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Pralsetinib is an orally bioavailable selective inhibitor of mutant forms of and fusion products involving the proto-oncogene receptor tyrosine kinase RET, with potential antineoplastic activity. Upon administration, pralsetinib binds to and targets various RET mutants and RET-containing fusion products. RET gene mutations and translocations result in the upregulation and/or activation of RET tyrosine kinase activity in various cancer cell types; dysregulation of RET activity plays a key role in the development and regression of these cancers.

Pralsetinib, similar to the previously approved selpercatinib, is a kinase inhibitor with enhanced specificity for RET tyrosine kinase receptors (RTKs) over other RTK classes. Enhanced RET (Rearranged during transfection) oncogene expression is a hallmark of many cancers, including non-small cell lung cancer. Although multikinase inhibitors, including cabozantinib, ponatinib, sorafenib, sunitinib, and vandetanib, have shown efficacy in RET-driven cancers, their lack of specificity is generally associated with substantial toxicity. Pralsetinib (BLU-667) and selpercatinib (LOXO-292) represent the first generation of specific RET RTK inhibitors for the treatment of RET-driven cancers.^[rx]

Although a phase 1/2 trial of pralsetinib termed ARROW (NCT03037385) is still ongoing, pralsetinib was granted accelerated FDA approval on September 4, 2020, for the treatment of metastatic RET-fusion positive non-small cell lung cancer. It is currently marketed under the brand name GAVRETO™ by Blueprint Medicines.

Mechanism of action

Rearranged during transfection (RET) is a transmembrane receptor tyrosine kinase containing extracellular, transmembrane, and intracellular domains whose activity is required for normal kidney and nervous system development. Constitutive RET activation is achieved through chromosomal rearrangements producing 5′ fusions of dimerizable domains to the 3′ RET tyrosine kinase domain leading to constitutive dimerization and subsequent autophosphorylation; the most common fusions are KIF5B-RET and CCDC6-RET, although more than 35 genes have been reported to fuse with RET. Constitutive activation leads to increased downstream signalling and is associated with tumour invasion, migration, and proliferation.^[rx]

Pralsetinib (formerly referred to as BLU-667) was developed through screening more than 10,000 agnostically designed kinase inhibitors followed by extensive chemical modification to improve its properties. Pralsetinib displays in vitro IC₅₀ values for both WT RET as well as several mutant forms, including CCDC6-RET, in the range of 0.3-0.4 nmol/L, and is 100-fold more selective for RET kinase over 96% of 371 kinases tested.⁵ It is this specific inhibition of RET kinase that is associated with anti-tumour activity and clinical benefit in patients.

Despite increased selectivity for RET over other kinases, pralsetinib has been reported to inhibit DDR1, TRKC, FLT3, JAK1-2, TRKA, VEGFR2, PDGFRb, and FGFR1-2 at clinically relevant concentrations. The significance of these findings remains uncertain.^[rx]

Pralsetinib exerts an anti-tumour effect through specific inhibition of the rearranged during transfection (RET) tyrosine kinase, including multiple distinct oncogenic RET fusions, mutated RET kinase domains harbouring gatekeeper mutations, and in RET kinases with a variety of activating single point mutations. Due to pralsetinib’s high selectivity for RET over other kinases, both in vitro and in vivo,^[rx] pralsetinib has been described as having a better safety profile compared to previously used multi-kinase inhibitors. Despite this, pralsetinib use may increase the risk of hypertension, hemorrhagic events, impaired wound healing, hepatotoxicity, interstitial lung disease/pneumonitis, and embryo-fetal toxicity.^[rx]

Indications

Treatment of lung cancer (small cell and non-small cell lung cancer )
Pralsetinib is a RET receptor tyrosine kinase inhibitor for the treatment of metastatic RET-driven non-small cell lung cancer.
Gavreto is indicated as monotherapy for the treatment of adult patients with rearranged during transfection (RET) fusion-positive advanced non-small cell lung cancer (NSCLC) not previously treated with a RET inhibitor.
Treatment of thyroid cancer
Pralsetinib is approved to treat: Medullary thyroid cancer that has a mutation in the RETgene and is advanced or metastatic. It is used in adults and children aged 12 years and older who need systemic therapy. Non-small cell lung cancer has a RET fusion gene and is metastatic. It is used in adults. Thyroid cancer that has a RET fusion gene and is metastatic or advanced. It is used in adults and children aged 12 years and older who need systemic therapy, including those who received radioactive iodine and it did not work or is no longer working.
Pralsetinib is indicated for the treatment of metastatic non-small cell lung cancer (NSCLC) in adult patients who are confirmed to possess a rearranged during transfection (RET) gene fusion, as determined by an FDA approved test. It is also indicated in adult and pediatric patients 12 years of age and older for the treatment of advanced or metastatic RET-mutant medullary thyroid cancer, and in this same population for the treatment of advanced or metastatic RET fusion-positive thyroid cancer who require systemic therapy and for whom radioactive iodine is not appropriate.^[rx]
Advanced RET-fusion Non Small Cell Lung Cancer
Advanced RET-fusion thyroid cancer
Advanced RET-mutant medullary thyroid cancer
Metastatic RET-fusion Non Small Cell Lung Cancer
Metastatic RET-fusion thyroid cancer
Metastatic RET-mutant medullary thyroid cancer

Use in Cancer

Pralsetinib is approved to treat:

Medullary thyroid cancer has a mutation in the RET gene and is advanced or metastatic. It is used in adults and children aged 12 years and older who need systemic therapy.
Non-small cell lung cancer has a RET fusion gene and is metastatic. It is used in adults.
Thyroid cancer that has a RET fusion gene and is metastatic or advanced. It is used in adults and children aged 12 years and older who need systemic therapy, including those who received radioactive iodine and it did not work or is no longer working.

¹This use is approved under FDA’s Accelerated Approval Program. As a condition of approval, confirmatory trial(s) must show that pralsetinib provides a clinical benefit in these patients.

Pralsetinib is also being studied in the treatment of other types of cancer.

Contraindications

high blood pressure
bleeding
recent operation
abnormal liver function tests
impaired wound healing
pregnancy
a patient who is producing milk and breastfeeding
lung tissue problem

Dosage

Strengths: 100 mg

Non-Small Cell Lung Cancer

400 mg orally once a day
Duration of therapy: Continue until disease progression or unacceptable toxicity
Select patients based on the presence of a RET (rearranged during transfection) gene fusion.
Information on FDA-approved tests for RET gene fusion is available at http://www.fda.gov/CompanionDiagnostics.

Thyroid Cancer

400 mg orally once a day
Duration of therapy: Continue until disease progression or unacceptable toxicity
Select patients based on the presence of a RET (rearranged during transfection) gene fusion (thyroid cancer) or RET gene mutation (MTC).
However, FDA-approved gene fusion tests for RET gene fusion (thyroid cancer) and RET gene mutations are currently not available.
For the treatment of advanced or metastatic RET mutant medullary thyroid cancer (MTC) who require systemic therapy.
For the treatment of advanced or metastatic RET fusion-positive thyroid cancer who require systemic therapy and who are radioactive iodine-refractory (if radioactive iodine is appropriate).

Pediatric Dose for Thyroid Cancer

12 years or older: 400 mg orally once a day
Duration of therapy: Continue until disease progression or unacceptable toxicity
Select patients based on the presence of a RET (rearranged during transfection) gene fusion (thyroid cancer) or RET gene mutation (MTC).
However, FDA-approved gene fusion tests for RET gene fusion (thyroid cancer) and RET gene mutations are currently not available.
For the treatment of advanced or metastatic RET mutant medullary thyroid cancer (MTC) who require systemic therapy.
For the treatment of advanced or metastatic RET fusion-positive thyroid cancer who require systemic therapy and who are radioactive iodine-refractory (if radioactive iodine is appropriate).

Renal Dose Adjustments

Mild to moderate renal impairment (CrCl 30 to less than 90 mL/min): No adjustment recommended.
Severe renal impairment (CrCl 15 to less than 30 mL/min): Data not available
ESRD: Data not available

Liver Dose Adjustments

Mild hepatic impairment (total bilirubin less than or equal to upper limit of normal [ULN] and AST greater than ULN; or total bilirubin greater than 1 to 1.5 x ULN and any AST): No adjustment recommended.
Moderate hepatic impairment (total bilirubin greater than 1.5 to 3 x ULN and any AST: Data not available
Severe hepatic impairment (total bilirubin greater than 3 x ULN and any AST): Data not available

Dose Adjustments

DOSE REDUCTIONS FOR ADVERSE REACTIONS:

First dose reduction: 300 mg orally once a day
Second dose reduction: 200 mg orally once a day
Third dose reduction: 100 mg orally once a day
Discontinue therapy in patients unable to tolerate 100 mg/day.

DOSE MODIFICATIONS FOR ADVERSE REACTIONS:
ILD/PNEUMONITIS:

Grade 1 or 2: Withhold therapy until resolution; resume at reduced dose
Grade 3 or 4 or recurrent: Permanently discontinue for confirmed ILD/pneumonitis

HYPERTENSION:

Grade 3: Withhold therapy for Grade 3 hypertension that persists despite optimal antihypertensives; resume at reduced dose when hypertension is controlled
Grade 4: Permanently discontinue therapy

HEPATOTOXICITY:

Grade 3 or 4: Withhold therapy, monitor transaminases weekly until recovery to Grade 1 or baseline; resume at reduced dose; if hepatotoxicity recurs at Grade 3 or higher, discontinue.

HEMORRHAGIC EVENTS:

Grade 3 or 4: Withhold therapy until recovery to baseline, Grade 0, or 1
Severe or life-threatening hemorrhagic events: Discontinue therapy

OTHER ADVERSE REACTIONS:

Grade 3 or 4: Withhold therapy until improvement to Grade 2 or less; resume at reduced dose
Recurrent Grade 4: Permanently discontinue

COADMINISTRATION WITH COMBINED P-GLYCOPROTEIN (P-gp) AND STRONG CYP450 3A INHIBITORS:

Avoid coadministration with combined P-gp and strong CYP450 3A inhibitors.
If coadministration cannot be avoided, reduce dose of pralsetinib (if current dose is 300 mg/day or 400 mg/day reduce dose to 200 mg/day; if current dose is 200 mg/day reduce dose to 100 mg/day).
After combined P-gp and strong CYP450 3A inhibitor has been discontinued for 3 to 5 elimination half-lives, resume pralsetinib at dose taken prior to initiating combined P-gp and strong CYP450 3A inhibitor

COADMINISTRATION WITH STRONG CYP450 3A INDUCERS:

Avoid coadministration with strong CYP450 3A inducers.
If coadministration with a strong CYP450 3A inducer cannot be avoided, increase the starting dose of pralsetinib to double the current dose starting on Day 7 of coadministration.
After CYP450 3A inducer has been discontinued for at least 14 days, resume pralsetinib at dose taken prior to initiating CYP450 3A inducer.

Administration advice:

Take orally on an empty stomach; no food should be consumed for at least 2 hours before and at least 1 hour after dosing

Side Effects

The Most Common

constipation
diarrhea
dry mouth
muscle or bone pain
swelling of hands, ankles, or feet
confusion, headache, shortness of breath, dizziness, or chest pain
fever, shortness of breath, or cough
pale skin, fatigue, or shortness of breath
yellowing of skin or eyes, dark-colored urine, bleeding or bruising more easily than normal, loss of appetite, decreased energy, or pain on the right side of the stomach area
black and tarry stools
red blood in stools
bloody vomit
vomiting material that looks like coffee grounds
coughing up blood
unusual bleeding or bruising
unusual vaginal bleeding
frequent nose bleeds
drowsiness, confusion, headache, or difficulty speaking
Bone pain
burning, numbness, tingling, or painful sensations
change in taste
constipation
decreased appetite

More common

Bleeding gums
blurred vision
chest pain
chills
cough
coughing up blood
dark urine
decrease or change in the amount of urine
difficulty in breathing or swallowing
dizziness
fainting
fast or slow heartbeat
fever
general feeling of discomfort or illness
headache
increased menstrual flow or vaginal bleeding
irregular pulse
joint pain, stiffness, or swelling
loss of appetite
lower back, side, or stomach pain
nausea
nervousness
nosebleeds
paralysis
pounding in the ears
prolonged bleeding from cuts
rapid weight gain
red or black, tarry stools
red or dark brown urine
slow or fast heartbeat
stomach pain, severe
swelling around the eye
swelling of the eyelids
swelling of the feet or lower legs
swelling or puffiness of the face
thickening of bronchial secretions
unusual tiredness or weakness
vomiting
yellow eyes or skin

Rare

Black, tarry stools
bladder pain
bloody or cloudy urine
chest pain or tightness
confusion
difficult, burning, or painful urination
frequent urge to urinate
lightheadedness
lower back or side pain
pale skin
sneezing
sore throat
sores, ulcers, or white spots on the lips or in the mouth
swollen glands
unusual bleeding or bruising
difficulty in moving
dry mouth
joint pain
lack or loss of strength
loss of taste
muscle aching or cramping
muscle pains or stiffness
neck pain
pain, swelling, or redness in the joints
swelling or inflammation of the mouth
tenderness
unsteadiness or awkwardness
watery or bloody diarrhea
weakness in the arms, hands, legs, or feet

Drug Interactions

DRUG	INTERACTION
Abametapir	The serum concentration of Pralsetinib can be increased when it is combined with Abametapir.
Abemaciclib	The serum concentration of Abemaciclib can be increased when it is combined with Pralsetinib.
Abrocitinib	The serum concentration of Pralsetinib can be increased when it is combined with Abrocitinib.
Acalabrutinib	The metabolism of Acalabrutinib can be increased when combined with Pralsetinib.
Acenocoumarol	The serum concentration of Acenocoumarol can be increased when it is combined with Pralsetinib.
Acetohexamide	The metabolism of Acetohexamide can be decreased when combined with Pralsetinib.
Acetylsalicylic acid	The metabolism of Acetylsalicylic acid can be decreased when combined with Pralsetinib.
Acyclovir	The excretion of Acyclovir can be decreased when combined with Pralsetinib.
Adefovir dipivoxil	The excretion of Adefovir dipivoxil can be decreased when combined with Pralsetinib.
Afatinib	The serum concentration of Pralsetinib can be increased when it is combined with Afatinib.
Albendazole	The metabolism of Albendazole can be increased when combined with Pralsetinib.
Alectinib	The metabolism of Alectinib can be increased when combined with Pralsetinib.
Alfentanil	The metabolism of Alfentanil can be decreased when combined with Pralsetinib.
Alfuzosin	The metabolism of Alfuzosin can be decreased when combined with Pralsetinib.
Allopurinol	Pralsetinib may decrease the excretion rate of Allopurinol which could result in a higher serum level.
Almotriptan	The metabolism of Almotriptan can be decreased when combined with Pralsetinib.
Alosetron	The metabolism of Alosetron can be decreased when combined with Pralsetinib.
Alpelisib	The serum concentration of Alpelisib can be increased when it is combined with Pralsetinib.
Alprazolam	The metabolism of Alprazolam can be decreased when combined with Pralsetinib.
Alprostadil	The excretion of Alprostadil can be decreased when combined with Pralsetinib.
Ambrisentan	The serum concentration of Ambrisentan can be increased when it is combined with Pralsetinib.
Aminohippuric acid	The excretion of Aminohippuric acid can be decreased when combined with Pralsetinib.
Aminophenazone	The metabolism of Aminophenazone can be decreased when combined with Pralsetinib.
Aminophylline	The metabolism of Aminophylline can be increased when combined with Pralsetinib.
Amiodarone	The serum concentration of Pralsetinib can be increased when it is combined with Amiodarone.
Amitriptyline	The metabolism of Amitriptyline can be decreased when combined with Pralsetinib.
Amlodipine	The metabolism of Amlodipine can be increased when combined with Pralsetinib.
Amodiaquine	The metabolism of Amodiaquine can be decreased when combined with Pralsetinib.
Amprenavir	The serum concentration of Pralsetinib can be increased when it is combined with Amprenavir.
Anastrozole	The metabolism of Anastrozole can be decreased when combined with Pralsetinib.
Antipyrine	The metabolism of Antipyrine can be decreased when combined with Pralsetinib.
Apalutamide	The serum concentration of Pralsetinib can be decreased when it is combined with Apalutamide.
Apixaban	Pralsetinib may decrease the excretion rate of Apixaban which could result in a higher serum level.
Apomorphine	The metabolism of Apomorphine can be decreased when combined with Pralsetinib.
Aprepitant	The metabolism of Pralsetinib can be decreased when combined with Aprepitant.
Arformoterol	The metabolism of Arformoterol can be decreased when combined with Pralsetinib.
Aripiprazole	The metabolism of Aripiprazole can be increased when combined with Pralsetinib.
Aripiprazole lauroxil	The metabolism of Aripiprazole lauroxil can be increased when combined with Pralsetinib.
Arsenic trioxide	The serum concentration of Pralsetinib can be increased when it is combined with Arsenic trioxide.
Artemether	The metabolism of Artemether can be decreased when combined with Pralsetinib.
Articaine	The risk or severity of methemoglobinemia can be increased when Pralsetinib is combined with Articaine.
Asciminib	The serum concentration of Pralsetinib can be increased when it is combined with Asciminib.
Astemizole	The metabolism of Astemizole can be increased when combined with Pralsetinib.
Asunaprevir	The serum concentration of Pralsetinib can be increased when it is combined with Asunaprevir.
Atazanavir	The serum concentration of Pralsetinib can be increased when it is combined with Atazanavir.
Atenolol	Pralsetinib may decrease the excretion rate of Atenolol which could result in a higher serum level.
Atogepant	The serum concentration of Atogepant can be increased when it is combined with Pralsetinib.
Atorvastatin	The metabolism of Atorvastatin can be decreased when combined with Pralsetinib.
Atropine	Pralsetinib may decrease the excretion rate of Atropine which could result in a higher serum level.
Avanafil	The serum concentration of Avanafil can be increased when it is combined with Pralsetinib.
Avapritinib	The metabolism of Avapritinib can be decreased when combined with Pralsetinib.
Avatrombopag	Avatrombopag may decrease the excretion rate of Pralsetinib which could result in a higher serum level.
Axitinib	The serum concentration of Axitinib can be increased when it is combined with Pralsetinib.
Azelastine	The metabolism of Azelastine can be decreased when combined with Pralsetinib.
Azithromycin	The metabolism of Azithromycin can be increased when combined with Pralsetinib.
Baricitinib	The excretion of Baricitinib can be decreased when combined with Pralsetinib.
Beclomethasone	Beclomethasone dipropionate may decrease the excretion rate of Pralsetinib which could result in a higher serum level.
Belantamab	Pralsetinib may decrease the excretion rate of Belantamab mafodotin which could result in a higher serum level.
Belinostat	The serum concentration of Belinostat can be increased when it is combined with Pralsetinib.
Belumosudil	The serum concentration of Pralsetinib can be increased when it is combined with Belumosudil.
Bempedoic acid	The excretion of Bempedoic acid can be decreased when combined with Pralsetinib.
Bendamustine	The serum concentration of Bendamustine can be increased when it is combined with Pralsetinib.
Benzocaine	The risk or severity of methemoglobinemia can be increased when Pralsetinib is combined with Benzocaine.
Benzyl alcohol	The risk or severity of methemoglobinemia can be increased when Pralsetinib is combined with Benzyl alcohol.
Benzylpenicillin	The excretion of Benzylpenicillin can be decreased when combined with Pralsetinib.
Berotralstat	The serum concentration of Berotralstat can be increased when it is combined with Pralsetinib.
Betrixaban	The serum concentration of Betrixaban can be increased when it is combined with Pralsetinib.
Bexarotene	The metabolism of Bexarotene can be decreased when combined with Pralsetinib.
Bicalutamide	The metabolism of Bicalutamide can be increased when combined with Pralsetinib.
Binimetinib	The serum concentration of Binimetinib can be increased when it is combined with Pralsetinib.
Bisoprolol	The serum concentration of Bisoprolol can be increased when it is combined with Pralsetinib.
Boceprevir	The serum concentration of Pralsetinib can be increased when it is combined with Boceprevir.
Bortezomib	The serum concentration of Bortezomib can be increased when it is combined with Pralsetinib.
Bosentan	The risk or severity of liver damage can be increased when Bosentan is combined with Pralsetinib.
Bosutinib	The serum concentration of Bosutinib can be increased when it is combined with Pralsetinib.
Brentuximab vedotin	The serum concentration of Brentuximab vedotin can be increased when it is combined with Pralsetinib.
Brigatinib	The metabolism of Brigatinib can be increased when combined with Pralsetinib.
Brincidofovir	The serum concentration of Brincidofovir can be increased when it is combined with Pralsetinib.
Brivaracetam	The metabolism of Brivaracetam can be decreased when combined with Pralsetinib.
Budesonide	Pralsetinib may decrease the excretion rate of Budesonide which could result in a higher serum level.
Bupivacaine	The risk or severity of methemoglobinemia can be increased when Pralsetinib is combined with Bupivacaine.
Buprenorphine	Buprenorphine may decrease the excretion rate of Pralsetinib which could result in a higher serum level.
Bupropion	The metabolism of Bupropion can be decreased when combined with Pralsetinib.
Buspirone	The metabolism of Buspirone can be decreased when combined with Pralsetinib.
Busulfan	The metabolism of Busulfan can be increased when combined with Pralsetinib.
Butacaine	The risk or severity of methemoglobinemia can be increased when Pralsetinib is combined with Butacaine.
Butamben	The risk or severity of methemoglobinemia can be increased when Pralsetinib is combined with Butamben.
Cabazitaxel	The serum concentration of Cabazitaxel can be increased when it is combined with Pralsetinib.
Cabergoline	The serum concentration of Cabergoline can be increased when it is combined with Pralsetinib.
Cabozantinib	The metabolism of Cabozantinib can be decreased when combined with Pralsetinib.
Caffeine	Caffeine may decrease the excretion rate of Pralsetinib which could result in a higher serum level.
Canagliflozin	The serum concentration of Pralsetinib can be increased when it is combined with Canagliflozin.
Candesartan	The metabolism of Candesartan cilexetil can be decreased when combined with Pralsetinib.
Cannabidiol	Cannabidiol may decrease the excretion rate of Pralsetinib which could result in a higher serum level.
Capecitabine	The metabolism of Capecitabine can be decreased when combined with Pralsetinib.
Capmatinib	The serum concentration of Capmatinib can be decreased when it is combined with Pralsetinib.
Capsaicin	The risk or severity of methemoglobinemia can be increased when Pralsetinib is combined with Capsaicin.
Captopril	The excretion of Captopril can be decreased when combined with Pralsetinib.
Carbamazepine	The serum concentration of Pralsetinib can be decreased when it is combined with Carbamazepine.
Carfilzomib	The serum concentration of Pralsetinib can be increased when it is combined with Carfilzomib.

Carvedilol	The serum concentration of Pralsetinib can be increased when it is combined with Carvedilol.
Caspofungin	The excretion of Caspofungin can be decreased when combined with Pralsetinib.
Cefaclor	Pralsetinib may decrease the excretion rate of Cefaclor which could result in a higher serum level.
Cefazolin	The excretion of Cefazolin can be decreased when combined with Pralsetinib.
Cefdinir	The excretion of Cefdinir can be decreased when combined with Pralsetinib.
Cefotiam	The excretion of Cefotiam can be decreased when combined with Pralsetinib.
Cefradine	The excretion of Cefradine can be decreased when combined with Pralsetinib.
Ceftibuten	The excretion of Ceftibuten can be decreased when combined with Pralsetinib.
Ceftizoxime	The excretion of Ceftizoxime can be decreased when combined with Pralsetinib.
Celecoxib	Pralsetinib may decrease the excretion rate of Celecoxib which could result in a higher serum level.
Cenobamate	The serum concentration of Pralsetinib can be decreased when it is combined with Cenobamate.
Cephalexin	The metabolism of Cephalexin can be increased when combined with Pralsetinib.
Ceritinib	The serum concentration of Ceritinib can be increased when it is combined with Pralsetinib.
Cerivastatin	Pralsetinib may decrease the excretion rate of Cerivastatin which could result in a higher serum level.
Chloroprocaine	The risk or severity of methemoglobinemia can be increased when Pralsetinib is combined with Chloroprocaine.
Chloroquine	The metabolism of Chloroquine can be decreased when combined with Pralsetinib.
Chlorpheniramine	The metabolism of Chlorpheniramine can be decreased when combined with Pralsetinib.
Chlorpromazine	The risk or severity of liver damage can be increased when Chlorpromazine is combined with Pralsetinib.
Chlorpropamide	The metabolism of Chlorpropamide can be decreased when combined with Pralsetinib.
Cholecystokinin	The excretion of Cholecystokinin can be decreased when combined with Pralsetinib.
Cholesterol	Cholesterol may increase the excretion rate of Pralsetinib which could result in a lower serum level and potentially a reduction in efficacy.
Cholic Acid	Pralsetinib may decrease the excretion rate of Cholic Acid which could result in a higher serum level.
Cidofovir	The excretion of Cidofovir can be decreased when combined with Pralsetinib.
Cilostazol	The metabolism of Cilostazol can be decreased when combined with Pralsetinib.
Cimetidine	The risk or severity of liver damage can be increased when Cimetidine is combined with Pralsetinib.
Cinchocaine	The risk or severity of methemoglobinemia can be increased when Pralsetinib is combined with Cinchocaine.
Cinnarizine	The metabolism of Cinnarizine can be decreased when combined with Pralsetinib.
Ciprofloxacin	The metabolism of Pralsetinib can be decreased when combined with Ciprofloxacin.
Cisapride	The metabolism of Cisapride can be increased when combined with Pralsetinib.
Cladribine	Pralsetinib may decrease the excretion rate of Cladribine which could result in a higher serum level.
Clarithromycin	The serum concentration of Pralsetinib can be increased when it is combined with Clarithromycin.
Clindamycin	The metabolism of Clindamycin can be increased when combined with Pralsetinib.
Clobazam	The serum concentration of Clobazam can be increased when it is combined with Pralsetinib.
Clofarabine	Pralsetinib may decrease the excretion rate of Clofarabine which could result in a higher serum level.
Clofazimine	The serum concentration of Pralsetinib can be increased when it is combined with Clofazimine.
Clomifene	The serum concentration of Clomifene can be increased when it is combined with Pralsetinib.
Clomipramine	The metabolism of Clomipramine can be increased when combined with Pralsetinib.
Clonazepam	The metabolism of Clonazepam can be increased when combined with Pralsetinib.
Clonidine	The metabolism of Clonidine can be increased when combined with Pralsetinib.
Clopidogrel	The metabolism of Clopidogrel can be decreased when combined with Pralsetinib.
Clozapine	The metabolism of Pralsetinib can be decreased when combined with Clozapine.
Cobicistat	The serum concentration of Pralsetinib can be increased when it is combined with Cobicistat.
Cobimetinib	The serum concentration of Cobimetinib can be increased when it is combined with Pralsetinib.
Cocaine	The risk or severity of methemoglobinemia can be increased when Pralsetinib is combined with Cocaine.
Colchicine	The serum concentration of Colchicine can be increased when it is combined with Pralsetinib.
Conivaptan	The serum concentration of Pralsetinib can be increased when it is combined with Conivaptan.
Conjugated	Pralsetinib may decrease the excretion rate of Conjugated estrogens which could result in a higher serum level.
Copanlisib	The serum concentration of Copanlisib can be increased when it is combined with Pralsetinib.
Crizotinib	The serum concentration of Pralsetinib can be increased when it is combined with Crizotinib.
Curcumin	The serum concentration of Pralsetinib can be increased when it is combined with Curcumin.
Cyclophosphamide	The metabolism of Cyclophosphamide can be increased when combined with Pralsetinib.
Cyclosporine	The serum concentration of Pralsetinib can be increased when it is combined with Cyclosporine.
Cyproterone acetate	The metabolism of Cyproterone acetate can be increased when combined with Pralsetinib.
Dabigatran etexilate	The serum concentration of Dabigatran etexilate can be increased when it is combined with Pralsetinib.
Dabrafenib	The serum concentration of Pralsetinib can be decreased when it is combined with Dabrafenib.
Daclatasvir	The serum concentration of Pralsetinib can be increased when it is combined with Daclatasvir.
Dacomitinib	The serum concentration of Pralsetinib can be increased when it is combined with Dacomitinib.
Dactinomycin	The serum concentration of Dactinomycin can be increased when it is combined with Pralsetinib.
Danazol	The serum concentration of Pralsetinib can be increased when it is combined with Danazol.
Dapagliflozin	The metabolism of Dapagliflozin can be decreased when combined with Pralsetinib.
Dapsone	The metabolism of Dapsone can be decreased when combined with Pralsetinib.
Daptomycin	The serum concentration of Daptomycin can be increased when it is combined with Pralsetinib.
Darbepoetin alfa	The risk or severity of Thrombosis can be increased when Darbepoetin alfa is combined with Pralsetinib.
Darolutamide	The serum concentration of Pralsetinib can be increased when it is combined with Darolutamide.
Darunavir	The serum concentration of Pralsetinib can be increased when it is combined with Darunavir.
Dasabuvir	Dasabuvir may decrease the excretion rate of Pralsetinib which could result in a higher serum level.
Dasatinib	The serum concentration of Dasatinib can be increased when it is combined with Pralsetinib.
Daunorubicin	Pralsetinib may decrease the excretion rate of Daunorubicin which could result in a higher serum level.
Delafloxacin	Pralsetinib may decrease the excretion rate of Delafloxacin which could result in a higher serum level.
Delavirdine	The serum concentration of Pralsetinib can be increased when it is combined with Delavirdine.
Desogestrel	The metabolism of Desogestrel can be increased when combined with Pralsetinib.
Desvenlafaxine	The metabolism of Pralsetinib can be decreased when combined with Desvenlafaxine.
Deutetrabenazine	The metabolism of Deutetrabenazine can be decreased when combined with Pralsetinib.
Dexamethasone	The serum concentration of Pralsetinib can be decreased when it is combined with Dexamethasone.
Dexamethasone	Dexamethasone acetate may decrease the excretion rate of Pralsetinib which could result in a higher serum level.
Dexibuprofen	The metabolism of Dexibuprofen can be decreased when combined with Pralsetinib.
Dextromethorphan	The metabolism of Dextromethorphan can be decreased when combined with Pralsetinib.
Diazepam	The metabolism of Diazepam can be decreased when combined with Pralsetinib.
Diclofenac	Pralsetinib may decrease the excretion rate of Diclofenac which could result in a higher serum level.
Dicoumarol	The metabolism of Dicoumarol can be decreased when combined with Pralsetinib.
Didanosine	The excretion of Didanosine can be decreased when combined with Pralsetinib.
Dienogest	The metabolism of Dienogest can be increased when combined with Pralsetinib.
Diethylstilbestrol	Pralsetinib may decrease the excretion rate of Diethylstilbestrol which could result in a higher serum level.
Digitoxin	The serum concentration of Digitoxin can be increased when it is combined with Pralsetinib.
Digoxin	Pralsetinib may decrease the excretion rate of Digoxin which could result in a higher serum level.
Dihydroergocornine	The metabolism of Dihydroergocornine can be increased when combined with Pralsetinib.
Dihydroergocristine	Pralsetinib may decrease the excretion rate of Dihydroergocristine which could result in a higher serum level.
Dihydroergotamine	The metabolism of Dihydroergotamine can be increased when combined with Pralsetinib.
Diltiazem	The metabolism of Pralsetinib can be decreased when combined with Diltiazem.
Dinoprostone	The excretion of Dinoprostone can be decreased when combined with Pralsetinib.
Diosmin	The serum concentration of Pralsetinib can be increased when it is combined with Diosmin.
Diphenhydramine	The risk or severity of methemoglobinemia can be increased when Pralsetinib is combined with Diphenhydramine.
Dipyridamole	Pralsetinib may decrease the excretion rate of Dipyridamole which could result in a higher serum level.
Disulfiram	Pralsetinib may decrease the excretion rate of Disulfiram which could result in a higher serum level.
Docetaxel	The metabolism of Docetaxel can be increased when combined with Pralsetinib.
Doconexent	The metabolism of Doconexent can be decreased when combined with Pralsetinib.
Dofetilide	The metabolism of Dofetilide can be increased when combined with Pralsetinib.
Dolutegravir	Pralsetinib may decrease the excretion rate of Dolutegravir which could result in a higher serum level.
Domperidone	The metabolism of Domperidone can be decreased when combined with Pralsetinib.
Donepezil	Pralsetinib may decrease the excretion rate of Donepezil which could result in a higher serum level.

Doravirine	The metabolism of Doravirine can be decreased when combined with Pralsetinib.
Doxazosin	The metabolism of Doxazosin can be increased when combined with Pralsetinib.
Doxepin	The metabolism of Doxepin can be decreased when combined with Pralsetinib.
Doxorubicin	The serum concentration of Doxorubicin can be increased when it is combined with Pralsetinib.
Dronabinol	The serum concentration of Dronabinol can be increased when it is combined with Pralsetinib.
Dronedarone	The serum concentration of Pralsetinib can be increased when it is combined with Dronedarone.
Drospirenone	The metabolism of Drospirenone can be increased when combined with Pralsetinib.
Duloxetine	The metabolism of Duloxetine can be decreased when combined with Pralsetinib.
Dutasteride	The metabolism of Dutasteride can be decreased when combined with Pralsetinib.
Duvelisib	Pralsetinib may decrease the excretion rate of Duvelisib which could result in a higher serum level.
Dyclonine	The risk or severity of methemoglobinemia can be increased when Pralsetinib is combined with Dyclonine.
Ebastine	The metabolism of Ebastine can be increased when combined with Pralsetinib.
Econazole	The serum concentration of Pralsetinib can be increased when it is combined with Econazole.
Edoxaban	The serum concentration of Edoxaban can be increased when it is combined with Pralsetinib.
Efavirenz	The serum concentration of Pralsetinib can be increased when it is combined with Efavirenz.
Elagolix	The serum concentration of Pralsetinib can be increased when it is combined with Elagolix.
Elbasvir	Elbasvir may decrease the excretion rate of Pralsetinib which could result in a higher serum level.
Eletriptan	The metabolism of Eletriptan can be decreased when combined with Pralsetinib.
Elexacaftor	The metabolism of Elexacaftor can be increased when combined with Pralsetinib.
Eliglustat	The metabolism of Eliglustat can be decreased when combined with Pralsetinib.
Eltrombopag	Eltrombopag may decrease the excretion rate of Pralsetinib which could result in a higher serum level.
Eluxadoline	The serum concentration of Eluxadoline can be increased when it is combined with Pralsetinib.
Elvitegravir	The serum concentration of Pralsetinib can be increased when it is combined with Elvitegravir.
Emtricitabine	The excretion of Emtricitabine can be decreased when combined with Pralsetinib.
Enalapril	The excretion of Enalapril can be decreased when combined with Pralsetinib.
Enasidenib	The serum concentration of Pralsetinib can be increased when it is combined with Enasidenib.
Enfortumab	The serum concentration of Enfortumab vedotin can be increased when it is combined with Pralsetinib.
Entrectinib	The metabolism of Entrectinib can be increased when combined with Pralsetinib.
Enzalutamide	The serum concentration of Pralsetinib can be decreased when it is combined with Enzalutamide.
Eplerenone	The metabolism of Eplerenone can be decreased when combined with Pralsetinib.
Erdafitinib	The serum concentration of Pralsetinib can be increased when it is combined with Erdafitinib.
Ergotamine	The serum concentration of Pralsetinib can be increased when it is combined with Ergotamine.
Erlotinib	The serum concentration of Erlotinib can be decreased when it is combined with Pralsetinib.
Ertugliflozin	Pralsetinib may decrease the excretion rate of Ertugliflozin which could result in a higher serum level.
Erythromycin	The serum concentration of Pralsetinib can be increased when it is combined with Erythromycin.
Erythropoietin	The risk or severity of Thrombosis can be increased when Erythropoietin is combined with Pralsetinib.
Esketamine	The metabolism of Esketamine can be decreased when combined with Pralsetinib.
Estetrol	The metabolism of Estetrol can be increased when combined with Pralsetinib.
Estradiol	Estradiol may decrease the excretion rate of Pralsetinib which could result in a higher serum level.
Estradiol acetate	Estradiol acetate may decrease the excretion rate of Pralsetinib which could result in a higher serum level.
Estradiol benzoate	Estradiol benzoate may decrease the excretion rate of Pralsetinib which could result in a higher serum level.
Estradiol cypionate	Estradiol cypionate may decrease the excretion rate of Pralsetinib which could result in a higher serum level.
Estradiol dienanthate	Estradiol dienanthate may decrease the excretion rate of Pralsetinib which could result in a higher serum level.
Estradiol valerate	Estradiol valerate may decrease the excretion rate of Pralsetinib which could result in a higher serum level.
Estrone sulfate	The metabolism of Estrone sulfate can be increased when combined with Pralsetinib.
Eszopiclone	The serum concentration of Eszopiclone can be decreased when it is combined with Pralsetinib.
Ethinylestradiol	The risk or severity of liver damage can be increased when Ethinylestradiol is combined with Pralsetinib.
Ethyl chloride	The risk or severity of methemoglobinemia can be increased when Pralsetinib is combined with Ethyl chloride.
Ethynodiol diacetate	The metabolism of Ethynodiol diacetate can be increased when combined with Pralsetinib.
Etidocaine	The risk or severity of methemoglobinemia can be increased when Pralsetinib is combined with Etidocaine.
Etodolac	The metabolism of Etodolac can be decreased when combined with Pralsetinib.
Etonogestrel	The metabolism of Etonogestrel can be increased when combined with Pralsetinib.
Etoposide	The serum concentration of Etoposide can be increased when it is combined with Pralsetinib.
Etoricoxib	The metabolism of Etoricoxib can be decreased when combined with Pralsetinib.
Etravirine	The metabolism of Etravirine can be decreased when combined with Pralsetinib.
Everolimus	The serum concentration of Pralsetinib can be increased when it is combined with Everolimus.
Ezetimibe	Pralsetinib may decrease the excretion rate of Ezetimibe which could result in a higher serum level.
Favipiravir	The serum concentration of Pralsetinib can be increased when it is combined with Favipiravir.
Febuxostat	The excretion of Pralsetinib can be decreased when combined with Febuxostat.
Fedratinib	The serum concentration of Pralsetinib can be increased when it is combined with Fedratinib.
Felodipine	Pralsetinib may decrease the excretion rate of Felodipine which could result in a higher serum level.
Fenofibrate	Pralsetinib may decrease the excretion rate of Fenofibrate which could result in a higher serum level.
Fentanyl	The metabolism of Fentanyl can be decreased when combined with Pralsetinib.
Fexinidazole	The metabolism of Fexinidazole can be decreased when combined with Pralsetinib.
Fexofenadine	The serum concentration of Fexofenadine can be increased when it is combined with Pralsetinib.
Finasteride	The metabolism of Finasteride can be decreased when combined with Pralsetinib.
Finerenone	The serum concentration of Finerenone can be increased when it is combined with Pralsetinib.
Flecainide	The excretion of Flecainide can be decreased when combined with Pralsetinib.
Flibanserin	The serum concentration of Pralsetinib can be increased when it is combined with Flibanserin.
Flucloxacillin	Pralsetinib may decrease the excretion rate of Flucloxacillin which could result in a higher serum level.
Fluconazole	The serum concentration of Pralsetinib can be increased when it is combined with Fluconazole.
Fluindione	The metabolism of Fluindione can be decreased when combined with Pralsetinib.
Flunarizine	The metabolism of Flunarizine can be decreased when combined with Pralsetinib.
Flunitrazepam	The metabolism of Flunitrazepam can be decreased when combined with Pralsetinib.
Fluorescein	Pralsetinib may decrease the excretion rate of Fluorescein which could result in a higher serum level.
Fluorouracil	The metabolism of Fluorouracil can be decreased when combined with Pralsetinib.
Fluoxetine	The metabolism of Fluoxetine can be decreased when combined with Pralsetinib.
Flurbiprofen	The metabolism of Flurbiprofen can be decreased when combined with Pralsetinib.
Flutamide	The metabolism of Flutamide can be decreased when combined with Pralsetinib.
Fluticasone	The metabolism of Fluticasone can be decreased when combined with Pralsetinib.
Fluticasone furoate	The metabolism of Fluticasone furoate can be decreased when combined with Pralsetinib.
Fluticasone	The metabolism of Fluticasone propionate can be decreased when combined with Pralsetinib.
Fluvastatin	The metabolism of Fluvastatin can be decreased when combined with Pralsetinib.
Fluvoxamine	Pralsetinib may decrease the excretion rate of Fluvoxamine which could result in a higher serum level.
Folic acid	Pralsetinib may decrease the excretion rate of Folic acid which could result in a higher serum level.
Formoterol	The metabolism of Formoterol can be decreased when combined with Pralsetinib.
Fosaprepitant	The metabolism of Fosaprepitant can be increased when combined with Pralsetinib.
Fosnetupitant	The metabolism of Pralsetinib can be decreased when combined with Fosnetupitant.
Fosphenytoin	The serum concentration of Pralsetinib can be decreased when it is combined with Fosphenytoin.
Fostamatinib	Fostamatinib may decrease the excretion rate of Pralsetinib which could result in a higher serum level.
Fostemsavir	Fostemsavir may decrease the excretion rate of Pralsetinib which could result in a higher serum level.
Fusidic acid	The metabolism of Pralsetinib can be decreased when combined with Fusidic acid.
Futibatinib	The serum concentration of Futibatinib can be increased when it is combined with Pralsetinib.
Gadoxetic acid	The excretion of Gadoxetic acid can be decreased when combined with Pralsetinib.
Ganciclovir	The excretion of Ganciclovir can be decreased when combined with Pralsetinib.
Gefitinib	Gefitinib may decrease the excretion rate of Pralsetinib which could result in a higher serum level.
Gemcitabine	The serum concentration of Gemcitabine can be increased when it is combined with Pralsetinib.
Gestrinone	The metabolism of Gestrinone can be increased when combined with Pralsetinib.
Gilteritinib	Gilteritinib may decrease the excretion rate of Pralsetinib which could result in a higher serum level.
Glasdegib	The serum concentration of Pralsetinib can be increased when it is combined with Glasdegib.

Glecaprevir	The serum concentration of Pralsetinib can be increased when it is combined with Glecaprevir.
Gliclazide	The metabolism of Gliclazide can be decreased when combined with Pralsetinib.
Glimepiride	Pralsetinib may decrease the excretion rate of Glimepiride which could result in a higher serum level.
Glipizide	Pralsetinib may decrease the excretion rate of Glipizide which could result in a higher serum level.
Gliquidone	The metabolism of Gliquidone can be decreased when combined with Pralsetinib.
Glyburide	Pralsetinib may decrease the excretion rate of Glyburide which could result in a higher serum level.
Glycyrrhizic acid	Pralsetinib may decrease the excretion rate of Glycyrrhizic acid which could result in a higher serum level.
Grazoprevir	Grazoprevir may decrease the excretion rate of Pralsetinib which could result in a higher serum level.
Grepafloxacin	The excretion of Grepafloxacin can be decreased when combined with Pralsetinib.
Guanidine	The excretion of Guanidine can be decreased when combined with Pralsetinib.
Halofantrine	The metabolism of Halofantrine can be decreased when combined with Pralsetinib.
Haloperidol	The serum concentration of Haloperidol can be increased when it is combined with Pralsetinib.
Halothane	The metabolism of Halothane can be decreased when combined with Pralsetinib.
Hydrocortisone	The metabolism of Hydrocortisone can be decreased when combined with Pralsetinib.
Hydrocortisone	The metabolism of Hydrocortisone acetate can be decreased when combined with Pralsetinib.
Hydrocortisone	The metabolism of Hydrocortisone butyrate can be decreased when combined with Pralsetinib.
Hydrocortisone	The metabolism of Hydrocortisone cypionate can be decreased when combined with Pralsetinib.
Hydrocortisone	The metabolism of Hydrocortisone phosphate can be decreased when combined with Pralsetinib.
Hydromorphone	The metabolism of Hydromorphone can be decreased when combined with Pralsetinib.
Hydroxychloroquine	The metabolism of Hydroxychloroquine can be decreased when combined with Pralsetinib.
Hydroxyprogester	The metabolism of Hydroxyprogesterone caproate can be increased when combined with Pralsetinib.
Hydroxyzine	The metabolism of Hydroxyzine can be decreased when combined with Pralsetinib.
Ibrutinib	The metabolism of Ibrutinib can be decreased when combined with Pralsetinib.
Ibuprofen	The metabolism of Ibuprofen can be decreased when combined with Pralsetinib.
Idarubicin	The metabolism of Idarubicin can be decreased when combined with Pralsetinib.
Idelalisib	The metabolism of Idelalisib can be increased when combined with Pralsetinib.
Ifosfamide	The metabolism of Ifosfamide can be increased when combined with Pralsetinib.
Iloperidone	The metabolism of Iloperidone can be decreased when combined with Pralsetinib.
Imatinib	Pralsetinib may decrease the excretion rate of Imatinib which could result in a higher serum level.
Imipramine	The serum concentration of Imipramine can be increased when it is combined with Pralsetinib.
Indacaterol	The serum concentration of Indacaterol can be increased when it is combined with Pralsetinib.
Indinavir	The serum concentration of Pralsetinib can be increased when it is combined with Indinavir.
Indocyanine	Pralsetinib may decrease the excretion rate of Indocyanine green acid form which could result in a higher serum level.
Indomethacin	Pralsetinib may decrease the excretion rate of Indomethacin which could result in a higher serum level.
Infigratinib	The metabolism of Infigratinib can be increased when combined with Pralsetinib.
Inotuzumab	The serum concentration of Inotuzumab ozogamicin can be increased when it is combined with Pralsetinib.
Irbesartan	The metabolism of Irbesartan can be decreased when combined with Pralsetinib.
Irinotecan	The metabolism of Irinotecan can be increased when combined with Pralsetinib.
Isavuconazole	The serum concentration of Pralsetinib can be increased when it is combined with Isavuconazole.
Isavuconazonium	The serum concentration of Pralsetinib can be increased when it is combined with Isavuconazonium.
Isoniazid	The metabolism of Pralsetinib can be decreased when combined with Isoniazid.
Isradipine	Pralsetinib may decrease the excretion rate of Isradipine which could result in a higher serum level.
Istradefylline	The serum concentration of Pralsetinib can be increased when it is combined with Istradefylline.
Itraconazole	The serum concentration of Pralsetinib can be increased when it is combined with Itraconazole.
Ivacaftor	The serum concentration of Pralsetinib can be increased when it is combined with Ivacaftor.
Ivermectin	Pralsetinib may decrease the excretion rate of Ivermectin which could result in a higher serum level.
Ivosidenib	The metabolism of Pralsetinib can be increased when combined with Ivosidenib.
Ixabepilone	The serum concentration of Pralsetinib can be increased when it is combined with Ixabepilone.
Ixazomib	The metabolism of Ixazomib can be increased when combined with Pralsetinib.
Ketamine	The metabolism of Ketamine can be decreased when combined with Pralsetinib.
Ketoconazole	The serum concentration of Pralsetinib can be increased when it is combined with Ketoconazole.
Ketorolac	The metabolism of Ketorolac can be decreased when combined with Pralsetinib.
Lacosamide	The metabolism of Lacosamide can be increased when combined with Pralsetinib.
Lamivudine	Pralsetinib may decrease the excretion rate of Lamivudine which could result in a higher serum level.
Lansoprazole	Lansoprazole may decrease the excretion rate of Pralsetinib which could result in a higher serum level.
Lapatinib	The serum concentration of Pralsetinib can be increased when it is combined with Lapatinib.
Larotrectinib	The serum concentration of Larotrectinib can be increased when it is combined with Pralsetinib.
Lasmiditan	The serum concentration of Pralsetinib can be increased when it is combined with Lasmiditan.
Ledipasvir	The serum concentration of Ledipasvir can be increased when it is combined with Pralsetinib.
Lefamulin	Pralsetinib may decrease the excretion rate of Lefamulin which could result in a higher serum level.
Leflunomide	Pralsetinib may decrease the excretion rate of Leflunomide which could result in a higher serum level.
Lemborexant	The serum concentration of Lemborexant can be increased when it is combined with Pralsetinib.
Lenvatinib	Pralsetinib may decrease the excretion rate of Lenvatinib which could result in a higher serum level.
Lercanidipine	The metabolism of Lercanidipine can be decreased when combined with Pralsetinib.
Lesinurad	The metabolism of Lesinurad can be decreased when combined with Pralsetinib.
Letermovir	Letermovir may decrease the excretion rate of Pralsetinib which could result in a higher serum level.
Levacetylmethadol	The metabolism of Levacetylmethadol can be increased when combined with Pralsetinib.
Levamlodipine	The serum concentration of Levamlodipine can be increased when it is combined with Pralsetinib.
Levobupivacaine	The risk or severity of methemoglobinemia can be increased when Pralsetinib is combined with Levobupivacaine.
Levofloxacin	The excretion of Levofloxacin can be decreased when combined with Pralsetinib.
Levoketoconazole	The serum concentration of Pralsetinib can be increased when it is combined with Levoketoconazole.
Levomilnacipran	The metabolism of Levomilnacipran can be increased when combined with Pralsetinib.
Levonorgestrel	The metabolism of Levonorgestrel can be increased when combined with Pralsetinib.
Levosalbutamol	The excretion of Levosalbutamol can be decreased when combined with Pralsetinib.
Lidocaine	The risk or severity of methemoglobinemia can be increased when Pralsetinib is combined with Lidocaine.
Linagliptin	The serum concentration of Pralsetinib can be increased when it is combined with Linagliptin.
Liothyronine	The excretion of Liothyronine can be decreased when combined with Pralsetinib.
Liotrix	The excretion of Liotrix can be decreased when combined with Pralsetinib.
Lomitapide	The serum concentration of Pralsetinib can be increased when it is combined with Lomitapide.
Lonafarnib	The serum concentration of Pralsetinib can be increased when it is combined with Lonafarnib.
Loncastuximab	The serum concentration of Loncastuximab tesirine can be increased when it is combined with Pralsetinib.
Loperamide	The excretion of Loperamide can be decreased when combined with Pralsetinib.
Lopinavir	The serum concentration of Pralsetinib can be increased when it is combined with Lopinavir.
Loratadine	Pralsetinib may decrease the excretion rate of Loratadine which could result in a higher serum level.
Lorlatinib	The metabolism of Lorlatinib can be decreased when combined with Pralsetinib.
Lornoxicam	The metabolism of Lornoxicam can be decreased when combined with Pralsetinib.
Losartan	Pralsetinib may decrease the excretion rate of Losartan which could result in a higher serum level.
Lovastatin	The metabolism of Lovastatin can be decreased when combined with Pralsetinib.
Loxapine	The serum concentration of Pralsetinib can be increased when it is combined with Loxapine.
Lumacaftor	The serum concentration of Pralsetinib can be increased when it is combined with Lumacaftor.
Lumateperone	The serum concentration of Lumateperone can be decreased when it is combined with Pralsetinib.
Lumiracoxib	The metabolism of Lumiracoxib can be decreased when combined with Pralsetinib.
Lusutrombopag	Pralsetinib may decrease the excretion rate of Lusutrombopag which could result in a higher serum level.
Lynestrenol	The metabolism of Lynestrenol can be increased when combined with Pralsetinib.
Mannitol	The serum concentration of Mannitol can be increased when it is combined with Pralsetinib.
Maribavir	The serum concentration of Pralsetinib can be increased when it is combined with Maribavir.
Mavacamten	The serum concentration of Pralsetinib can be decreased when it is combined with Mavacamten.
Medroxyprogestero	The metabolism of Medroxyprogesterone acetate can be increased when combined with Pralsetinib.
Mefenamic acid	The metabolism of Mefenamic acid can be decreased when combined with Pralsetinib.
Mefloquine	The serum concentration of Pralsetinib can be increased when it is combined with Mefloquine.

Megestrol acetate	The metabolism of Megestrol acetate can be increased when combined with Pralsetinib.
Meloxicam	The risk or severity of methemoglobinemia can be increased when Pralsetinib is combined with Meloxicam.
Meperidine	The metabolism of Meperidine can be increased when combined with Pralsetinib.
Mephenytoin	The metabolism of Mephenytoin can be decreased when combined with Pralsetinib.
Mepivacaine	The risk or severity of methemoglobinemia can be increased when Pralsetinib is combined with Mepivacaine.
Mestranol	The metabolism of Mestranol can be increased when combined with Pralsetinib.
Metformin	The excretion of Metformin can be decreased when combined with Pralsetinib.
Methadone	The metabolism of Methadone can be decreased when combined with Pralsetinib.
Methimazole	The serum concentration of Pralsetinib can be increased when it is combined with Methimazole.
Methotrexate	The metabolism of Methotrexate can be increased when combined with Pralsetinib.
Methoxy	The risk or severity of Thrombosis can be increased when Methoxy polyethylene glycol-epoetin beta is combined with Pralsetinib.
Methoxyflurane	The metabolism of Methoxyflurane can be decreased when combined with Pralsetinib.
Methylene blue	The serum concentration of Pralsetinib can be increased when it is combined with Methylene blue.
Methylprednisone	The metabolism of Methylprednisone can be increased when combined with Pralsetinib.
Methysergide	The metabolism of Methysergide can be increased when combined with Pralsetinib.
Metreleptin	The metabolism of Pralsetinib can be increased when combined with Metreleptin.
Metronidazole	The metabolism of Metronidazole can be decreased when combined with Pralsetinib.
Miconazole	The metabolism of Pralsetinib can be decreased when combined with Miconazole.
Midazolam	The serum concentration of Midazolam can be increased when it is combined with Pralsetinib.
Midostaurin	The serum concentration of Pralsetinib can be increased when it is combined with Midostaurin.
Mifepristone	The serum concentration of Pralsetinib can be increased when it is combined with Mifepristone.
Milnacipran	The metabolism of Milnacipran can be increased when combined with Pralsetinib.
Mirabegron	The serum concentration of Pralsetinib can be increased when it is combined with Mirabegron.
Mitapivat	The serum concentration of Pralsetinib can be increased when it is combined with Mitapivat.
Mitotane	The serum concentration of Pralsetinib can be decreased when it is combined with Mitotane.
Mitoxantrone	Pralsetinib may decrease the excretion rate of Mitoxantrone which could result in a higher serum level.
Mobocertinib	The metabolism of Mobocertinib can be decreased when combined with Pralsetinib.
Modafinil	The metabolism of Modafinil can be decreased when combined with Pralsetinib.
Montelukast	The metabolism of Montelukast can be decreased when combined with Pralsetinib.
Morphine	The serum concentration of Morphine can be increased when it is combined with Pralsetinib.
Mycophenolate	Pralsetinib may decrease the excretion rate of Mycophenolate mofetil which could result in a higher serum level.
Nabilone	The metabolism of Nabilone can be decreased when combined with Pralsetinib.
Nabumetone	The metabolism of Nabumetone can be decreased when combined with Pralsetinib.
Nadolol	The excretion of Nadolol can be decreased when combined with Pralsetinib.
Naloxegol	The serum concentration of Naloxegol can be increased when it is combined with Pralsetinib.
Naloxone	The serum concentration of Pralsetinib can be increased when it is combined with Naloxone.
Naproxen	Pralsetinib may decrease the excretion rate of Naproxen which could result in a higher serum level.
Nateglinide	The metabolism of Nateglinide can be decreased when combined with Pralsetinib.
Nefazodone	The serum concentration of Pralsetinib can be increased when it is combined with Nefazodone.
Nelfinavir	The serum concentration of Pralsetinib can be increased when it is combined with Nelfinavir.
Neratinib	The serum concentration of Pralsetinib can be increased when it is combined with Neratinib.
Netupitant	The serum concentration of Pralsetinib can be increased when it is combined with Netupitant.
Nevirapine	The metabolism of Nevirapine can be decreased when combined with Pralsetinib.
Nicardipine	Pralsetinib may decrease the excretion rate of Nicardipine which could result in a higher serum level.
Niclosamide	The metabolism of Niclosamide can be decreased when combined with Pralsetinib.
Nifedipine	Pralsetinib may decrease the excretion rate of Nifedipine which could result in a higher serum level.
Nilotinib	The serum concentration of Pralsetinib can be increased when it is combined with Nilotinib.
Nilvadipine	The metabolism of Pralsetinib can be decreased when combined with Nilvadipine.
Nintedanib	The serum concentration of Nintedanib can be increased when it is combined with Pralsetinib.
Nisoldipine	The metabolism of Nisoldipine can be decreased when combined with Pralsetinib.
Nitrendipine	Pralsetinib may decrease the excretion rate of Nitrendipine which could result in a higher serum level.
Nitrofurantoin	Pralsetinib may decrease the excretion rate of Nitrofurantoin which could result in a higher serum level.
Nomegestrol	The metabolism of Nomegestrol can be increased when combined with Pralsetinib.
Nomegestrol acetate	The metabolism of Nomegestrol acetate can be increased when combined with Pralsetinib.
Norelgestromin	The metabolism of Norelgestromin can be increased when combined with Pralsetinib.
Norethisterone	The metabolism of Norethisterone can be increased when combined with Pralsetinib.
Norethynodrel	The metabolism of Norethynodrel can be increased when combined with Pralsetinib.
Norgestimate	The serum concentration of Pralsetinib can be increased when it is combined with Norgestimate.
Norgestrel	The metabolism of Norgestrel can be increased when combined with Pralsetinib.
Nortriptyline	The serum concentration of Nortriptyline can be increased when it is combined with Pralsetinib.
Novobiocin	Novobiocin may decrease the excretion rate of Pralsetinib which could result in a higher serum level.
Obeticholic acid	The risk or severity of adverse effects can be increased when Pralsetinib is combined with Obeticholic acid.
Ofloxacin	Pralsetinib may decrease the excretion rate of Ofloxacin which could result in a higher serum level.
Olaparib	The metabolism of Olaparib can be increased when combined with Pralsetinib.
Oliceridine	The serum concentration of Oliceridine can be decreased when it is combined with Pralsetinib.
Olmesartan	The risk or severity of liver damage can be increased when Olmesartan is combined with Pralsetinib.
Olodaterol	The metabolism of Olodaterol can be decreased when combined with Pralsetinib.
Omadacycline	The serum concentration of Omadacycline can be increased when it is combined with Pralsetinib.
Ombitasvir	Pralsetinib may decrease the excretion rate of Ombitasvir which could result in a higher serum level.
Omeprazole	Omeprazole may decrease the excretion rate of Pralsetinib which could result in a higher serum level.
Ondansetron	The metabolism of Ondansetron can be decreased when combined with Pralsetinib.
Osimertinib	The serum concentration of Osimertinib can be increased when it is combined with Pralsetinib.
Ospemifene	The metabolism of Ospemifene can be decreased when combined with Pralsetinib.
Oteseconazole	The serum concentration of Pralsetinib can be increased when it is combined with Oteseconazole.
Ouabain	The excretion of Ouabain can be decreased when combined with Pralsetinib.
Oxaliplatin	Pralsetinib may decrease the excretion rate of Oxaliplatin which could result in a higher serum level.
Oxetacaine	The risk or severity of methemoglobinemia can be increased when Pralsetinib is combined with Oxetacaine.
Oxybuprocaine	The risk or severity of methemoglobinemia can be increased when Pralsetinib is combined with Oxybuprocaine.
Oxybutynin	The metabolism of Oxybutynin can be decreased when combined with Pralsetinib.
Oxycodone	The metabolism of Oxycodone can be decreased when combined with Pralsetinib.
Ozanimod	Pralsetinib may decrease the excretion rate of Ozanimod which could result in a higher serum level.
Paclitaxel	The metabolism of Paclitaxel can be increased when combined with Pralsetinib.
Pacritinib	The serum concentration of Pralsetinib can be increased when it is combined with Pacritinib.
Palbociclib	The serum concentration of Pralsetinib can be increased when it is combined with Palbociclib.
Paliperidone	The serum concentration of Pralsetinib can be increased when it is combined with Paliperidone.
Panobinostat	The serum concentration of Panobinostat can be increased when it is combined with Pralsetinib.
Pantoprazole	Pantoprazole may decrease the excretion rate of Pralsetinib which could result in a higher serum level.
Paramethadione	The metabolism of Paramethadione can be decreased when combined with Pralsetinib.
Parecoxib	The metabolism of Parecoxib can be decreased when combined with Pralsetinib.
Paritaprevir	Paritaprevir may decrease the excretion rate of Pralsetinib which could result in a higher serum level.
Pazopanib	The serum concentration of Pazopanib can be increased when it is combined with Pralsetinib.
Peginesatide	The risk or severity of Thrombosis can be increased when Peginesatide is combined with Pralsetinib.
Penicillamine	The excretion of Penicillamine can be decreased when combined with Pralsetinib.
Pentamidine	The metabolism of Pentamidine can be decreased when combined with Pralsetinib.
Pentobarbital	The serum concentration of Pralsetinib can be decreased when it is combined with Pentobarbital.
Perampanel	The metabolism of Perampanel can be increased when combined with Pralsetinib.
Pexidartinib	The metabolism of Pexidartinib can be increased when combined with Pralsetinib.
Phenobarbital	The serum concentration of Pralsetinib can be decreased when it is combined with Phenobarbital.
Phenol	The risk or severity of methemoglobinemia can be increased when Pralsetinib is combined with Phenol.
Phenprocoumon	The metabolism of Phenprocoumon can be increased when combined with Pralsetinib.

Phenylbutazone	The metabolism of Phenylbutazone can be decreased when combined with Pralsetinib.
Phenytoin	The serum concentration of Pralsetinib can be decreased when it is combined with Phenytoin.
Pibrentasvir	The serum concentration of Pralsetinib can be increased when it is combined with Pibrentasvir.
Pimavanserin	The metabolism of Pimavanserin can be increased when combined with Pralsetinib.
Pimozide	The metabolism of Pimozide can be increased when combined with Pralsetinib.
Pioglitazone	The metabolism of Pioglitazone can be increased when combined with Pralsetinib.
Piperaquine	The metabolism of Piperaquine can be decreased when combined with Pralsetinib.
Pirfenidone	The metabolism of Pirfenidone can be decreased when combined with Pralsetinib.
Piroxicam	The metabolism of Piroxicam can be decreased when combined with Pralsetinib.
Pitavastatin	Pralsetinib may decrease the excretion rate of Pitavastatin which could result in a higher serum level.
Pitolisant	The serum concentration of Pralsetinib can be decreased when it is combined with Pitolisant.
Pomalidomide	The serum concentration of Pomalidomide can be increased when it is combined with Pralsetinib.
Ponatinib	The serum concentration of Pralsetinib can be increased when it is combined with Ponatinib.
Ponesimod	The metabolism of Ponesimod can be decreased when combined with Pralsetinib.
Posaconazole	The serum concentration of Pralsetinib can be increased when it is combined with Posaconazole.
Pralatrexate	Pralsetinib may decrease the excretion rate of Pralatrexate which could result in a higher serum level.
Pramocaine	The risk or severity of methemoglobinemia can be increased when Pralsetinib is combined with Pramocaine.
Prasugrel	The metabolism of Prasugrel can be decreased when combined with Pralsetinib.
Pravastatin	Pralsetinib may decrease the excretion rate of Pravastatin which could result in a higher serum level.
Praziquantel	The metabolism of Praziquantel can be decreased when combined with Pralsetinib.
Prazosin	Pralsetinib may decrease the excretion rate of Prazosin which could result in a higher serum level.
Prednisolone	The serum concentration of Prednisolone phosphate can be increased when it is combined with Pralsetinib.
Pretomanid	The metabolism of Pretomanid can be increased when combined with Pralsetinib.
Prilocaine	The risk or severity of methemoglobinemia can be increased when Pralsetinib is combined with Prilocaine.
Primaquine	The metabolism of Pralsetinib can be decreased when combined with Primaquine.
Primidone	The serum concentration of Pralsetinib can be decreased when it is combined with Primidone.
Procainamide	The excretion of Procainamide can be decreased when combined with Pralsetinib.
Procaine	The risk or severity of methemoglobinemia can be increased when Pralsetinib is combined with Procaine.
Progesterone	Progesterone may decrease the excretion rate of Pralsetinib which could result in a higher serum level.
Proguanil	The metabolism of Proguanil can be decreased when combined with Pralsetinib.
Promazine	The metabolism of Promazine can be decreased when combined with Pralsetinib.
Propafenone	The serum concentration of Pralsetinib can be increased when it is combined with Propafenone.
Proparacaine	The risk or severity of methemoglobinemia can be increased when Pralsetinib is combined with Proparacaine.
Propofol	The metabolism of Propofol can be decreased when combined with Pralsetinib.
Propoxycaine	The risk or severity of methemoglobinemia can be increased when Pralsetinib is combined with Propoxycaine.
Propranolol	The metabolism of Propranolol can be decreased when combined with Pralsetinib.
Prucalopride	The serum concentration of Prucalopride can be increased when it is combined with Pralsetinib.
Quazepam	The metabolism of Quazepam can be decreased when combined with Pralsetinib.
Quetiapine	The metabolism of Quetiapine can be decreased when combined with Pralsetinib.
Quinidine	The serum concentration of Pralsetinib can be increased when it is combined with Quinidine.
Quinine	The serum concentration of Pralsetinib can be increased when it is combined with Quinine.
Rabeprazole	Rabeprazole may decrease the excretion rate of Pralsetinib which could result in a higher serum level.
Raloxifene	Pralsetinib may decrease the excretion rate of Raloxifene which could result in a higher serum level.
Ramelteon	The metabolism of Ramelteon can be decreased when combined with Pralsetinib.
Ranitidine	The excretion of Ranitidine can be decreased when combined with Pralsetinib.
Ranolazine	The metabolism of Ranolazine can be increased when combined with Pralsetinib.
Regorafenib	The serum concentration of Pralsetinib can be increased when it is combined with Regorafenib.
Relebactam	The excretion of Relebactam can be decreased when combined with Pralsetinib.
Relugolix	The serum concentration of Relugolix can be increased when it is combined with Pralsetinib.
Repaglinide	Pralsetinib may decrease the excretion rate of Repaglinide which could result in a higher serum level.
Reserpine	The serum concentration of Pralsetinib can be increased when it is combined with Reserpine.
Retapamulin	The metabolism of Retapamulin can be decreased when combined with Pralsetinib.
Revefenacin	Pralsetinib may decrease the excretion rate of Revefenacin which could result in a higher serum level.
Ribociclib	The serum concentration of Pralsetinib can be increased when it is combined with Ribociclib.
Rifampicin	The serum concentration of Pralsetinib can be decreased when it is combined with Rifampicin.
Rifamycin	The serum concentration of Pralsetinib can be increased when it is combined with Rifamycin.
Rifapentine	The serum concentration of Pralsetinib can be decreased when it is combined with Rifapentine.
Rifaximin	The serum concentration of Rifaximin can be increased when it is combined with Pralsetinib.
Rilpivirine	The serum concentration of Rilpivirine can be increased when it is combined with Pralsetinib.
Riluzole	Pralsetinib may decrease the excretion rate of Riluzole which could result in a higher serum level.
Rimegepant	The metabolism of Rimegepant can be increased when combined with Pralsetinib.
Rimexolone	The serum concentration of Pralsetinib can be decreased when it is combined with Rimexolone.
Riociguat	Pralsetinib may decrease the excretion rate of Riociguat which could result in a higher serum level.
Ripretinib	The serum concentration of Pralsetinib can be increased when it is combined with Ripretinib.
Risperidone	The metabolism of Risperidone can be decreased when combined with Pralsetinib.
Ritonavir	The serum concentration of Pralsetinib can be increased when it is combined with Ritonavir.
Rivaroxaban	Pralsetinib may decrease the excretion rate of Rivaroxaban which could result in a higher serum level.
Rofecoxib	The metabolism of Rofecoxib can be decreased when combined with Pralsetinib.
Roflumilast	The serum concentration of Roflumilast can be increased when it is combined with Pralsetinib.
Rolapitant	The serum concentration of Pralsetinib can be increased when it is combined with Rolapitant.
Romidepsin	The serum concentration of Romidepsin can be increased when it is combined with Pralsetinib.
Ropivacaine	The risk or severity of methemoglobinemia can be increased when Pralsetinib is combined with Ropivacaine.
Rosiglitazone	Pralsetinib may decrease the excretion rate of Rosiglitazone which could result in a higher serum level.
Rosuvastatin	Pralsetinib may decrease the excretion rate of Rosuvastatin which could result in a higher serum level.
Roxadustat	The serum concentration of Pralsetinib can be increased when it is combined with Roxadustat.
Rucaparib	Rucaparib may decrease the excretion rate of Pralsetinib which could result in a higher serum level.
Rupatadine	The metabolism of Rupatadine can be decreased when combined with Pralsetinib.
Ruxolitinib	The metabolism of Ruxolitinib can be increased when combined with Pralsetinib.
Safinamide	Safinamide may decrease the excretion rate of Pralsetinib which could result in a higher serum level.
Salicylic acid	The metabolism of Salicylic acid can be decreased when combined with Pralsetinib.
Salmeterol	The metabolism of Salmeterol can be decreased when combined with Pralsetinib.
Sapropterin	The serum concentration of Pralsetinib can be increased when it is combined with Sapropterin.
Saquinavir	The serum concentration of Pralsetinib can be increased when it is combined with Saquinavir.
Sarecycline	The serum concentration of Pralsetinib can be increased when it is combined with Sarecycline.
Satralizumab	The serum concentration of Pralsetinib can be decreased when it is combined with Satralizumab.
Saxagliptin	The metabolism of Saxagliptin can be decreased when combined with Pralsetinib.
Segesterone	The metabolism of Segesterone acetate can be increased when combined with Pralsetinib.
Selegiline	The metabolism of Selegiline can be decreased when combined with Pralsetinib.
Selexipag	The serum concentration of Selexipag can be increased when it is combined with Pralsetinib.
Selpercatinib	The serum concentration of Selpercatinib can be increased when it is combined with Pralsetinib.
Selumetinib	Pralsetinib may decrease the excretion rate of Selumetinib which could result in a higher serum level.
Sertraline	The metabolism of Sertraline can be decreased when combined with Pralsetinib.
Sildenafil	The serum concentration of Pralsetinib can be increased when it is combined with Sildenafil.
Silodosin	The excretion of Silodosin can be decreased when combined with Pralsetinib.
Simeprevir	The serum concentration of Pralsetinib can be increased when it is combined with Simeprevir.
Simvastatin	The serum concentration of Pralsetinib can be increased when it is combined with Simvastatin.
Sincalide	The excretion of Sincalide can be decreased when combined with Pralsetinib.
Siponimod	The metabolism of Siponimod can be increased when combined with Pralsetinib.
Sirolimus	The serum concentration of Sirolimus can be increased when it is combined with Pralsetinib.
Sitagliptin	The serum concentration of Sitagliptin can be increased when it is combined with Pralsetinib.

Sitaxentan	The metabolism of Sitaxentan can be decreased when combined with Pralsetinib.
Sofosbuvir	Pralsetinib may decrease the excretion rate of Sofosbuvir which could result in a higher serum level.
Solriamfetol	The excretion of Solriamfetol can be decreased when combined with Pralsetinib.
Somatrogon	The metabolism of Pralsetinib can be increased when combined with Somatrogon.
Sonidegib	The metabolism of Sonidegib can be increased when combined with Pralsetinib.
Sorafenib	The serum concentration of Pralsetinib can be increased when it is combined with Sorafenib.
Sotagliflozin	The serum concentration of Pralsetinib can be increased when it is combined with Sotagliflozin.
Sotorasib	The serum concentration of Pralsetinib can be increased when it is combined with Sotorasib.
Spironolactone	Pralsetinib may decrease the excretion rate of Spironolactone which could result in a higher serum level.
St. John’s Wort	The serum concentration of Pralsetinib can be decreased when it is combined with St. John’s Wort.
Stavudine	The excretion of Stavudine can be decreased when combined with Pralsetinib.
Stiripentol	The serum concentration of Pralsetinib can be increased when it is combined with Stiripentol.
Sulfadiazine	The metabolism of Sulfadiazine can be decreased when combined with Pralsetinib.
Sulfamethoxazole	Pralsetinib may decrease the excretion rate of Sulfamethoxazole which could result in a higher serum level.
Sulfasalazine	Sulfasalazine may decrease the excretion rate of Pralsetinib which could result in a higher serum level.
Sulfinpyrazone	Pralsetinib may decrease the excretion rate of Sulfinpyrazone which could result in a higher serum level.
Sumatriptan	Pralsetinib may decrease the excretion rate of Sumatriptan which could result in a higher serum level.
Sunitinib	The metabolism of Sunitinib can be increased when combined with Pralsetinib.
Suvorexant	The serum concentration of Pralsetinib can be increased when it is combined with Suvorexant.
Tacrolimus	The serum concentration of Tacrolimus can be increased when it is combined with Pralsetinib.
Tadalafil	The metabolism of Tadalafil can be decreased when combined with Pralsetinib.
Tafamidis	The serum concentration of Pralsetinib can be increased when it is combined with Tafamidis.
Talazoparib	The serum concentration of Talazoparib can be increased when it is combined with Pralsetinib.
Tamoxifen	The serum concentration of Pralsetinib can be increased when it is combined with Tamoxifen.
Tasimelteon	The metabolism of Tasimelteon can be increased when combined with Pralsetinib.
Taurocholic acid	Pralsetinib may decrease the excretion rate of Taurocholic acid which could result in a higher serum level.
Tazarotene	The metabolism of Tazarotene can be decreased when combined with Pralsetinib.
Tazemetostat	Pralsetinib may decrease the excretion rate of Tazemetostat which could result in a higher serum level.
Tazobactam	The excretion of Tazobactam can be decreased when combined with Pralsetinib.
Technetium	The excretion of Technetium Tc-99m mebrofenin can be decreased when combined with Pralsetinib.
Technetium	The serum concentration of Technetium Tc-99m sestamibi can be increased when it is combined with Pralsetinib.
Tegafur	The metabolism of Tegafur can be decreased when combined with Pralsetinib.
Tegaserod	Pralsetinib may decrease the excretion rate of Tegaserod which could result in a higher serum level.
Telaprevir	The serum concentration of Pralsetinib can be increased when it is combined with Telaprevir.
Telithromycin	The serum concentration of Pralsetinib can be increased when it is combined with Telithromycin.
Telmisartan	Pralsetinib may decrease the excretion rate of Telmisartan which could result in a higher serum level.
Telotristat ethyl	The serum concentration of Pralsetinib can be decreased when it is combined with Telotristat ethyl.
Temsirolimus	The serum concentration of Pralsetinib can be increased when it is combined with Temsirolimus.
Teniposide	The metabolism of Teniposide can be increased when combined with Pralsetinib.
Tenofovir alafenamide	The serum concentration of Tenofovir alafenamide can be increased when it is combined with Pralsetinib.
Tenofovir disoproxil	The serum concentration of Tenofovir disoproxil can be increased when it is combined with Pralsetinib.
Tenoxicam	The metabolism of Tenoxicam can be decreased when combined with Pralsetinib.
Tepotinib	The serum concentration of Tepotinib can be increased when it is combined with Pralsetinib.
Terbinafine	The metabolism of Terbinafine can be decreased when combined with Pralsetinib.
Terfenadine	The serum concentration of Pralsetinib can be increased when it is combined with Terfenadine.
Teriflunomide	Teriflunomide may decrease the excretion rate of Pralsetinib which could result in a higher serum level.
Testosterone	Pralsetinib may decrease the excretion rate of Testosterone which could result in a higher serum level.
Testosterone	Pralsetinib may decrease the excretion rate of Testosterone cypionate which could result in a higher serum level.
Testosterone	Pralsetinib may decrease the excretion rate of Testosterone enanthate which could result in a higher serum level.
Tetracaine	The risk or severity of methemoglobinemia can be increased when Pralsetinib is combined with Tetracaine.
Tezacaftor	The serum concentration of Tezacaftor can be increased when it is combined with Pralsetinib.
Thalidomide	The metabolism of Thalidomide can be decreased when combined with Pralsetinib.
Theophylline	The metabolism of Theophylline can be increased when combined with Pralsetinib.
Thiamylal	The metabolism of Thiamylal can be decreased when combined with Pralsetinib.
Thiotepa	The metabolism of Thiotepa can be increased when combined with Pralsetinib.
Ticagrelor	The serum concentration of Pralsetinib can be increased when it is combined with Ticagrelor.
Tinidazole	Pralsetinib may decrease the excretion rate of Tinidazole which could result in a higher serum level.
Tipranavir	The serum concentration of Pralsetinib can be increased when it is combined with Tipranavir.
Tivozanib	The metabolism of Tivozanib can be increased when combined with Pralsetinib.
Tofacitinib	The metabolism of Tofacitinib can be decreased when combined with Pralsetinib.
Tolazamide	The metabolism of Tolazamide can be decreased when combined with Pralsetinib.
Tolbutamide	The metabolism of Tolbutamide can be decreased when combined with Pralsetinib.
Tolterodine	The metabolism of Tolterodine can be decreased when combined with Pralsetinib.
Tolvaptan	The serum concentration of Tolvaptan can be increased when it is combined with Pralsetinib.
Topotecan	The serum concentration of Topotecan can be increased when it is combined with Pralsetinib.
Torasemide	The metabolism of Torasemide can be decreased when combined with Pralsetinib.
Toremifene	The serum concentration of Pralsetinib can be increased when it is combined with Toremifene.
Trabectedin	The metabolism of Trabectedin can be increased when combined with Pralsetinib.
Tramadol	The metabolism of Tramadol can be decreased when combined with Pralsetinib.
Trastuzumab	The serum concentration of Trastuzumab emtansine can be increased when it is combined with Pralsetinib.
Trazodone	The metabolism of Trazodone can be decreased when combined with Pralsetinib.
Treprostinil	The metabolism of Treprostinil can be decreased when combined with Pralsetinib.
Tretinoin	The metabolism of Tretinoin can be decreased when combined with Pralsetinib.
Triamcinolone	The metabolism of Triamcinolone can be decreased when combined with Pralsetinib.
Triazolam	The metabolism of Triazolam can be decreased when combined with Pralsetinib.
Triclabendazole	The metabolism of Triclabendazole can be decreased when combined with Pralsetinib.
Trifluridine	The excretion of Trifluridine can be decreased when combined with Pralsetinib.
Trilaciclib	Pralsetinib may decrease the excretion rate of Trilaciclib which could result in a higher serum level.
Trimethadione	The metabolism of Trimethadione can be decreased when combined with Pralsetinib.
Trimethoprim	The metabolism of Trimethoprim can be decreased when combined with Pralsetinib.
Trimipramine	The serum concentration of Trimipramine can be increased when it is combined with Pralsetinib.
Troglitazone	The risk or severity of liver damage can be increased when Troglitazone is combined with Pralsetinib.
Troleandomycin	The serum concentration of Pralsetinib can be increased when it is combined with Troleandomycin.
Tucatinib	Tucatinib may decrease the excretion rate of Pralsetinib which could result in a higher serum level.
Ubrogepant	The serum concentration of Ubrogepant can be increased when it is combined with Pralsetinib.
Udenafil	The metabolism of Udenafil can be decreased when combined with Pralsetinib.
Ulipristal	The metabolism of Ulipristal can be increased when combined with Pralsetinib.
Umbralisib	The serum concentration of Pralsetinib can be increased when it is combined with Umbralisib.
Umeclidinium	The serum concentration of Umeclidinium can be increased when it is combined with Pralsetinib.
Ursodeoxycholic acid	Pralsetinib may decrease the excretion rate of Ursodeoxycholic acid which could result in a higher serum level.
Valbenazine	The metabolism of Valbenazine can be decreased when combined with Pralsetinib.
Valdecoxib	The metabolism of Valdecoxib can be decreased when combined with Pralsetinib.
Valproic acid	The metabolism of Valproic acid can be decreased when combined with Pralsetinib.
Valsartan	The metabolism of Valsartan can be decreased when combined with Pralsetinib.
Vandetanib	The serum concentration of Pralsetinib can be increased when it is combined with Vandetanib.
Vardenafil	The metabolism of Vardenafil can be decreased when combined with Pralsetinib.
Velpatasvir	The serum concentration of Pralsetinib can be increased when it is combined with Velpatasvir.
Vemurafenib	The serum concentration of Pralsetinib can be increased when it is combined with Vemurafenib.
Venetoclax	The serum concentration of Pralsetinib can be increased when it is combined with Venetoclax.
Venlafaxine	Venlafaxine may increase the excretion rate of Pralsetinib which could result in a lower serum level and potentially a reduction in efficacy.

Verapamil	The serum concentration of Pralsetinib can be increased when it is combined with Verapamil.
Viloxazine	The metabolism of Pralsetinib can be decreased when combined with Viloxazine.
Vinblastine	The serum concentration of Vinblastine can be increased when it is combined with Pralsetinib.
Vincristine	The excretion of Vincristine can be decreased when combined with Pralsetinib.
Vindesine	The metabolism of Vindesine can be increased when combined with Pralsetinib.
Vinflunine	The serum concentration of Vinflunine can be increased when it is combined with Pralsetinib.
Vinorelbine	The metabolism of Vinorelbine can be increased when combined with Pralsetinib.
Vismodegib	Vismodegib may decrease the excretion rate of Pralsetinib which could result in a higher serum level.
Voclosporin	The serum concentration of Pralsetinib can be increased when it is combined with Voclosporin.
Vonoprazan	The metabolism of Vonoprazan can be decreased when combined with Pralsetinib.
Vorapaxar	The serum concentration of Pralsetinib can be increased when it is combined with Vorapaxar.
Voriconazole	The serum concentration of Pralsetinib can be increased when it is combined with Voriconazole.
Vortioxetine	The metabolism of Vortioxetine can be decreased when combined with Pralsetinib.
Voxelotor	The serum concentration of Voxelotor can be increased when it is combined with Pralsetinib.
Voxilaprevir	The serum concentration of Pralsetinib can be increased when it is combined with Voxilaprevir.
Warfarin	The serum concentration of Warfarin can be increased when it is combined with Pralsetinib.
Ximelagatran	The metabolism of Ximelagatran can be decreased when combined with Pralsetinib.
Zafirlukast	The metabolism of Zafirlukast can be decreased when combined with Pralsetinib.
Zalcitabine	The excretion of Zalcitabine can be decreased when combined with Pralsetinib.
Zaleplon	The metabolism of Zaleplon can be decreased when combined with Pralsetinib.
Zanubrutinib	The metabolism of Zanubrutinib can be increased when combined with Pralsetinib.
Zidovudine	Pralsetinib may decrease the excretion rate of Zidovudine which could result in a higher serum level.
Zileuton	The metabolism of Zileuton can be decreased when combined with Pralsetinib.
Zimelidine	The metabolism of Pralsetinib can be decreased when combined with Zimelidine.
Ziprasidone	The metabolism of Pralsetinib can be decreased when combined with Ziprasidone.
Zolpidem	The metabolism of Zolpidem can be increased when combined with Pralsetinib.
Zonisamide	The serum concentration of Pralsetinib can be increased when it is combined with Zonisamide.
Zopiclone	The metabolism of Zopiclone can be decreased when combined with Pralsetinib.
Zuclopenthixol	The metabolism of Zuclopenthixol can be increased when combined with Pralsetinib.

Pregnancy and Lactation

US FDA pregnancy category: Not assigned.

Pregnancy

Based on findings from animal studies and its mechanism of action, this drug can cause fetal harm when administered to a pregnant woman. Pregnancy status should be verified prior to initiating therapy. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential harm to the fetus. Females of reproductive potential should use effective nonhormonal contraception during therapy and for 2 weeks after; this drug may render hormonal contraceptives ineffective. Male patients with female partners of reproductive potential should use effective contraception during therapy and for 1 week after the final dose.

Lactation

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

How should this medicine be used?

Pralsetinib comes as a capsule to take by mouth. It is usually taken once daily on an empty stomach, at least 2 hours before and at least 1 hour after a meal. Take pralsetinib at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take pralsetinib exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

If you vomit after taking pralsetinib, do not take another dose. Continue your regular dosing schedule.

Your doctor may decrease your dose or temporarily or permanently stop your treatment if you experience certain side effects. Be sure to tell your doctor how you are feeling during your treatment with pralsetinib. Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.

What special precautions should I follow?

Before taking pralsetinib,

tell your doctor and pharmacist if you are allergic to pralsetinib, any other medications, or any of the ingredients in pralsetinib capsules. Ask your pharmacist for a list of the ingredients.
tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: antifungal medications including itraconazole (Onmel, Sporanox) and ketoconazole; clarithromycin (in Biaxin); certain HIV medications such as efavirenz (Sustiva, in Atripla, Symfi), indinavir (Crixivan), nelfinavir (Viracept), nevirapine (Viramune), ritonavir (Norvir, in Kaletra, Viekira Pak), and saquinavir (Invirase); oxcarbazepine (Oxtellar XR, Trileptal); phenobarbital; phenytoin (Dilantin, Phenytek); pioglitazone (Actos, in Oseni, Duetact); rifabutin (Mycobutin); and rifampin (Rifadin, Rimactane, in Rifater). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
tell your doctor what herbal products you are taking, especially St. John’s wort.
tell your doctor if you have or have ever had lung or breathing problems other than lung cancer, bleeding problems, high blood pressure, or liver disease.
tell your doctor if you are pregnant, plan to become pregnant, or if you plan to father a child. Pralsetinib may interfere with the action of hormonal contraceptives (birth control pills, patches, rings, implants, or injections), so you should not use these as your only method of birth control during your treatment. You must use non-hormonal birth control such as a barrier method (a device that blocks sperm from entering the uterus such as a condom or a diaphragm). Ask your doctor to help you choose a method of birth control that will work for you. If you are female, you will need to have a pregnancy test before you start treatment, and you should use non-hormonal birth control to prevent pregnancy during your treatment and for 2 weeks after your final dose. If you are a male and your partner can become pregnant, you should use effective birth control to prevent pregnancy during your treatment and for 1 week after your final dose. You should know that this medication may decrease fertility in men and women; however, you should not assume that you cannot get pregnant or that you cannot get someone else pregnant. If you or your partner becomes pregnant while taking pralsetinib, call your doctor. Pralsetinib may harm the fetus.
tell your doctor if you are breastfeeding or plan to breastfeed. You should not breastfeed while taking trametinib and for 1 week after your final dose.
you should know that this medication may decrease fertility in men and women. Talk to your doctor about the risks of taking pralsetinib.
if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking pralsetinib. Your doctor may tell you not to take pralsetinib 5 days before your surgery and will tell you when to start taking the medication again.
you should know that your blood pressure may increase during your treatment with pralsetinib. Your doctor will monitor your blood pressure carefully, and may prescribe medication to treat high blood pressure if it develops.
you should know that you may experience tumor lysis syndrome (TLS; a condition caused by the fast breakdown of cancer cells that can cause kidney failure and other complications) during your treatment with pralsetinib. To help reduce your risk of experiencing TLS, your doctor may ask you to drink water before and during your treatment, and each time your dose is increased. In addition, your doctor will give you a medication to take before starting and during your treatment to help prevent this side effect. If you experience any of the following symptoms of TLS, call your doctor immediately: fever, chills, nausea, vomiting, confusion, shortness of breath, seizures, irregular heartbeat, dark or cloudy urine, unusual tiredness, or muscle or joint pain.

References

https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/214701s000lbl.pdf
https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-pralsetinib-lung-cancer-ret-gene-fusions
https://pubchem.ncbi.nlm.nih.gov/compound/Pralsetinib
https://www.cancer.gov/about-cancer/treatment/drugs/pralsetinib
https://medlineplus.gov/druginfo/meds/a620057.html
https://go.drugbank.com/drugs/DB15822
https://en.wikipedia.org/wiki/Pralsetinib
https://www.drugs.com/pregnancy/pralsetinib.html
https://www.webmd.com/drugs/2/drug-180055/pralsetinib-oral/details/list-contraindications
https://www.mayoclinic.org/drugs-supplements/pralsetinib-oral-route/side-effects/drg-20502467?p=1
ChEMBL

http://www.ebi.ac.uk/Information/termsofuse.html

https://www.ebi.ac.uk/chembl/compound_report_card/CHEMBL4582651/

ChEMBL Protein Target Tree

https://www.ebi.ac.uk/chembl/g/#browse/targets
IUPHAR/BPS Guide to PHARMACOLOGY

https://www.guidetopharmacology.org/about.jsp#license

pralsetinib

https://www.guidetopharmacology.org/GRAC/LigandDisplayForward?ligandId=10033

Guide to Pharmacology Target Classification

https://www.guidetopharmacology.org/targets.jsp
Therapeutic Target Database (TTD)

Pralsetinib

http://idrblab.net/ttd/data/drug/details/D0OD2I
ChemIDplus

LICENSE

https://www.nlm.nih.gov/copyright.html

Pralsetinib [INN]

https://chem.nlm.nih.gov/chemidplus/sid/2097132948

ChemIDplus Chemical Information Classification

https://chem.nlm.nih.gov/chemidplus/
European Chemicals Agency (ECHA)

https://echa.europa.eu/web/guest/legal-notice

https://echa.europa.eu/information-on-chemicals
FDA Global Substance Registration System (GSRS)

https://www.fda.gov/about-fda/about-website/website-policies#linking

PRALSETINIB

https://gsrs.ncats.nih.gov/ginas/app/beta/substances/1WPE73O1WV
ClinicalTrials.gov

https://clinicaltrials.gov/ct2/about-site/terms-conditions#Use

https://clinicaltrials.gov/
DailyMed

LICENSE

https://www.nlm.nih.gov/copyright.html

PRALSETINIB

https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=PRALSETINIB
EU Clinical Trials Register

https://www.clinicaltrialsregister.eu/
European Medicines Agency (EMA)

https://www.ema.europa.eu/en/about-us/legal-notice

BLU-667 (P/0266/2019)

https://www.ema.europa.eu/en/medicines/human/paediatric-investigation-plans/emea-002575-pip01-19

Gavreto (EMEA/H/C/005413)

https://www.ema.europa.eu/en/medicines/human/EPAR/gavreto

pralsetinib (P/0271/2021)

https://www.ema.europa.eu/en/medicines/human/paediatric-investigation-plans/emea-002575-pip02-20
FDA Orange Book

https://www.fda.gov/about-fda/about-website/website-policies#linking

https://www.fda.gov/drugs/drug-approvals-and-databases/approved-drug-products-therapeutic-equivalence-evaluations-orange-book
WHO Anatomical Therapeutic Chemical (ATC) Classification

https://www.whocc.no/copyright_disclaimer/

https://www.whocc.no/atc/

ATC Code

https://www.whocc.no/atc_ddd_index/
FDA Pharm Classes

https://www.fda.gov/about-fda/about-website/website-policies#linking

PRALSETINIB

https://dailymed.nlm.nih.gov/dailymed/browse-drug-classes.cfm
National Drug Code (NDC) Directory

https://www.fda.gov/about-fda/about-website/website-policies#linking

PRALSETINIB

https://www.fda.gov/drugs/drug-approvals-and-databases/national-drug-code-directory
NCI Thesaurus (NCIt)

https://www.cancer.gov/policies/copyright-reuse

https://ncithesaurus.nci.nih.gov/ncitbrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&ns=ncit&code=C132295

NCI Thesaurus Tree

https://ncit.nci.nih.gov
NCI Cancer Drugs

LICENSE

https://www.cancer.gov/policies/copyright-reuse

Gavreto (Pralsetinib)

https://www.cancer.gov/about-cancer/treatment/drugs/pralsetinib
NIPH Clinical Trials Search of Japan

https://rctportal.niph.go.jp/en/
NLM RxNorm Terminology

https://www.nlm.nih.gov/research/umls/rxnorm/docs/termsofservice.html

pralsetinib

https://rxnav.nlm.nih.gov/id/rxnorm/2394936
Protein Data Bank in Europe (PDBe)

http://www.ebi.ac.uk/pdbe-srv/pdbechem/chemicalCompound/show/Q4J
PubChem

https://pubchem.ncbi.nlm.nih.gov

PFAS and Fluorinated Compounds in PubChem

https://gitlab.lcsb.uni.lu/eci/pubchem-docs/-/raw/main/pfas-tree/PFAS_Tree.pdf?inline=false
Springer Nature

https://pubchem.ncbi.nlm.nih.gov/substance/?source=15745&sourceid=39053268-243527935
Thieme Chemistry

https://creativecommons.org/licenses/by-nc-nd/4.0/

https://pubchem.ncbi.nlm.nih.gov/substance/?source=22163&sourceid=39053290-965629879
Medical Subject Headings (MeSH)

https://www.nlm.nih.gov/copyright.html

pralsetinib

https://www.ncbi.nlm.nih.gov/mesh/2049798

MeSH Tree

http://www.nlm.nih.gov/mesh/meshhome.html

Antineoplastic Agents

https://www.ncbi.nlm.nih.gov/mesh/68000970
KEGG

https://www.kegg.jp/kegg/legal.html

USP drug classification

http://www.genome.jp/kegg-bin/get_htext?br08302.keg

Anatomical Therapeutic Chemical (ATC) classification

http://www.genome.jp/kegg-bin/get_htext?br08303.keg

Target-based classification of drugs

http://www.genome.jp/kegg-bin/get_htext?br08310.keg

Drug Groups

http://www.genome.jp/kegg-bin/get_htext?br08330.keg
PATENT SCOPE
(WIPO)

SID 394999054

https://pubchem.ncbi.nlm.nih.gov/substance/394999054

SID 394999077

https://pubchem.ncbi.nlm.nih.gov/substance/394999077

SID 427458103

https://pubchem.ncbi.nlm.nih.gov/substance/427458103

SID 464899392

https://pubchem.ncbi.nlm.nih.gov/substance/464899392