERZENIO INTERACTION WITH CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Verzenio. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Verzenio. The impact of cannabis may affect how well you stick to your Verzenio treatment plan.

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

Certain medical conditions and other factors may increase the risk of interactions with Verzenio. Before you take this drug, be sure to talk with your doctor about your health history. Verzenio may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Verzenio include:

• Liver problems: If you have severe liver problems, Verzenio can build up in your body. This may raise your risk of side effects, so your doctor may prescribe a lower dosage of Verzenio than usual. As well, Verzenio can worsen any liver problems you already have. Your doctor will likely monitor your liver function during Verzenio treatment.
• Kidney problems: If you have a kidney problem, Verzenio can make it worse. Your doctor will likely monitor your kidney function during Verzenio treatment.
• Infections: Verzenio can lower your white blood cell count, which can make it harder for your body to fight infections. If you have an infection, your doctor may prescribe medication to treat it before you start Verzenio.
• Low white blood cell count: If you already have a low white blood cell count, Verzenio can make this worse. This may raise your risk of infections. Your doctor will check your white blood cell count before you start Verzenio and regularly throughout your treatment. If needed, your doctor may delay starting Verzenio until your white blood cell count increases. If your white blood cell count gets too low during treatment, your doctor may reduce your Verzenio dosage or pause your treatment.
• History of blood clots: Verzenio can raise your risk of blood clots, such as deep vein thrombosis or pulmonary embolism. If you’ve had a past blood clot, talk with your doctor about whether Verzenio is right for you.
• Lung or breathing problems: Verzenio can rarely have side effects on your lungs. If you have any lung or breathing problems, tell your doctor right away if your symptoms worsen while you’re taking Verzenio.
• Allergic reaction: If you’ve had an allergic reaction to Verzenio or any of its ingredients, your doctor will likely not prescribe Verzenio. Taking the drug can cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
• Breastfeeding: It is unknown whether it’s safe to use Verzenio while breastfeeding. You should not breastfeed during Verzenio treatment and for 3 weeks after your last dose. If you’re breastfeeding or planning to, talk with your doctor before using Verzenio. They can talk with you about treatment options and ways to feed your child.
• Pregnancy: Due to the way Verzenio works, it’s likely not safe to take this drug while pregnant. Animal studies show that the drug may cause congenital anomalies (commonly known as birth defects). However, animal studies don’t always predict what would happen in humans. If you’re pregnant or planning to become pregnant, tell your doctor before starting Verzenio. They can advise you on the right treatment plan for you. If you’re able to become pregnant, you should use birth control while taking Verzenio and for 3 weeks after your last dose.

You can take certain steps to help prevent interactions with Verzenio. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Verzenio label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If Verzenio doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Verzenio by taking it exactly as your doctor prescribes.

Besides learning about interactions, you may want to find out more about Verzenio. These resources might help:

• Overview of Verzenio:For a general overview of Verzenio, you can see this article.
• Side effects:For information on Verzenio’s side effects, see this article. Alternatively, refer to the Verzenio prescribing information.
• Dosage specifics: To learn about the dosage of Verzenio, see this article.
• Cost: If you’d like to learn about Verzenio and cost, see this article.
• Facts about breast cancer: To learn more about your condition, see our breast cancer hub.

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