Ponatinib – Uses, Dosage, Side Effects, Interaction

Last updated: February 8, 2026Reviewed date: February 8, 2026Reading time: 84 min read
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Medical guide Drugs (A - Z) Feb 8, 2026 41 reads
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Ponatinib is an orally bioavailable multitargeted receptor tyrosine kinase (RTK) inhibitor with potential antiangiogenic and antineoplastic activities. Ponatinib inhibits unmutated and all mutated forms of Bcr-Abl, including T315I, the highly drug therapy-resistant missense mutation of Bcr-Abl. This agent also inhibits other tyrosine kinases including those associated with vascular endothelial...

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Article Summary

Ponatinib is an orally bioavailable multitargeted receptor tyrosine kinase (RTK) inhibitor with potential antiangiogenic and antineoplastic activities. Ponatinib inhibits unmutated and all mutated forms of Bcr-Abl, including T315I, the highly drug therapy-resistant missense mutation of Bcr-Abl. This agent also inhibits other tyrosine kinases including those associated with vascular endothelial growth factor receptors (VEGFRs) and fibroblast growth factor receptors (FGFRs); in addition, it inhibits the tyrosine kinase receptor TIE2 and FMS-related tyrosine kinase receptor-3...

Key Takeaways

  • This article explains Mechanism of Action in simple medical language.
  • This article explains Indications in simple medical language.
  • This article explains Contraindications in simple medical language.
  • This article explains Dosage in simple medical language.
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Definition

Ponatinib is an orally bioavailable multitargeted receptor tyrosine kinase (RTK) inhibitor with potential antiangiogenic and antineoplastic activities. Ponatinib inhibits unmutated and all mutated forms of Bcr-Abl, including T315I, the highly drug therapy-resistant missense mutation of Bcr-Abl. This agent also inhibits other tyrosine kinases including those associated with vascular endothelial growth factor receptors (VEGFRs) and fibroblast growth factor receptors (FGFRs); in addition, it inhibits the tyrosine kinase receptor TIE2 and FMS-related tyrosine kinase receptor-3 (Flt3). RTK inhibition by ponatinib may result in the inhibition of cellular proliferation and angiogenesis and may induce cell death. Bcr-Abl is a fusion tyrosine kinase encoded by the Philadelphia chromosome.

Ponatinib is a tyrosine kinase receptor inhibitor that is used in the therapy of refractory chronic myelogenous leukemia (CML) positive for the Philadelphia chromosome. Ponatinib is commonly associated with transient elevations in serum aminotransferase levels during treatment, but with only rare instances of clinically apparent acute liver injury.

Ponatinib is a benzamide obtained by the formal condensation of the carboxy group of 3-(imidazo[1,2-b]pyridazin-3-ylethynyl)-4-methyl benzoic acid with the aniline group of 4-[(4-methylpiperazin-1-yl)methyl]-3-(trifluoromethyl)aniline. It is a multi-target tyrosine kinase inhibitor that targets ABL, SRC, FGFR, and others and was designed to overcome the resistance of BCR-ABL mutation to imatinib, in particular the gatekeeper mutation ABL(T315I). It has a role as an antineoplastic agent and a tyrosine kinase inhibitor. It is an N-methyl piperazine, a member of benzamides, an acetylenic compound, an imidazopyridine, and a member of (trifluoromethyl)benzenes. It is a conjugate base of ponatinib(1+).

Ponatinib Hydrochloride is the hydrochloride salt form of an orally bioavailable multitargeted receptor tyrosine kinase (RTK) inhibitor with potential antiangiogenic and antineoplastic activities. Ponatinib inhibits unmutated and all mutated forms of Bcr-Abl, including T315I, the highly drug therapy-resistant missense mutation of Bcr-Abl. This agent also inhibits other tyrosine kinases including those associated with vascular endothelial growth factor receptors (VEGFRs) and fibroblast growth factor receptors (FGFRs); in addition, it inhibits the tyrosine kinase receptor TIE2 and FMS-related tyrosine kinase receptor-3 (Flt3). RTK inhibition by ponatinib may result in the inhibition of cellular proliferation and angiogenesis and may induce cell death. Bcr-Abl is a fusion tyrosine kinase encoded by the Philadelphia chromosome.

Ponatinib hydrochloride is the hydrochloride salt of ponatinib. It is a potent pan inhibitor of tyrosine kinases, active in all single resistance ABL kinase mutations including the T315l mutation. It is approved for the treatment of chronic myeloid leukemia. It has a role as an antineoplastic agent and a tyrosine kinase inhibitor. It contains ponatinib(1+).

Mechanism of Action

Ponatinib is a multi-target kinase inhibitor. Its primary cellular target is the Bcr-Abl tyrosine kinase protein which is constitutively active and promotes the progression of CML. This protein arises from the fused Bcr and Abl genes- what is commonly known as the Philadelphia chromosome. Ponatinib is unique in that it is especially useful in the treatment of resistant CML because it inhibits the tyrosine kinase activity of Abl and T315I mutant kinases. The T315I mutation confers resistance in cells as it prevents other Bcr-Abl inhibitors from binding to the Abl kinase. Other targets that ponatinib inhibits are members of the VEGFR, PDGFR, FGFR, EPH receptors, and SRC families of kinases, and KIT, RET, TIE2, and FLT3. A decrease in tumor size expressing native or T315I mutant BCR-ABL has been observed in rats.

or

Ponatinib is a kinase inhibitor. Ponatinib inhibited the in vitro tyrosine kinase activity of ABL and T315I mutant ABL with IC50 concentrations of 0.4 and 2.0 nM, respectively. Ponatinib inhibited the in vitro activity of additional kinases with IC50 concentrations between 0.1 and 20 nM, including members of the VEGFR, PDGFR, FGFR, EPH receptors, and SRC families of kinases, and KIT, RET, TIE2, and FLT3. Ponatinib inhibited the in vitro viability of cells expressing native or mutant BCR-ABL, including T315I. In mice, treatment with ponatinib reduced the size of tumors expressing native or T315I mutant BCR-ABL when compared to controls.

Gain-of-function mutations of membrane receptor tyrosine kinase KIT especially gate-keeper D816V point mutation in KIT render kinase auto-activation, disease progression, and poor prognosis. D816V KIT is found in -80% of the patients of systemic mastocytosis (SM) and is resistant to the first and second generations of tyrosine kinase inhibitors (TKIs). The purpose of this investigation was aimed at explore whether ponatinib (AP24534), a novel effective TKI against T315I Bcr-Abl was active against D816V KIT. /The researchers/ discovered that ponatinib abrogated the phosphorylation of KIT harboring either V560G (sensitive to imatinib) or D816V mutation (resistant to imatinib) and the downstream signaling transduction. Ponatinib inhibited the growth of D816V KIT-expressing cells in culture and nude mouse xenografted tumors. Ponatinib triggered apoptosis by inducing the release of cytochrome c and AIF, downregulation of Mcl-1. Furthermore, ponatinib abrogated the phosphorylation of beta-catenin at site Y654, suppressed the translocation of beta-catenin, inhibited the transcription and DNA binding of TCF and the expression of its targets (e.g. Axin2, c-Myc, and cyclin D1). Moreover, ponatinib was highly active against xenografted D816V KIT tumors in nude mice and significantly prolonged the survival of mice with aggressive SM or mast cell leukemia by impeding the expansion and infiltration of mast cells with imatinib-resistant D814Y KIT.

Indications

  • Ponatinib is indicated for the treatment of adult patients with chronic phase, accelerated phase, or blast phase chronic myeloid leukemia (CML) that is resistant or intolerant to prior tyrosine kinase inhibitor therapy or Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ALL) that is resistant or intolerant to prior tyrosine kinase inhibitor therapy.
  • Iclusig is indicated in adult patients with chronic phase, accelerated phase, or blast phase chronic myeloid leukaemia (CML) who are resistant to dasatinib or nilotinib; who are intolerant to dasatinib or nilotinib and for whom subsequent treatment with imatinib is not clinically appropriate; or who have the T315I mutation.
  • Iclusig is indicated in adult patients with chronic phase, accelerated phase, or blast phase chronic myeloid leukaemia (CML) who are resistant to dasatinib or nilotinib; who are intolerant to dasatinib or nilotinib and for whom subsequent treatment with imatinib is not clinically appropriate; or who have the T315I mutation Philadelphia chromosome-positive acute lymphoblastic leukaemia (Ph+ ALL) who are resistant to dasatinib; who are intolerant to dasatinib and for whom subsequent treatment with imatinib is not clinically appropriate; or who have the T315I mutation.
  • Treatment of acute lymphoblastic leukaemia, Treatment of chronic myeloid leukaemia
  • Ponatinib is a novel Bcr-Abl tyrosine kinase inhibitor that is especially effective against the T315I mutation for the treatment of chronic myeloid leukemia.
  • Accelerated phase chronic myologenic leukemia
  • Acute Lymphoblastic Leukemia (ALL)
  • Myeloid Leukemia, Chronic, Chronic Phase
  • Blast phase Chronic myelocytic leukemia

Contraindications

  • anemia
  • decreased blood platelets
  • low levels of a type of white blood cell called neutrophils
  • high blood pressure
  • a heart attack
  • acute blood clot in the heart
  • coronary artery disease
  • slow heartbeat
  • supraventricular arrhythmias, a type of abnormal heart rhythm
  • chronic heart failure
  • sudden and serious symptoms of heart failure called acute decompensated heart failure
  • a blood clot in the brain
  • a stroke
  • a localized weakening and ballooning in an artery wall called an arterial aneurysm
  • obstruction of a blood vessel by a blood clot
  • a blood clot in an artery
  • peripheral vascular disease
  • blood clot formation in vein
  • bleeding
  • blockage or closing off of blood vessels
  • damage to the liver and infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">inflammation
  • recent operation
  • visible water retention
  • abnormal liver function tests
  • impaired wound healing
  • pregnancy
  • a patient who is producing milk and breastfeeding
  • a rupture in the wall of the stomach or intestine
  • reactivation of hepatitis B infection
  • pancreatitis
  • a type of brain disorder called posterior reversible encephalopathy syndrome
  • dissection of artery

Dosage

Strengths: 30 mg; 45 mg; 15 mg; 10 mg

Chronic Myelogenous Leukemia

Chronic phase chronic myeloid leukemia (CP-CML):

  • Initial Dose: 45 mg orally once a day
  • Upon achievement of 1% BCR-ABL1 or less (standardized according to International Scale): 15 mg orally once a day
  • For loss of response: Re-escalate to a previously tolerated dosage of 30 mg or 45 mg orally once a day

Accelerated phase chronic myeloid leukemia (AP-CML), blast phase chronic myeloid leukemia (BP-CML) or Philadelphia chromosome positive acute lymphoblastic leukemia (Ph+ ALL):

  • Initial dose: 45 mg orally once a day
  • The optimal dose has not been identified for AP-CML, BP-CML, and Ph+ ALL.
  • Consider dose reduction for AP-CML patients who have achieved major cytogenic response.
  • Continue treatment until loss of response or unacceptable toxicity.
  • Drug discontinuation should be considered if patient response has not occurred by 3 months (90 days).
  • This drug is not indicated and is not recommended for the treatment of patients with newly diagnosed chronic phase chronic myeloid leukemia (CP-CML).
  • For the treatment of adult patients with CP-CML with resistance or intolerance to at least two prior kinase inhibitors
  • For the treatment of adult patients with AP-CML, or BP-CML or Ph+ ALL for whom no other kinase inhibitors are indicated
  • For the treatment of adult patients with T315I-positive CML (chronic phase, accelerated phase, or blast phase) or T315I-positive Ph+ ALL

Acute Lymphoblastic Leukemia

Chronic phase chronic myeloid leukemia (CP-CML):

  • Initial Dose: 45 mg orally once a day
  • Upon achievement of 1% BCR-ABL1 or less (standardized according to International Scale): 15 mg orally once a day
  • For loss of response: Re-escalate to a previously tolerated dosage of 30 mg or 45 mg orally once a day

Accelerated phase chronic myeloid leukemia (AP-CML), blast phase chronic myeloid leukemia (BP-CML) or Philadelphia chromosome positive acute lymphoblastic leukemia (Ph+ ALL):

  • Initial dose: 45 mg orally once a day
  • The optimal dose has not been identified for AP-CML, BP-CML, and Ph+ ALL.
  • Consider dose reduction for AP-CML patients who have achieved major cytogenic response.
  • Continue treatment until loss of response or unacceptable toxicity.
  • Drug discontinuation should be considered if patient response has not occurred by 3 months (90 days).
  • This drug is not indicated and is not recommended for the treatment of patients with newly diagnosed chronic phase chronic myeloid leukemia (CP-CML).
  • For the treatment of adult patients with CP-CML with resistance or intolerance to at least two prior kinase inhibitors
  • For the treatment of adult patients with AP-CML, or BP-CML or Ph+ ALL for whom no other kinase inhibitors are indicated
  • For the treatment of adult patients with T315I-positive CML (chronic phase, accelerated phase, or blast phase) or T315I-positive Ph+ ALL

Liver Dose Adjustments

ANY LEVEL OF LIVER DYSFUNCTION (CHILD-PUGH A, B, OR C):

  • Reduce the initial dose to 30 mg once a day in patients with preexisting liver dysfunction (Child-Pugh A, B, or C) and monitor for adverse reactions.
  • The safety of multiple doses, or doses higher than 30 mg have not been studied in patients with hepatic impairment.

IF HEPATOTOXICITY DEVELOPS DURING TREATMENT:
Elevation of liver transaminase greater than 3 times the upper limit of normal (ULN) and if:

  • Occurrence at 45 mg: Interrupt dosing and monitor hepatic function; and resume treatment at 30 mg after recovery to Grade 1 or less (less than 3 x ULN)
  • AST or ALT at least 3 times ULN with an elevation of bilirubin greater than 2 times ULN and alkaline phosphatase less than 2 times ULN: Discontinue treatment

Dose Adjustments

  • Patients with chronic phase myeloid leukemia who have achieved a 1% BCR-ABL1 or less (standardized according to International Scale) or patients with accelerated phase chronic myeloid leukemia who achieve a major cytogenetic response: Consider reducing the dose
  • If response to treatment has not occurred by 3 months: Consider treatment discontinuation

DOSAGE MODIFICATION FOR COADMINISTRATION OF STRONG CYP450 3A INHIBITORS/INDUCERS:

  • Concomitant use of strong CYP450 3A inducer: Avoid unless the benefit outweighs the risk and monitor for reduced efficacy; select a concomitant medication with no or minimal CYP450 3A induction potential if possible
  • Concomitant use of strong CYP450 3A inhibitors:
  • If current dose 45 mg once a day: Reduce dose to 30 mg once a day
  • If current dose 30 mg once a day: Reduce dose to 15 mg once a day
  • If current dose is 15 mg once a day: Reduce dose to 10 mg once a day
  • If current dose is 10 mg once a day: Avoid use
  • Resume the dosage that was tolerated prior to initiating the strong CYP450 3A inhibitor after the strong CYP450 3A inhibitor has been discontinued for 3 to 5 elimination half-lives.

RECOMMENDED DOSE REDUCTION FOR ADVERSE REACTIONS:

  • First Reduction: 30 mg orally once a day for CP-CML, AP-CML, BP-CML, and Ph+ ALL
  • Second Reduction: 15 mg orally once a day for CP-CML, AP-CML, BP-CML, and Ph+ ALL
  • Third reduction: 10 mg orally once a day for CP-CML and permanently discontinue for AP-CML, BP-CML, and Ph+ ALL patients unable to tolerate the second dose reduction
  • Subsequent reduction: Permanently discontinue treatment for CP-CML, AP-CML, BP-CML, and Ph+ ALL

HEPATOTOXICITY:
Elevation of liver transaminase greater than 3 times the upper limit of normal (ULN) and if:

  • Occurrence at 45 mg: Interrupt dosing and monitor hepatic function; and resume treatment at 30 mg after recovery to Grade 1 or less (less than 3 x ULN)
  • AST or ALT at least 3 times ULN with an elevation of bilirubin greater than 2 times ULN and alkaline phosphatase less than 2 times ULN: Discontinue treatment

ELEVATED LIPASE/PANCREATITIS:

  • Serum lipase greater than 1 to 1.5 x ULN: Consider treatment interruption until resolution and then resume at same dose
  • Serum lipase greater than 1.5 to 2 times ULN, 2 to 5 times ULN and asymptomatic, or asymptomatic radiologic pancreatitis: Interrupt until Grade 0 or 1 (less than 1.5 times ULN) and then resume at next lower dose
  • Serum lipase greater than 2 to 5 times ULN and symptomatic, symptomatic Grade 3 pancreatitis, or serum lipase greater than 5 times ULN and asymptomatic: Interrupt until complete resolution of symptoms and after recovery of lipase elevation Grade 0 or 1, then resume at next lower dose
  • Symptomatic pancreatitis and serum lipase greater than 5 times ULN: Discontinue treatment

MYELOSUPPRESSION:

  • ANC less than 1 x 10(9)/L or platelets less than 50 x 10(9)/L and if:
  • First Occurrence: Interrupt treatment and resume at same dose after recovery to ANC 1.5 x 10(9)/L or greater and platelets 75 x 10(9)/L or greater
  • Recurrence: Interrupt treatment until resolution and then resume at next lower dose

ARTERIAL OCCLUSIVE EVENTS:
Cardiovascular or Cerebrovascular:

  • Grade 1: Interrupt treatment until resolved, then resume at same dose
  • Grade 2: Interrupt treatment until Grade 0 or 1, then resume at next lower dose and discontinue if recurrence
  • Grade 3 or 4: Discontinue treatment

Peripheral vascular and other or venous thromboembolic events:

  • Grade 1: Interrupt treatment until resolved, resume at same dose
  • Grade 2: Interrupt treatment until Grade 0 or 1, then resume at same dose and if recurrence, interrupt treatment until Grade 0 or 1, then resume at next lower dose
  • Grade 3: Interrupt treatment until Grade 0 or 1, then resume at next lower dose and discontinue if recurrence
  • Grade 4: Discontinue treatment

HEART FAILURE:

  • Grade 2 or 3: Interrupt treatment until Grade 0 or 1, then resume at the next lower dose and discontinue if recurrence
  • Grade 4: Discontinue treatment

OTHER NON-HEMATOLOGIC ADVERSE REACTIONS:

  • Grade 1: Interrupt treatment until resolved, then resume at the same dose
  • Grade 2: Interrupt treatment until Grade 0 or 1, then resume at the same dose, and if recurrence, interrupt until Grade 0 or 1, then resume at the next lower dose
  • Grade 3 or 4: Interrupt treatment until Grade 0 or 1, then resume at the next lower dose and discontinue if recurrence

Administration Advice:

  • This drug may be taken with or without food and at the same approximate time each day.
  • Swallow tablets whole; do not crush, break, cut, chew, or dissolve the tablets.
  • If a dose is missed, take the next dose at the regularly scheduled time the next day.
  • Do not take 2 doses at the same time to make up for a missed dose.
  • This drug contains lactose monohydrate, care, and close monitoring is recommended for intolerant patients.

Monitoring:

  • Monitor for evidence of arterial occlusive events and venous thromboembolic events.
  • Monitor for heart failure.
  • Monitor liver function tests at baseline, then at least monthly or as clinically indicated.
  • Monitor blood pressure at baseline and as clinically in indicated.
  • Monitor serum lipase every 2 weeks for the first 2 months and then monthly thereafter or as clinically indicated.
  • Monitor for symptoms of peripheral and cranial neuropathy.
  • Monitor for vision at baseline and periodically during treatment.
  • Monitor for hemorrhage.
  • Monitor for fluid retention.
  • Monitor for signs and symptoms of arrhythmias.
  • Monitor blood counts every 2 weeks for the first 3 months and then monthly or as indicated for myelosuppression.

Patient Advice:

  • Advise the patient to read the approved patient labeling (Medication Guide).
  • Advise females of the potential risk to a fetus and inform their healthcare provider of a known or suspected pregnancy.
  • Advise females of reproductive potential to use effective contraception during treatment and for at least 3 weeks after the last dose.
  • Advise females of the potential for reduced fertility.
  • Advise not to breastfeed during treatment and for 6 days after the last dose.
  • Advise patients to inform of any planned surgical procedure.
  • Advise patients to immediately report any symptoms suggestive of a blood clot such as chest pain, shortness of breath, weakness on one side of the body, speech problems, leg pain, or leg swelling.
  • Advise patients to report any signs and symptoms suggestive of hemorrhages such as unusual bleeding or easy bruising.
  • Advise patients to report symptoms suggestive of heart complications such as chest pain, shortness of breath, hypertension, palpitations, dizziness, or fainting.
  • Advise patients to report any symptoms suggestive of pancreatitides such as nausea, vomiting, abdominal pain, or abdominal discomfort.
  • Advise patients to report any developing fluid retention such as leg swelling, abdominal swelling, weight gain, or shortness of breath.
  • Advise patients to report fever, infection, headache, seizure, altered mental status, and neurological disturbances.
  • Advise patients to report symptoms of liver problems such as jaundice, anorexia, bleeding or bruising.
  • Advise patients to avoid drinking grapefruit juice or eating grapefruit during treatment.
  • Inform patients that the tablets contain lactose monohydrate.
  • Advise patients to report symptoms of neuropathy such as hypo- and hyperesthesia, paresthesia, discomfort, a burning sensation, neuropathic pain, or weakness.
  • Advise patients to report symptoms of ocular toxicity such as blurred vision, dry eye, or eye pain.

Side Effects

The Most Common

  • rash
  • dry skin
  • diarrhea
  • constipation
  • hair loss
  • white patches or sores on the lips or in the mouth and throat
  • loss of appetite
  • weight loss
  • cough
  • difficulty falling asleep or staying asleep
  • back, bone, joint, limb, or muscle pain
  • unusual bruising or bleeding
  • bloody or black, tarry stools
  • blood in the urine
  • bloody vomit
  • unusual vaginal bleeding or heavier than usual menstrual bleeding
  • vomit that looks like coffee grounds
  • frequent nose bleeds
  • coughing up blood
  • dry, red, painful, or irritated eyes
  • sensitivity to light
  • blurred vision, floaters, double vision, or other vision changes
  • wounds that do not heal
  • fever, sore throat, chills, or other signs of infection
  • changes in taste; muscle weakness; drooping eyelids or part of face; tingling, burning, pain, or loss of feeling in hands or feet
  • headache, seizures, confusion, problems thinking, or changes or loss of vision
  • decreased urination
  • extreme tiredness or weakness
  • weight gain
  • swelling of your face, hands, feet, ankles, or lower legs
  • pain, swelling, or tenderness in the abdomen (stomach area)
  • nausea
  • vomiting
  • ongoing pain that begins in the stomach area but may spread to the back

More common

  • Bladder pain
  • bleeding gums
  • bloating or swelling of the face, arms, hands, lower legs, or feet
  • blurred vision
  • chest pain
  • chills
  • cloudy urine
  • confusion
  • constipation
  • cough or hoarseness
  • coughing up blood
  • decreased urine output
  • difficult, burning, or painful urination
  • difficulty with breathing or swallowing
  • dilated neck veins
  • dizziness
  • fainting
  • frequent urge to urinate
  • increased menstrual flow or vaginal bleeding
  • indigestion
  • irregular breathing
  • joint pain, stiffness, or swelling
  • lightheadedness
  • lower back, side, or stomach pain
  • nervousness
  • nosebleeds
  • pains in the chest, groin, or legs, especially calves of the legs
  • pains in the stomach, side, or abdomen, possibly radiating to the back
  • pale skin
  • paralysis
  • pinpoint red spots on the skin
  • pounding in the ears
  • prolonged bleeding from cuts
  • rapid weight gain
  • rapid, shallow breathing
  • red or black, tarry stools
  • red or dark brown urine
  • severe headaches of sudden onset
  • slow or fast heartbeat
  • sore throat
  • sudden loss of coordination
  • sudden slurred speech
  • sudden vision changes
  • tingling of the hands or feet
  • ulcers, sores, or white spots in the mouth
  • unusual bleeding or bruising
  • unusual weight gain or loss

Rare

  • Anxiety
  • burning, numbness, tingling, or painful sensations
  • chest discomfort
  • fast, pounding, or irregular heartbeat or pulse
  • pain, redness, or swelling in the arms or legs
  • unsteadiness or awkwardness
  • weakness in the arms, hands, legs, or feet
  • Blistering, peeling, loosening of the skin
  • bloody, black, or tarry stools
  • blue-green halos seen around objects
  • clay-colored stools
  • dark urine
  • decreased appetite
  • diarrhea
  • dry eyes
  • fever
  • headache
  • heartburn
  • indigestion
  • itching or skin rash
  • joint or muscle pain
  • loss of appetite
  • nausea and vomiting
  • red irritated eyes
  • red skin lesions, often with a purple center
  • sensitivity of the eyes to light
  • sensitivity to heat
  • severe vomiting, sometimes with blood
  • sore throat
  • stomach cramps or tenderness
  • sweating
  • trouble sleeping
  • unusual tiredness or weakness
  • vomiting of material that looks like coffee grounds, severe and continuous
  • weight loss
  • yellow eyes or skin

Drug Interactions

Pregnancy and Lactation

AU TGA pregnancy category D

Pregnancy

Based on its mechanism of action and findings in animals, Iclusig can cause fetal harm when administered to a pregnant woman [see Data]. There are no available data on Iclusig use in pregnant women. In animal reproduction studies, oral administration of ponatinib to pregnant rats during organogenesis caused adverse developmental effects at doses lower than human exposures at the recommended human dose [see Data]. Advise pregnant women of the potential risk to a fetus

Lactation

No information is available on the clinical use of ponatinib during breastfeeding. Because ponatinib is more than 99% bound to plasma proteins, the amount in milk is likely to be low. However, its half-life is about 24 hours and it might accumulate in the infant. National Comprehensive Cancer Network guidelines recommend avoiding breastfeeding during ponatinib therapy and the manufacturer recommends withholding breastfeeding for 6 days following the last dose.[1]

How should this medicine be used?

Ponatinib comes as a tablet to take by mouth. It is usually taken once a day with or without food. Take ponatinib 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 ponatinib exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Swallow the tablets whole; do not split, chew, or crush them. Your doctor may need to delay your treatment, adjust your dose, or permanently stop your treatment of ponatinib depending on your response to treatment and any side effects that you experience. Talk to your doctor about how you are feeling during your treatment. Continue to take ponatinib even if you feel well. Do not stop taking ponatinib without talking to your doctor.

What special precautions should I follow?

Before taking ponatinib,

  • tell your doctor and pharmacist if you are allergic to ponatinib, any other medications, lactose, or any of the ingredients in ponatinib tablets. Ask your pharmacist or check the Medication Guide 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: ketoconazole (Nizoral); medications to reduce stomach acid, such as lansoprazole (Prevacid); and rifampin (Rifadin, Rimactane, in Rifamate, in Rifater). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with ponatinib, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.
  • tell your doctor if you have or have ever had a bleeding problem; diabetes; pancreatitis (swelling of the pancreas, a gland behind the stomach that produces substances to help with digestion); or if you are lactose intolerant (inability to digest dairy products). Also, tell your doctor if you drink or have ever drunk large amounts of alcohol.
  • you should know that ponatinib may decrease fertility in women. However, you should not assume that you or your partner cannot become pregnant. Tell your doctor if you are pregnant or plan to become pregnant. If you are female, you will need to take a pregnancy test before you start treatment. You should use birth control to prevent pregnancy during your treatment with ponatinib and for 3 weeks after you stop taking the medication. Talk to your doctor about the types of birth control that will work for you. If you become pregnant while taking ponatinib, call your doctor immediately. Ponatinib may harm the fetus.
  • tell your doctor if you are breastfeeding or plan to breastfeed. You should not breastfeed while taking ponatinib and for 6 days after your final dose.
  • if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking ponatinib. If you are scheduled to have surgery, your doctor will tell you to stop taking ponatinib for at least 7 days before the surgery or procedure. Your doctor will tell you when to start taking ponatinib again after your surgery.
  • you should know that your blood pressure may increase during your treatment with ponatinib. Your doctor will probably monitor your blood pressure during your treatment.

 

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Frequently Asked Questions

Mechanism of Action Ponatinib is a multi-target kinase inhibitor. Its primary cellular target is the Bcr-Abl tyrosine kinase protein which is constitutively active and promotes the progression of CML. This protein arises from the fused Bcr and Abl genes- what is commonly known as the Philadelphia chromosome. Ponatinib is unique in that it is especially useful in the treatment of resistant CML because it inhibits the tyrosine kinase activity of Abl and T315I mutant kinases. The T315I mutation confers resistance in cells as it prevents other Bcr-Abl inhibitors from binding to the Abl kinase. Other targets that ponatinib inhibits are members of the VEGFR, PDGFR, FGFR, EPH receptors, and SRC families of kinases, and KIT, RET, TIE2, and FLT3. A decrease in tumor size expressing native or T315I mutant BCR-ABL has been observed in rats. or Ponatinib is a kinase inhibitor. Ponatinib inhibited the in vitro tyrosine kinase activity of ABL and T315I mutant ABL with IC50 concentrations of 0.4 and 2.0 nM, respectively. Ponatinib inhibited the in vitro activity of additional kinases with IC50 concentrations between 0.1 and 20 nM, including members of the VEGFR, PDGFR, FGFR, EPH receptors, and SRC families of kinases, and KIT, RET, TIE2, and FLT3. Ponatinib inhibited the in vitro viability of cells expressing native or mutant BCR-ABL, including T315I. In mice, treatment with ponatinib reduced the size of tumors expressing native or T315I mutant BCR-ABL when compared to controls. Gain-of-function mutations of membrane receptor tyrosine kinase KIT especially gate-keeper D816V point mutation in KIT render kinase auto-activation, disease progression, and poor prognosis. D816V KIT is found in -80% of the patients of systemic mastocytosis (SM) and is resistant to the first and second generations of tyrosine kinase inhibitors (TKIs). The purpose of this investigation was aimed at explore whether ponatinib (AP24534), a novel effective TKI against T315I Bcr-Abl was active against D816V KIT. /The researchers/ discovered that ponatinib abrogated the phosphorylation of KIT harboring either V560G (sensitive to imatinib) or D816V mutation (resistant to imatinib) and the downstream signaling transduction. Ponatinib inhibited the growth of D816V KIT-expressing cells in culture and nude mouse xenografted tumors. Ponatinib triggered apoptosis by inducing the release of cytochrome c and AIF, downregulation of Mcl-1. Furthermore, ponatinib abrogated the phosphorylation of beta-catenin at site Y654, suppressed the translocation of beta-catenin, inhibited the transcription and DNA binding of TCF and the expression of its targets (e.g. Axin2, c-Myc, and cyclin D1). Moreover, ponatinib was highly active against xenografted D816V KIT tumors in nude mice and significantly prolonged the survival of mice with aggressive SM or mast cell leukemia by impeding the expansion and infiltration of mast cells with imatinib-resistant D814Y KIT. Indications Ponatinib is indicated for the treatment of adult patients with chronic phase, accelerated phase, or blast phase chronic myeloid leukemia (CML) that is resistant or intolerant to prior tyrosine kinase inhibitor therapy or Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ALL) that is resistant or intolerant to prior tyrosine kinase inhibitor therapy. Iclusig is indicated in adult patients with chronic phase, accelerated phase, or blast phase chronic myeloid leukaemia (CML) who are resistant to dasatinib or nilotinib; who are intolerant to dasatinib or nilotinib and for whom subsequent treatment with imatinib is not clinically appropriate; or who have the T315I mutation. Iclusig is indicated in adult patients with chronic phase, accelerated phase, or blast phase chronic myeloid leukaemia (CML) who are resistant to dasatinib or nilotinib; who are intolerant to dasatinib or nilotinib and for whom subsequent treatment with imatinib is not clinically appropriate; or who have the T315I mutation Philadelphia chromosome-positive acute lymphoblastic leukaemia (Ph+ ALL) who are resistant to dasatinib; who are intolerant to dasatinib and for whom subsequent treatment with imatinib is not clinically appropriate; or who have the T315I mutation. Treatment of acute lymphoblastic leukaemia, Treatment of chronic myeloid leukaemia Ponatinib is a novel Bcr-Abl tyrosine kinase inhibitor that is especially effective against the T315I mutation for the treatment of chronic myeloid leukemia. Accelerated phase chronic myologenic leukemia Acute Lymphoblastic Leukemia (ALL) Myeloid Leukemia, Chronic, Chronic Phase Blast phase Chronic myelocytic leukemia Contraindications anemia decreased blood platelets low levels of a type of white blood cell called neutrophils high blood pressure a heart attack acute blood clot in the heart coronary artery disease slow heartbeat supraventricular arrhythmias, a type of abnormal heart rhythm chronic heart failure sudden and serious symptoms of heart failure called acute decompensated heart failure a blood clot in the brain a stroke a localized weakening and ballooning in an artery wall called an arterial aneurysm obstruction of a blood vessel by a blood clot a blood clot in an artery peripheral vascular disease blood clot formation in vein bleeding blockage or closing off of blood vessels damage to the liver and inflammation recent operation visible water retention abnormal liver function tests impaired wound healing pregnancy a patient who is producing milk and breastfeeding a rupture in the wall of the stomach or intestine reactivation of hepatitis B infection pancreatitis a type of brain disorder called posterior reversible encephalopathy syndrome dissection of artery Dosage Strengths: 30 mg; 45 mg; 15 mg; 10 mg Chronic Myelogenous Leukemia Chronic phase chronic myeloid leukemia (CP-CML): Initial Dose: 45 mg orally once a day Upon achievement of 1% BCR-ABL1 or less (standardized according to International Scale): 15 mg orally once a day For loss of response: Re-escalate to a previously tolerated dosage of 30 mg or 45 mg orally once a day Accelerated phase chronic myeloid leukemia (AP-CML), blast phase chronic myeloid leukemia (BP-CML) or Philadelphia chromosome positive acute lymphoblastic leukemia (Ph+ ALL): Initial dose: 45 mg orally once a day The optimal dose has not been identified for AP-CML, BP-CML, and Ph+ ALL. Consider dose reduction for AP-CML patients who have achieved major cytogenic response. Continue treatment until loss of response or unacceptable toxicity. Drug discontinuation should be considered if patient response has not occurred by 3 months (90 days). This drug is not indicated and is not recommended for the treatment of patients with newly diagnosed chronic phase chronic myeloid leukemia (CP-CML). For the treatment of adult patients with CP-CML with resistance or intolerance to at least two prior kinase inhibitors For the treatment of adult patients with AP-CML, or BP-CML or Ph+ ALL for whom no other kinase inhibitors are indicated For the treatment of adult patients with T315I-positive CML (chronic phase, accelerated phase, or blast phase) or T315I-positive Ph+ ALL Acute Lymphoblastic Leukemia Chronic phase chronic myeloid leukemia (CP-CML): Initial Dose: 45 mg orally once a day Upon achievement of 1% BCR-ABL1 or less (standardized according to International Scale): 15 mg orally once a day For loss of response: Re-escalate to a previously tolerated dosage of 30 mg or 45 mg orally once a day Accelerated phase chronic myeloid leukemia (AP-CML), blast phase chronic myeloid leukemia (BP-CML) or Philadelphia chromosome positive acute lymphoblastic leukemia (Ph+ ALL): Initial dose: 45 mg orally once a day The optimal dose has not been identified for AP-CML, BP-CML, and Ph+ ALL. Consider dose reduction for AP-CML patients who have achieved major cytogenic response. Continue treatment until loss of response or unacceptable toxicity. Drug discontinuation should be considered if patient response has not occurred by 3 months (90 days). This drug is not indicated and is not recommended for the treatment of patients with newly diagnosed chronic phase chronic myeloid leukemia (CP-CML). For the treatment of adult patients with CP-CML with resistance or intolerance to at least two prior kinase inhibitors For the treatment of adult patients with AP-CML, or BP-CML or Ph+ ALL for whom no other kinase inhibitors are indicated For the treatment of adult patients with T315I-positive CML (chronic phase, accelerated phase, or blast phase) or T315I-positive Ph+ ALL Liver Dose Adjustments ANY LEVEL OF LIVER DYSFUNCTION (CHILD-PUGH A, B, OR C): Reduce the initial dose to 30 mg once a day in patients with preexisting liver dysfunction (Child-Pugh A, B, or C) and monitor for adverse reactions. The safety of multiple doses, or doses higher than 30 mg have not been studied in patients with hepatic impairment. IF HEPATOTOXICITY DEVELOPS DURING TREATMENT: Elevation of liver transaminase greater than 3 times the upper limit of normal (ULN) and if: Occurrence at 45 mg: Interrupt dosing and monitor hepatic function; and resume treatment at 30 mg after recovery to Grade 1 or less (less than 3 x ULN) AST or ALT at least 3 times ULN with an elevation of bilirubin greater than 2 times ULN and alkaline phosphatase less than 2 times ULN: Discontinue treatment Dose Adjustments Patients with chronic phase myeloid leukemia who have achieved a 1% BCR-ABL1 or less (standardized according to International Scale) or patients with accelerated phase chronic myeloid leukemia who achieve a major cytogenetic response: Consider reducing the dose If response to treatment has not occurred by 3 months: Consider treatment discontinuation DOSAGE MODIFICATION FOR COADMINISTRATION OF STRONG CYP450 3A INHIBITORS/INDUCERS: Concomitant use of strong CYP450 3A inducer: Avoid unless the benefit outweighs the risk and monitor for reduced efficacy; select a concomitant medication with no or minimal CYP450 3A induction potential if possible Concomitant use of strong CYP450 3A inhibitors: If current dose 45 mg once a day: Reduce dose to 30 mg once a day If current dose 30 mg once a day: Reduce dose to 15 mg once a day If current dose is 15 mg once a day: Reduce dose to 10 mg once a day If current dose is 10 mg once a day: Avoid use Resume the dosage that was tolerated prior to initiating the strong CYP450 3A inhibitor after the strong CYP450 3A inhibitor has been discontinued for 3 to 5 elimination half-lives. RECOMMENDED DOSE REDUCTION FOR ADVERSE REACTIONS: First Reduction: 30 mg orally once a day for CP-CML, AP-CML, BP-CML, and Ph+ ALL Second Reduction: 15 mg orally once a day for CP-CML, AP-CML, BP-CML, and Ph+ ALL Third reduction: 10 mg orally once a day for CP-CML and permanently discontinue for AP-CML, BP-CML, and Ph+ ALL patients unable to tolerate the second dose reduction Subsequent reduction: Permanently discontinue treatment for CP-CML, AP-CML, BP-CML, and Ph+ ALL HEPATOTOXICITY: Elevation of liver transaminase greater than 3 times the upper limit of normal (ULN) and if: Occurrence at 45 mg: Interrupt dosing and monitor hepatic function; and resume treatment at 30 mg after recovery to Grade 1 or less (less than 3 x ULN) AST or ALT at least 3 times ULN with an elevation of bilirubin greater than 2 times ULN and alkaline phosphatase less than 2 times ULN: Discontinue treatment ELEVATED LIPASE/PANCREATITIS: Serum lipase greater than 1 to 1.5 x ULN: Consider treatment interruption until resolution and then resume at same dose Serum lipase greater than 1.5 to 2 times ULN, 2 to 5 times ULN and asymptomatic, or asymptomatic radiologic pancreatitis: Interrupt until Grade 0 or 1 (less than 1.5 times ULN) and then resume at next lower dose Serum lipase greater than 2 to 5 times ULN and symptomatic, symptomatic Grade 3 pancreatitis, or serum lipase greater than 5 times ULN and asymptomatic: Interrupt until complete resolution of symptoms and after recovery of lipase elevation Grade 0 or 1, then resume at next lower dose Symptomatic pancreatitis and serum lipase greater than 5 times ULN: Discontinue treatment MYELOSUPPRESSION: ANC less than 1 x 10(9)/L or platelets less than 50 x 10(9)/L and if: First Occurrence: Interrupt treatment and resume at same dose after recovery to ANC 1.5 x 10(9)/L or greater and platelets 75 x 10(9)/L or greater Recurrence: Interrupt treatment until resolution and then resume at next lower dose ARTERIAL OCCLUSIVE EVENTS: Cardiovascular or Cerebrovascular: Grade 1: Interrupt treatment until resolved, then resume at same dose Grade 2: Interrupt treatment until Grade 0 or 1, then resume at next lower dose and discontinue if recurrence Grade 3 or 4: Discontinue treatment Peripheral vascular and other or venous thromboembolic events: Grade 1: Interrupt treatment until resolved, resume at same dose Grade 2: Interrupt treatment until Grade 0 or 1, then resume at same dose and if recurrence, interrupt treatment until Grade 0 or 1, then resume at next lower dose Grade 3: Interrupt treatment until Grade 0 or 1, then resume at next lower dose and discontinue if recurrence Grade 4: Discontinue treatment HEART FAILURE: Grade 2 or 3: Interrupt treatment until Grade 0 or 1, then resume at the next lower dose and discontinue if recurrence Grade 4: Discontinue treatment OTHER NON-HEMATOLOGIC ADVERSE REACTIONS: Grade 1: Interrupt treatment until resolved, then resume at the same dose Grade 2: Interrupt treatment until Grade 0 or 1, then resume at the same dose, and if recurrence, interrupt until Grade 0 or 1, then resume at the next lower dose Grade 3 or 4: Interrupt treatment until Grade 0 or 1, then resume at the next lower dose and discontinue if recurrence Administration Advice: This drug may be taken with or without food and at the same approximate time each day. Swallow tablets whole; do not crush, break, cut, chew, or dissolve the tablets. If a dose is missed, take the next dose at the regularly scheduled time the next day. Do not take 2 doses at the same time to make up for a missed dose. This drug contains lactose monohydrate, care, and close monitoring is recommended for intolerant patients. Monitoring: Monitor for evidence of arterial occlusive events and venous thromboembolic events. Monitor for heart failure. Monitor liver function tests at baseline, then at least monthly or as clinically indicated. Monitor blood pressure at baseline and as clinically in indicated. Monitor serum lipase every 2 weeks for the first 2 months and then monthly thereafter or as clinically indicated. Monitor for symptoms of peripheral and cranial neuropathy. Monitor for vision at baseline and periodically during treatment. Monitor for hemorrhage. Monitor for fluid retention. Monitor for signs and symptoms of arrhythmias. Monitor blood counts every 2 weeks for the first 3 months and then monthly or as indicated for myelosuppression. Patient Advice: Advise the patient to read the approved patient labeling (Medication Guide). Advise females of the potential risk to a fetus and inform their healthcare provider of a known or suspected pregnancy. Advise females of reproductive potential to use effective contraception during treatment and for at least 3 weeks after the last dose. Advise females of the potential for reduced fertility. Advise not to breastfeed during treatment and for 6 days after the last dose. Advise patients to inform of any planned surgical procedure. Advise patients to immediately report any symptoms suggestive of a blood clot such as chest pain, shortness of breath, weakness on one side of the body, speech problems, leg pain, or leg swelling. Advise patients to report any signs and symptoms suggestive of hemorrhages such as unusual bleeding or easy bruising. Advise patients to report symptoms suggestive of heart complications such as chest pain, shortness of breath, hypertension, palpitations, dizziness, or fainting. Advise patients to report any symptoms suggestive of pancreatitides such as nausea, vomiting, abdominal pain, or abdominal discomfort. Advise patients to report any developing fluid retention such as leg swelling, abdominal swelling, weight gain, or shortness of breath. Advise patients to report fever, infection, headache, seizure, altered mental status, and neurological disturbances. Advise patients to report symptoms of liver problems such as jaundice, anorexia, bleeding or bruising. Advise patients to avoid drinking grapefruit juice or eating grapefruit during treatment. Inform patients that the tablets contain lactose monohydrate. Advise patients to report symptoms of neuropathy such as hypo- and hyperesthesia, paresthesia, discomfort, a burning sensation, neuropathic pain, or weakness. Advise patients to report symptoms of ocular toxicity such as blurred vision, dry eye, or eye pain. Side Effects The Most Common rash dry skin diarrhea constipation hair loss white patches or sores on the lips or in the mouth and throat loss of appetite weight loss cough difficulty falling asleep or staying asleep back, bone, joint, limb, or muscle pain unusual bruising or bleeding bloody or black, tarry stools blood in the urine bloody vomit unusual vaginal bleeding or heavier than usual menstrual bleeding vomit that looks like coffee grounds frequent nose bleeds coughing up blood dry, red, painful, or irritated eyes sensitivity to light blurred vision, floaters, double vision, or other vision changes wounds that do not heal fever, sore throat, chills, or other signs of infection changes in taste; muscle weakness; drooping eyelids or part of face; tingling, burning, pain, or loss of feeling in hands or feet headache, seizures, confusion, problems thinking, or changes or loss of vision decreased urination extreme tiredness or weakness weight gain swelling of your face, hands, feet, ankles, or lower legs pain, swelling, or tenderness in the abdomen (stomach area) nausea vomiting ongoing pain that begins in the stomach area but may spread to the back More common Bladder pain bleeding gums bloating or swelling of the face, arms, hands, lower legs, or feet blurred vision chest pain chills cloudy urine confusion constipation cough or hoarseness coughing up blood decreased urine output difficult, burning, or painful urination difficulty with breathing or swallowing dilated neck veins dizziness fainting frequent urge to urinate increased menstrual flow or vaginal bleeding indigestion irregular breathing joint pain, stiffness, or swelling lightheadedness lower back, side, or stomach pain nervousness nosebleeds pains in the chest, groin, or legs, especially calves of the legs pains in the stomach, side, or abdomen, possibly radiating to the back pale skin paralysis pinpoint red spots on the skin pounding in the ears prolonged bleeding from cuts rapid weight gain rapid, shallow breathing red or black, tarry stools red or dark brown urine severe headaches of sudden onset slow or fast heartbeat sore throat sudden loss of coordination sudden slurred speech sudden vision changes tingling of the hands or feet ulcers, sores, or white spots in the mouth unusual bleeding or bruising unusual weight gain or loss Rare Anxiety burning, numbness, tingling, or painful sensations chest discomfort fast, pounding, or irregular heartbeat or pulse pain, redness, or swelling in the arms or legs unsteadiness or awkwardness weakness in the arms, hands, legs, or feet Blistering, peeling, loosening of the skin bloody, black, or tarry stools blue-green halos seen around objects clay-colored stools dark urine decreased appetite diarrhea dry eyes fever headache heartburn indigestion itching or skin rash joint or muscle pain loss of appetite nausea and vomiting red irritated eyes red skin lesions, often with a purple center sensitivity of the eyes to light sensitivity to heat severe vomiting, sometimes with blood sore throat stomach cramps or tenderness sweating trouble sleeping unusual tiredness or weakness vomiting of material that looks like coffee grounds, severe and continuous weight loss yellow eyes or skin Drug Interactions DRUG INTERACTION Abaloparatide The therapeutic efficacy of Abaloparatide can be decreased when used in combination with Ponatinib. Abametapir The serum concentration of Ponatinib can be increased when it is combined with Abametapir. Abatacept The metabolism of Ponatinib can be increased when combined with Abatacept. Abciximab The risk or severity of bleeding can be increased when Abciximab is combined with Ponatinib. Abemaciclib The serum concentration of Abemaciclib can be increased when it is combined with Ponatinib. Abiraterone The metabolism of Ponatinib can be decreased when combined with Abiraterone. Acalabrutinib The metabolism of Ponatinib can be decreased when combined with Acalabrutinib. Acebutolol The metabolism of Ponatinib can be decreased when combined with Acebutolol. Acenocoumarol The risk or severity of bleeding can be increased when Acenocoumarol is combined with Ponatinib. Acetaminophen The metabolism of Ponatinib can be increased when combined with Acetaminophen. Acetazolamide The metabolism of Ponatinib can be decreased when combined with Acetazolamide. Acetylsalicylic acid The risk or severity of bleeding can be increased when Acetylsalicylic acid is combined with Ponatinib. Adalimumab The metabolism of Ponatinib can be increased when combined with Adalimumab. Adenovirus The risk or severity of infection can be increased when Adenovirus type 7 vaccine live is combined with Ponatinib. Afatinib The serum concentration of Afatinib can be increased when it is combined with Ponatinib. Albendazole The metabolism of Ponatinib can be decreased when combined with Albendazole. Aldesleukin The metabolism of Ponatinib can be decreased when combined with Aldesleukin. Alectinib Alectinib may decrease the excretion rate of Ponatinib which could result in a higher serum level. Alefacept The risk or severity of adverse effects can be increased when Alefacept is combined with Ponatinib. Alemtuzumab The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Ponatinib. Alfentanil The metabolism of Ponatinib can be decreased when combined with Alfentanil. Allogeneic The therapeutic efficacy of Allogeneic processed thymus tissue can be decreased when used in combination with Ponatinib. Allopurinol The risk or severity of adverse effects can be increased when Allopurinol is combined with Ponatinib. Almotriptan The metabolism of Ponatinib can be decreased when combined with Almotriptan. Alogliptin The metabolism of Ponatinib can be decreased when combined with Alogliptin. Alpelisib The serum concentration of Alpelisib can be increased when it is combined with Ponatinib. Alprazolam The metabolism of Ponatinib can be decreased when combined with Alprazolam. Alteplase The risk or severity of bleeding can be increased when Alteplase is combined with Ponatinib. Altretamine The risk or severity of adverse effects can be increased when Altretamine is combined with Ponatinib. Ambrisentan The metabolism of Ponatinib can be decreased when combined with Ambrisentan. Aminoglutethimide The metabolism of Ponatinib can be increased when combined with Aminoglutethimide. Aminophenazone The metabolism of Ponatinib can be decreased when combined with Aminophenazone. Amiodarone The metabolism of Ponatinib can be decreased when combined with Amiodarone. Amitriptyline The metabolism of Ponatinib can be decreased when combined with Amitriptyline. Amobarbital The metabolism of Ponatinib can be increased when combined with Amobarbital. Amodiaquine The metabolism of Ponatinib can be decreased when combined with Amodiaquine. Amoxapine The metabolism of Ponatinib can be decreased when combined with Amoxapine. Amphetamine The metabolism of Ponatinib can be decreased when combined with Amphetamine. Amprenavir The metabolism of Ponatinib can be decreased when combined with Amprenavir. Amsacrine The risk or severity of adverse effects can be increased when Amsacrine is combined with Ponatinib. Anagrelide The risk or severity of bleeding can be increased when Anagrelide is combined with Ponatinib. Anakinra The metabolism of Ponatinib can be increased when combined with Anakinra. Anastrozole The metabolism of Ponatinib can be decreased when combined with Anastrozole. Ancrod The risk or severity of bleeding can be increased when Ancrod is combined with Ponatinib. Anifrolumab The risk or severity of adverse effects can be increased when Ponatinib is combined with Anifrolumab. Anistreplase The risk or severity of bleeding can be increased when Anistreplase is combined with Ponatinib. Anthrax immune The therapeutic efficacy of Anthrax immune globulin human can be decreased when used in combination with Ponatinib. Anthrax vaccine The risk or severity of infection can be increased when Anthrax vaccine is combined with Ponatinib. Antilymphocyte The risk or severity of adverse effects can be increased when Ponatinib is combined with Antilymphocyte immunoglobulin (horse). Antipyrine The metabolism of Ponatinib can be decreased when combined with Antipyrine. Antithrombin Alfa The risk or severity of bleeding can be increased when Antithrombin Alfa is combined with Ponatinib. Antithrombin III The risk or severity of bleeding can be increased when Antithrombin III human is combined with Ponatinib. Antithymocyte The risk or severity of adverse effects can be increased when Antithymocyte immunoglobulin (rabbit) is combined with Ponatinib. Apalutamide The metabolism of Ponatinib can be increased when combined with Apalutamide. Apixaban The metabolism of Ponatinib can be decreased when combined with Apixaban. Apomorphine The metabolism of Ponatinib can be decreased when combined with Apomorphine. Apremilast The metabolism of Ponatinib can be increased when combined with Apremilast. Aprepitant The metabolism of Ponatinib can be decreased when combined with Aprepitant. Ardeparin The risk or severity of bleeding can be increased when Ardeparin is combined with Ponatinib. Arformoterol The metabolism of Ponatinib can be decreased when combined with Arformoterol. Argatroban The risk or severity of bleeding can be increased when Argatroban is combined with Ponatinib. Aripiprazole The metabolism of Ponatinib can be decreased when combined with Aripiprazole. Aripiprazole The metabolism of Ponatinib can be decreased when combined with Aripiprazole lauroxil. Armodafinil The metabolism of Ponatinib can be increased when combined with Armodafinil. Arsenic trioxide The risk or severity of adverse effects can be increased when Arsenic trioxide is combined with Ponatinib. Artemether The metabolism of Ponatinib can be decreased when combined with Artemether. Artenimol The metabolism of Ponatinib can be decreased when combined with Artenimol. Articaine The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Articaine. Asciminib The serum concentration of Ponatinib can be increased when it is combined with Asciminib. Astemizole The metabolism of Ponatinib can be decreased when combined with Astemizole. ACOVID-19 Vacci The therapeutic efficacy of AstraZeneca COVID-19 Vaccine can be decreased when used in combination with Ponatinib. Asunaprevir The metabolism of Ponatinib can be decreased when combined with Asunaprevir. Atazanavir The metabolism of Ponatinib can be decreased when combined with Atazanavir. Atenolol The metabolism of Ponatinib can be decreased when combined with Atenolol. Atomoxetine The metabolism of Ponatinib can be decreased when combined with Atomoxetine. Atorvastatin The metabolism of Ponatinib can be decreased when combined with Atorvastatin. Avacopan The metabolism of Ponatinib can be decreased when combined with Avacopan. Avanafil The serum concentration of Avanafil can be increased when it is combined with Ponatinib. Avatrombopag The metabolism of Ponatinib can be increased when combined with Avatrombopag. Axitinib The serum concentration of Axitinib can be increased when it is combined with Ponatinib. Azacitidine The risk or severity of adverse effects can be increased when Azacitidine is combined with Ponatinib. Azathioprine The risk or severity of adverse effects can be increased when Azathioprine is combined with Ponatinib. Azelastine The metabolism of Ponatinib can be decreased when combined with Azelastine. Azithromycin The metabolism of Ponatinib can be decreased when combined with Azithromycin. Bacillus antigen The risk or severity of infection can be increased when Bacillus calmette-guerin substrain connaught live antigen is combined with Ponatinib. Bacillus The therapeutic efficacy of Bacillus calmette-guerin substrain russian BCG-I live antigen can be decreased when used in combination with Ponatinib. Bacillus calmette The risk or severity of infection can be increased when Bacillus calmette-guerin substrain tice live antigen is combined with Ponatinib. Baricitinib The risk or severity of adverse effects can be increased when Ponatinib is combined with Baricitinib. Basiliximab The risk or severity of adverse effects can be increased when Basiliximab is combined with Ponatinib. BCG vaccine The risk or severity of infection can be increased when BCG vaccine is combined with Ponatinib. Beclomethasone The metabolism of Ponatinib can be increased when combined with Beclomethasone dipropionate. Belantamab The serum concentration of Belantamab mafodotin can be increased when it is combined with Ponatinib. Belatacept The risk or severity of adverse effects can be increased when Belatacept is combined with Ponatinib. Belimumab The risk or severity of adverse effects can be increased when Belimumab is combined with Ponatinib. Belinostat The risk or severity of adverse effects can be increased when Belinostat is combined with Ponatinib. Belumosudil The risk or severity of adverse effects can be increased when Ponatinib is combined with Belumosudil. Belzutifan The serum concentration of Ponatinib can be decreased when it is combined with Belzutifan. Bemiparin The risk or severity of bleeding can be increased when Bemiparin is combined with Ponatinib. Bendamustine The serum concentration of Bendamustine can be increased when it is combined with Ponatinib. Bendroflumethia The risk or severity of neutropenia and thrombocytopenia can be increased when Bendroflumethiazide is combined with Ponatinib. Benzatropine The metabolism of Ponatinib can be decreased when combined with Benzatropine. Benzocaine The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Benzocaine. Benzthiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Benzthiazide is combined with Ponatinib. Benzyl alcohol The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Benzyl alcohol. Bepridil The metabolism of Ponatinib can be decreased when combined with Bepridil. Berotralstat The serum concentration of Berotralstat can be increased when it is combined with Ponatinib. Betamethasone The metabolism of Ponatinib can be increased when combined with Betamethasone. Betamethasone The metabolism of Ponatinib can be increased when combined with Betamethasone phosphate. Betaxolol The metabolism of Ponatinib can be decreased when combined with Betaxolol. Betrixaban The serum concentration of Betrixaban can be increased when it is combined with Ponatinib. Bexarotene The metabolism of Ponatinib can be increased when combined with Bexarotene. Bezafibrate The metabolism of Ponatinib can be decreased when combined with Bezafibrate. Bicalutamide The metabolism of Ponatinib can be decreased when combined with Bicalutamide. Bifonazole The metabolism of Ponatinib can be decreased when combined with Bifonazole. Bimekizumab The metabolism of Ponatinib can be increased when combined with Bimekizumab. Binimetinib The serum concentration of Binimetinib can be increased when it is combined with Ponatinib. Biperiden The metabolism of Ponatinib can be decreased when combined with Biperiden. Bisoprolol The serum concentration of Bisoprolol can be increased when it is combined with Ponatinib. Bivalirudin The risk or severity of bleeding can be increased when Bivalirudin is combined with Ponatinib. Bleomycin The risk or severity of adverse effects can be increased when Bleomycin is combined with Ponatinib. Blinatumomab The risk or severity of adverse effects can be increased when Ponatinib is combined with Blinatumomab. Boceprevir The metabolism of Ponatinib can be decreased when combined with Boceprevir. Bordetella The therapeutic efficacy of Bordetella pertussis toxoid antigen (formaldehyde, glutaraldehyde inactivated) can be decreased when used in combination with Ponatinib. Bortezomib The serum concentration of Bortezomib can be increased when it is combined with Ponatinib. Bosentan The metabolism of Ponatinib can be increased when combined with Bosentan. Bosutinib The serum concentration of Bosutinib can be increased when it is combined with Ponatinib. Brentuximab The serum concentration of Brentuximab vedotin can be increased when it is combined with Ponatinib. Brexpiprazole The metabolism of Ponatinib can be decreased when combined with Brexpiprazole. Brigatinib The metabolism of Brigatinib can be decreased when combined with Ponatinib. Brodalumab The risk or severity of adverse effects can be increased when Ponatinib is combined with Brodalumab. Budesonide The metabolism of Ponatinib can be increased when combined with Budesonide. Bupivacaine The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Bupivacaine. Buprenorphine The metabolism of Ponatinib can be decreased when combined with Buprenorphine. Bupropion The metabolism of Ponatinib can be decreased when combined with Bupropion. Buspirone The metabolism of Ponatinib can be decreased when combined with Buspirone. Busulfan The risk or severity of adverse effects can be increased when Busulfan is combined with Ponatinib. Butacaine The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Butacaine. Butalbital The metabolism of Ponatinib can be increased when combined with Butalbital. Butamben The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Butamben. Cabazitaxel The serum concentration of Cabazitaxel can be increased when it is combined with Ponatinib. Cabergoline The serum concentration of Cabergoline can be increased when it is combined with Ponatinib. Cabozantinib The metabolism of Ponatinib can be decreased when combined with Cabozantinib. Caffeine Caffeine may decrease the excretion rate of Ponatinib which could result in a higher serum level. Calcitriol The metabolism of Ponatinib can be increased when combined with Calcitriol. Canagliflozin The serum concentration of Canagliflozin can be increased when it is combined with Ponatinib. Canakinumab The metabolism of Ponatinib can be increased when combined with Canakinumab. Candesartan The metabolism of Ponatinib can be decreased when combined with Candesartan cilexetil. Candicidin The metabolism of Ponatinib can be decreased when combined with Candicidin. Cangrelor The risk or severity of bleeding can be increased when Cangrelor is combined with Ponatinib. Cannabidiol The metabolism of Ponatinib can be decreased when combined with Cannabidiol. Capecitabine The risk or severity of adverse effects can be increased when Capecitabine is combined with Ponatinib. Caplacizumab The risk or severity of bleeding can be increased when Caplacizumab is combined with Ponatinib. Capmatinib The serum concentration of Ponatinib can be increased when it is combined with Capmatinib. Capsaicin The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Capsaicin. Carbamazepine The metabolism of Ponatinib can be increased when combined with Carbamazepine. Carbimazole The therapeutic efficacy of Carbimazole can be decreased when used in combination with Ponatinib. Carboplatin The risk or severity of adverse effects can be increased when Carboplatin is combined with Ponatinib. Carfilzomib The serum concentration of Carfilzomib can be increased when it is combined with Ponatinib. Carmustine The risk or severity of adverse effects can be increased when Carmustine is combined with Ponatinib. Carvedilol The metabolism of Ponatinib can be decreased when combined with Carvedilol. Cefradine The metabolism of Ponatinib can be increased when combined with Cefradine. Celecoxib The metabolism of Ponatinib can be decreased when combined with Celecoxib. Celiprolol The metabolism of Ponatinib can be decreased when combined with Celiprolol. Cenobamate The serum concentration of Ponatinib can be decreased when it is combined with Cenobamate. Cephalexin The metabolism of Ponatinib can be decreased when combined with Cephalexin. Ceritinib The serum concentration of Ceritinib can be increased when it is combined with Ponatinib. Cerivastatin The metabolism of Ponatinib can be increased when combined with Cerivastatin. Certolizumab The metabolism of Ponatinib can be increased when combined with Certolizumab pegol. Cevimeline The metabolism of Ponatinib can be decreased when combined with Cevimeline. Chlorambucil The risk or severity of adverse effects can be increased when Chlorambucil is combined with Ponatinib. Chloramphenicol The metabolism of Ponatinib can be decreased when combined with Chloramphenicol. Chloroprocaine The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Chloroprocaine. Chloroquine The metabolism of Ponatinib can be decreased when combined with Chloroquine. Chlorothiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Chlorothiazide is combined with Ponatinib. Chlorpheniramine The metabolism of Ponatinib can be decreased when combined with Chlorpheniramine. Chlorpromazine The metabolism of Ponatinib can be decreased when combined with Chlorpromazine. Chlorzoxazone The metabolism of Ponatinib can be decreased when combined with Chlorzoxazone. Cholecalciferol The metabolism of Ponatinib can be decreased when combined with Cholecalciferol. Cholesterol Cholesterol may increase the excretion rate of Ponatinib which could result in a lower serum level and potentially a reduction in efficacy. Ciclesonide The metabolism of Ponatinib can be decreased when combined with Ciclesonide. Cilostazol The metabolism of Ponatinib can be decreased when combined with Cilostazol. Cimetidine The metabolism of Ponatinib can be decreased when combined with Cimetidine. Cinacalcet The metabolism of Ponatinib can be decreased when combined with Cinacalcet. Cinchocaine The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Cinchocaine. Cinnarizine The metabolism of Ponatinib can be decreased when combined with Cinnarizine. Ciprofloxacin The metabolism of Ponatinib can be decreased when combined with Ciprofloxacin. Cisapride The metabolism of Ponatinib can be decreased when combined with Cisapride. Cisplatin The risk or severity of adverse effects can be increased when Cisplatin is combined with Ponatinib. Citalopram The metabolism of Ponatinib can be decreased when combined with Citalopram. Cladribine The risk or severity of adverse effects can be increased when Cladribine is combined with Ponatinib. Clarithromycin The metabolism of Ponatinib can be decreased when combined with Clarithromycin. Clemastine The metabolism of Ponatinib can be decreased when combined with Clemastine. Clevidipine The metabolism of Ponatinib can be increased when combined with Clevidipine. Clindamycin The metabolism of Ponatinib can be decreased when combined with Clindamycin. Clobazam The metabolism of Ponatinib can be decreased when combined with Clobazam. Clobetasol The metabolism of Ponatinib can be increased when combined with Clobetasol propionate. Clofarabine The risk or severity of adverse effects can be increased when Clofarabine is combined with Ponatinib. Clofazimine The metabolism of Ponatinib can be decreased when combined with Clofazimine. Clofibrate The metabolism of Ponatinib can be increased when combined with Clofibrate. Clomifene The serum concentration of Clomifene can be increased when it is combined with Ponatinib. Clomipramine The metabolism of Ponatinib can be decreased when combined with Clomipramine. Clonidine The metabolism of Ponatinib can be decreased when combined with Clonidine. Clopidogrel The metabolism of Ponatinib can be decreased when combined with Clopidogrel. Clostridium The therapeutic efficacy of Clostridium tetani toxoid antigen (formaldehyde inactivated) can be decreased when used in combination with Ponatinib. Clozapine The risk or severity of neutropenia can be increased when Ponatinib is combined with Clozapine. Cobicistat The metabolism of Ponatinib can be decreased when combined with Cobicistat. Cobimetinib The serum concentration of Cobimetinib can be increased when it is combined with Ponatinib. Cocaine The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Cocaine. Codeine The metabolism of Ponatinib can be decreased when combined with Codeine. Colchicine The serum concentration of Colchicine can be increased when it is combined with Ponatinib. Conivaptan The metabolism of Ponatinib can be decreased when combined with Conivaptan. Conestrogens Ponatinib 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 Ponatinib. Corticotropin The metabolism of Ponatinib can be increased when combined with Corticotropin. Cortisone acetate The metabolism of Ponatinib can be increased when combined with Cortisone acetate. Corynebacterium The therapeutic efficacy of Corynebacterium diphtheriae toxoid antigen (formaldehyde inactivated) can be decreased when used in combination with Ponatinib. Crizotinib The metabolism of Ponatinib can be decreased when combined with Crizotinib. Curcumin The metabolism of Ponatinib can be decreased when combined with Curcumin. Cyanocobalamin The therapeutic efficacy of Cyanocobalamin can be decreased when used in combination with Ponatinib. Cyclopenthiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Cyclopenthiazide is combined with Ponatinib. Cyclophosphamide The metabolism of Ponatinib can be increased when combined with Cyclophosphamide. Cyclosporine Ponatinib may increase the immunosuppressive activities of Cyclosporine. Cyclothiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Cyclothiazide is combined with Ponatinib. Cyproterone The metabolism of Ponatinib can be decreased when combined with Cyproterone acetate. Cytarabine The risk or severity of adverse effects can be increased when Cytarabine is combined with Ponatinib. Dabigatran The risk or severity of bleeding can be increased when Dabigatran is combined with Ponatinib. Dabigatran The serum concentration of Dabigatran etexilate can be increased when it is combined with Ponatinib. Dabrafenib The serum concentration of Ponatinib can be decreased when it is combined with Dabrafenib. Dacarbazine The risk or severity of adverse effects can be increased when Dacarbazine is combined with Ponatinib. Daclatasvir The metabolism of Ponatinib can be decreased when combined with Daclatasvir. Dacomitinib The serum concentration of Dacomitinib can be increased when it is combined with Ponatinib. Dactinomycin The serum concentration of Dactinomycin can be increased when it is combined with Ponatinib. Dalfopristin The metabolism of Ponatinib can be decreased when combined with Dalfopristin. Dalteparin The risk or severity of bleeding can be increased when Dalteparin is combined with Ponatinib. Danaparoid The risk or severity of bleeding can be increased when Danaparoid is combined with Ponatinib. Danazol The metabolism of Ponatinib can be decreased when combined with Danazol. Dapagliflozin The metabolism of Ponatinib can be decreased when combined with Dapagliflozin. Dapsone The metabolism of Ponatinib can be decreased when combined with Dapsone. Daptomycin The serum concentration of Daptomycin can be increased when it is combined with Ponatinib. Darbepoetin alfa The risk or severity of Thrombosis can be increased when Darbepoetin alfa is combined with Ponatinib. Darifenacin The metabolism of Ponatinib can be decreased when combined with Darifenacin. Darolutamide The serum concentration of Ponatinib can be increased when it is combined with Darolutamide. Darunavir The serum concentration of Ponatinib can be increased when it is combined with Darunavir. Dasabuvir The metabolism of Ponatinib can be decreased when combined with Dasabuvir. Dasatinib The serum concentration of Dasatinib can be increased when it is combined with Ponatinib. Daunorubicin The metabolism of Ponatinib can be decreased when combined with Daunorubicin. Debrisoquine The metabolism of Ponatinib can be decreased when combined with Debrisoquine. Decitabine The risk or severity of adverse effects can be increased when Decitabine is combined with Ponatinib. Deferasirox The metabolism of Ponatinib can be increased when combined with Deferasirox. Defibrotide The risk or severity of bleeding can be increased when Defibrotide is combined with Ponatinib. Deflazacort The metabolism of Ponatinib can be increased when combined with Deflazacort. Delafloxacin Ponatinib may decrease the excretion rate of Delafloxacin which could result in a higher serum level. Delavirdine The metabolism of Ponatinib can be decreased when combined with Delavirdine. Denosumab The risk or severity of adverse effects can be increased when Denosumab is combined with Ponatinib. Desipramine The metabolism of Ponatinib can be decreased when combined with Desipramine. Desirudin The risk or severity of bleeding can be increased when Desirudin is combined with Ponatinib. Desoximetasone The risk or severity of adverse effects can be increased when Desoximetasone is combined with Ponatinib. Desvenlafaxine The metabolism of Ponatinib can be decreased when combined with Desvenlafaxine. Deucravacitinib The risk or severity of adverse effects can be increased when Ponatinib is combined with Deucravacitinib. Deutetrabenazine The metabolism of Ponatinib can be decreased when combined with Deutetrabenazine. Dexamethasone The metabolism of Ponatinib can be increased when combined with Dexamethasone. Dexamethasone The metabolism of Ponatinib can be increased when combined with Dexamethasone acetate. Dexchlorphenira The metabolism of Ponatinib can be decreased when combined with Dexchlorpheniramine maleate. Dexfenfluramine The metabolism of Ponatinib can be decreased when combined with Dexfenfluramine. Dexibuprofen The metabolism of Ponatinib can be decreased when combined with Dexibuprofen. Dexmedetomidine The metabolism of Ponatinib can be decreased when combined with Dexmedetomidine. Dexrazoxane The risk or severity of adverse effects can be increased when Dexrazoxane is combined with Ponatinib. Dextran The risk or severity of bleeding can be increased when Dextran is combined with Ponatinib. Dextroampheta The metabolism of Ponatinib can be decreased when combined with Dextroamphetamine. Dextromethorphan The metabolism of Ponatinib can be decreased when combined with Dextromethorphan. Dextropropox The metabolism of Ponatinib can be decreased when combined with Dextropropoxyphene. Diacerein The metabolism of Ponatinib can be decreased when combined with Diacerein. Diazepam The metabolism of Ponatinib can be decreased when combined with Diazepam. Diclofenac The metabolism of Ponatinib can be decreased when combined with Diclofenac. Dicloxacillin The metabolism of Ponatinib can be increased when combined with Dicloxacillin. Dicoumarol The risk or severity of bleeding can be increased when Dicoumarol is combined with Ponatinib. Diethylstilbestrol The metabolism of Ponatinib can be decreased when combined with Diethylstilbestrol. Difluocortolone The metabolism of Ponatinib can be increased when combined with Difluocortolone. Digitoxin The serum concentration of Digitoxin can be increased when it is combined with Ponatinib. Digoxin Ponatinib may decrease the excretion rate of Digoxin which could result in a higher serum level. Dihydrocodeine The metabolism of Ponatinib can be decreased when combined with Dihydrocodeine. Dihydroergocornine The metabolism of Ponatinib can be decreased when combined with Dihydroergocornine. Dihydroergocristine The metabolism of Ponatinib can be decreased when combined with Dihydroergocristine. Dihydroergotamine The metabolism of Ponatinib can be decreased when combined with Dihydroergotamine. Diltiazem The metabolism of Ponatinib can be decreased when combined with Diltiazem. Dimethyl fumarate The risk or severity of adverse effects can be increased when Ponatinib is combined with Dimethyl fumarate. Dimethyl sulfoxide The metabolism of Ponatinib can be decreased when combined with Dimethyl sulfoxide. Dinutuximab The risk or severity of adverse effects can be increased when Ponatinib is combined with Dinutuximab. Diosmin The metabolism of Ponatinib can be decreased when combined with Diosmin. Diphenhydramine The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Diphenhydramine. Dipyridamole The risk or severity of bleeding can be increased when Dipyridamole is combined with Ponatinib. Diroximel fumarate The risk or severity of adverse effects can be increased when Ponatinib is combined with Diroximel fumarate. Disulfiram The metabolism of Ponatinib can be decreased when combined with Disulfiram. Docetaxel The metabolism of Ponatinib can be decreased when combined with Docetaxel. Dolasetron The metabolism of Ponatinib can be decreased when combined with Dolasetron. Dolutegravir Ponatinib may decrease the excretion rate of Dolutegravir which could result in a higher serum level. Domperidone The metabolism of Ponatinib can be decreased when combined with Domperidone. Donepezil The metabolism of Ponatinib can be decreased when combined with Donepezil. Doravirine The metabolism of Ponatinib can be decreased when combined with Doravirine. Dosulepin The metabolism of Ponatinib can be decreased when combined with Dosulepin. Doxazosin The metabolism of Ponatinib can be decreased when combined with Doxazosin. Doxepin The metabolism of Ponatinib can be decreased when combined with Doxepin. Doxorubicin The serum concentration of Doxorubicin can be increased when it is combined with Ponatinib. Dronabinol The metabolism of Ponatinib can be decreased when combined with Dronabinol. Dronedarone The serum concentration of Ponatinib can be increased when it is combined with Dronedarone. Drospirenone The metabolism of Ponatinib can be decreased when combined with Drospirenone. Drotrecogin alfa The risk or severity of bleeding can be increased when Drotrecogin alfa is combined with Ponatinib. Duloxetine The metabolism of Ponatinib can be decreased when combined with Duloxetine. Dutasteride The metabolism of Ponatinib can be decreased when combined with Dutasteride. Duvelisib The metabolism of Ponatinib can be decreased when combined with Duvelisib. Dyclonine The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Dyclonine. Ebastine The metabolism of Ponatinib can be decreased when combined with Ebastine. Ebola Zaire) The therapeutic efficacy of Ebola Zaire vaccine (live, attenuated) can be decreased when used in combination with Ponatinib. Echinacea The metabolism of Ponatinib can be increased when combined with Echinacea. Eculizumab The risk or severity of adverse effects can be increased when Eculizumab is combined with Ponatinib. Edetic acid The risk or severity of bleeding can be increased when Edetic acid is combined with Ponatinib. Edoxaban The serum concentration of Edoxaban can be increased when it is combined with Ponatinib. Efalizumab The risk or severity of adverse effects can be increased when Efalizumab is combined with Ponatinib. Efavirenz The metabolism of Ponatinib can be decreased when combined with Efavirenz. Elagolix The metabolism of Ponatinib can be decreased when combined with Elagolix. Elbasvir The metabolism of Ponatinib can be decreased when combined with Elbasvir. Eletriptan The metabolism of Ponatinib can be decreased when combined with Eletriptan. Elexacaftor The metabolism of Ponatinib can be decreased when combined with Elexacaftor. Eliglustat The metabolism of Ponatinib can be decreased when combined with Eliglustat. Eltrombopag The metabolism of Ponatinib can be decreased when combined with Eltrombopag. Elvitegravir The metabolism of Ponatinib can be decreased when combined with Elvitegravir. Emapalumab The metabolism of Ponatinib can be increased when combined with Emapalumab. Enasidenib The metabolism of Ponatinib can be increased when combined with Enasidenib. Encainide The metabolism of Ponatinib can be decreased when combined with Encainide. Encorafenib The metabolism of Ponatinib can be decreased when combined with Encorafenib. Enfortumab The serum concentration of Enfortumab vedotin can be increased when it is combined with Ponatinib. Enoxaparin The risk or severity of bleeding can be increased when Enoxaparin is combined with Ponatinib. Entacapone The metabolism of Ponatinib can be decreased when combined with Entacapone. Enzalutamide The serum concentration of Ponatinib can be decreased when it is combined with Enzalutamide. Epinastine The metabolism of Ponatinib can be decreased when combined with Epinastine. Epinephrine The metabolism of Ponatinib can be decreased when combined with Epinephrine. Epirubicin The risk or severity of adverse effects can be increased when Epirubicin is combined with Ponatinib. Eplerenone The metabolism of Ponatinib can be decreased when combined with Eplerenone. Epoprostenol The risk or severity of bleeding can be increased when Epoprostenol is combined with Ponatinib. Eptifibatide The risk or severity of bleeding can be increased when Eptifibatide is combined with Ponatinib. Ergotamine The metabolism of Ponatinib can be decreased when combined with Ergotamine. Eribulin The risk or severity of adverse effects can be increased when Eribulin is combined with Ponatinib. Erlotinib The metabolism of Ponatinib can be decreased when combined with Erlotinib. Ertugliflozin Ponatinib may decrease the excretion rate of Ertugliflozin which could result in a higher serum level. Erythromycin The metabolism of Ponatinib can be decreased when combined with Erythromycin. Erythropoietin The risk or severity of Thrombosis can be increased when Erythropoietin is combined with Ponatinib. Escitalopram The serum concentration of Ponatinib can be increased when it is combined with Escitalopram. Esketamine The metabolism of Ponatinib can be increased when combined with Esketamine. Eslicarbazepine The metabolism of Ponatinib can be increased when combined with Eslicarbazepine. Eslicarbazepine The metabolism of Ponatinib can be increased when combined with Eslicarbazepine acetate. Esmolol The metabolism of Ponatinib can be decreased when combined with Esmolol. Estetrol The metabolism of Ponatinib can be decreased when combined with Estetrol. Estradiol The metabolism of Ponatinib can be decreased when combined with Estradiol. Estradiol acetate The metabolism of Ponatinib can be increased when combined with Estradiol acetate. Estradiol benzoate The metabolism of Ponatinib can be increased when combined with Estradiol benzoate. Estradiol cypionate The metabolism of Ponatinib can be increased when combined with Estradiol cypionate. Estradiol dienant The metabolism of Ponatinib can be increased when combined with Estradiol dienanthate. Estradiol valerate The metabolism of Ponatinib can be increased when combined with Estradiol valerate. Estramustine The risk or severity of adverse effects can be increased when Estramustine is combined with Ponatinib. Eszopiclone The metabolism of Ponatinib can be decreased when combined with Eszopiclone. Etanercept The metabolism of Ponatinib can be increased when combined with Etanercept. Ethambutol The metabolism of Ponatinib can be decreased when combined with Ethambutol. Ethanol The metabolism of Ponatinib can be increased when combined with Ethanol. Ethinylestradiol The metabolism of Ponatinib can be decreased when combined with Ethinylestradiol. Ethyl chloride The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Ethyl chloride. Etidocaine The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Etidocaine. Etoposide The serum concentration of Etoposide can be increased when it is combined with Ponatinib. Etoricoxib The metabolism of Ponatinib can be decreased when combined with Etoricoxib. Etravirine The metabolism of Ponatinib can be increased when combined with Etravirine. Everolimus The serum concentration of Everolimus can be increased when it is combined with Ponatinib. Ezetimibe Ponatinib may decrease the excretion rate of Ezetimibe which could result in a higher serum level. Famtozinameran The therapeutic efficacy of Famtozinameran can be decreased when used in combination with Ponatinib. Favipiravir The metabolism of Ponatinib can be decreased when combined with Favipiravir. Febuxostat The excretion of Ponatinib can be decreased when combined with Febuxostat. Fedratinib The metabolism of Ponatinib can be decreased when combined with Fedratinib. Felbamate The metabolism of Ponatinib can be increased when combined with Felbamate. Felodipine The metabolism of Ponatinib can be decreased when combined with Felodipine. Fenfluramine The metabolism of Ponatinib can be decreased when combined with Fenfluramine. Fenofibrate The metabolism of Ponatinib can be decreased when combined with Fenofibrate. Fesoterodine The metabolism of Ponatinib can be decreased when combined with Fesoterodine. Fexinidazole The metabolism of Ponatinib can be decreased when combined with Fexinidazole. Fexofenadine The serum concentration of Fexofenadine can be increased when it is combined with Ponatinib. Filgotinib The risk or severity of adverse effects can be increased when Ponatinib is combined with Filgotinib. Finasteride The metabolism of Ponatinib can be decreased when combined with Finasteride. Finerenone The metabolism of Ponatinib can be decreased when combined with Finerenone. Fingolimod Ponatinib may increase the immunosuppressive activities of Fingolimod. Flecainide The metabolism of Ponatinib can be decreased when combined with Flecainide. Floxuridine The risk or severity of adverse effects can be increased when Floxuridine is combined with Ponatinib. Flucloxacillin The metabolism of Ponatinib can be increased when combined with Flucloxacillin. Fluconazole The metabolism of Ponatinib can be decreased when combined with Fluconazole. Flucytosine The risk or severity of adverse effects can be increased when Flucytosine is combined with Ponatinib. Fludarabine The risk or severity of adverse effects can be increased when Fludarabine is combined with Ponatinib. Fludrocortisone The risk or severity of adverse effects can be increased when Fludrocortisone is combined with Ponatinib. Fluindione The risk or severity of bleeding can be increased when Fluindione is combined with Ponatinib. Flunarizine The metabolism of Ponatinib can be decreased when combined with Flunarizine. Flunisolide The metabolism of Ponatinib can be increased when combined with Flunisolide. Fluocinolone The metabolism of Ponatinib can be increased when combined with Fluocinolone acetonide. Fluocinonide The metabolism of Ponatinib can be increased when combined with Fluocinonide. Fluocortolone The metabolism of Ponatinib can be increased when combined with Fluocortolone. Fluorometholone The risk or severity of adverse effects can be increased when Fluorometholone is combined with Ponatinib. Irinotecan The metabolism of Ponatinib can be decreased when combined with Irinotecan. Isavuconazole The metabolism of Ponatinib can be increased when combined with Isavuconazole. Isavuconazonium The metabolism of Ponatinib can be increased when combined with Isavuconazonium. Isoniazid The metabolism of Ponatinib can be decreased when combined with Isoniazid. Isradipine The metabolism of Ponatinib can be decreased when combined with Isradipine. Istradefylline The metabolism of Ponatinib can be decreased when combined with Istradefylline. Itraconazole The metabolism of Ponatinib can be decreased when combined with Itraconazole. Ivacaftor The metabolism of Ponatinib can be decreased when combined with Ivacaftor. Ivermectin Ponatinib may decrease the excretion rate of Ivermectin which could result in a higher serum level. Ivosidenib The metabolism of Ponatinib can be increased when combined with Ivosidenib. Ixabepilone The risk or severity of adverse effects can be increased when Ixabepilone is combined with Ponatinib. Ixekizumab The risk or severity of adverse effects can be increased when Ponatinib is combined with Ixekizumab. Janssen COVID The therapeutic efficacy of Janssen COVID-19 Vaccine can be decreased when used in combination with Ponatinib. Ja encephalits The therapeutic efficacy of Japanese encephalitis virus strain sa 14-14-2 antigen (formaldehyde inactivated) can be decreased when used in combination with Ponatinib. Ketamine The metabolism of Ponatinib can be decreased when combined with Ketamine. Ketazolam The metabolism of Ponatinib can be decreased when combined with Ketazolam. Ketoconazole The metabolism of Ponatinib can be decreased when combined with Ketoconazole. Ketoprofen The metabolism of Ponatinib can be decreased when combined with Ketoprofen. Ketorolac The metabolism of Ponatinib can be decreased when combined with Ketorolac. Labetalol The metabolism of Ponatinib can be decreased when combined with Labetalol. Lacosamide The metabolism of Ponatinib can be decreased when combined with Lacosamide. Lamivudine Ponatinib may decrease the excretion rate of Lamivudine which could result in a higher serum level. Lanreotide The metabolism of Ponatinib can be decreased when combined with Lanreotide. Lansoprazole The metabolism of Ponatinib can be decreased when combined with Lansoprazole. Lapatinib The metabolism of Ponatinib can be decreased when combined with Lapatinib. Larotrectinib The serum concentration of Larotrectinib can be increased when it is combined with Ponatinib. Lasmiditan The serum concentration of Ponatinib can be increased when it is combined with Lasmiditan. Ledipasvir The serum concentration of Ledipasvir can be increased when it is combined with Ponatinib. Lefamulin Ponatinib may decrease the excretion rate of Lefamulin which could result in a higher serum level. Leflunomide The risk or severity of adverse effects can be increased when Ponatinib is combined with Leflunomide. Lemborexant The metabolism of Ponatinib can be decreased when combined with Lemborexant. Lenalidomide The risk or severity of adverse effects can be increased when Lenalidomide is combined with Ponatinib. Lenvatinib Ponatinib may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Lepirudin The risk or severity of bleeding can be increased when Lepirudin is combined with Ponatinib. Lercanidipine The metabolism of Ponatinib can be decreased when combined with Lercanidipine. Lesinurad The metabolism of Ponatinib can be increased when combined with Lesinurad. Letermovir The metabolism of Ponatinib can be decreased when combined with Letermovir. Levamlodipine The metabolism of Ponatinib can be decreased when combined with Levamlodipine. Levobetaxolol The metabolism of Ponatinib can be decreased when combined with Levobetaxolol. Levobupivacaine The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Levobupivacaine. Levoketoconazole The metabolism of Ponatinib can be decreased when combined with Levoketoconazole. Levomilnacipran The metabolism of Ponatinib can be decreased when combined with Levomilnacipran. Levonorgestrel The metabolism of Ponatinib can be decreased when combined with Levonorgestrel. Levothyroxine The therapeutic efficacy of Levothyroxine can be decreased when used in combination with Ponatinib. Lidocaine The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Lidocaine. Linagliptin The metabolism of Ponatinib can be decreased when combined with Linagliptin. Linezolid The risk or severity of adverse effects can be increased when Linezolid is combined with Ponatinib. Linzagolix The serum concentration of Ponatinib can be increased when it is combined with Linzagolix. Liothyronine The therapeutic efficacy of Liothyronine can be decreased when used in combination with Ponatinib. Liotrix The therapeutic efficacy of Liotrix can be decreased when used in combination with Ponatinib. Lipegfilgrastim Ponatinib may increase the myelosuppressive activities of Lipegfilgrastim. Lisdexamfeta The metabolism of Ponatinib can be decreased when combined with Lisdexamfetamine. Lisuride The metabolism of Ponatinib can be decreased when combined with Lisuride. Lofexidine The metabolism of Ponatinib can be decreased when combined with Lofexidine. Lomitapide The metabolism of Ponatinib can be decreased when combined with Lomitapide. Lomustine The risk or severity of adverse effects can be increased when Lomustine is combined with Ponatinib. Lonafarnib The metabolism of Ponatinib can be decreased when combined with Lonafarnib. Loncastuximab The serum concentration of Loncastuximab tesirine can be increased when it is combined with Ponatinib. Loperamide The excretion of Loperamide can be decreased when combined with Ponatinib. Lopinavir The metabolism of Ponatinib can be decreased when combined with Lopinavir. Loratadine The metabolism of Ponatinib can be decreased when combined with Loratadine. Lorcaserin The metabolism of Ponatinib can be decreased when combined with Lorcaserin. Lorlatinib The metabolism of Ponatinib can be increased when combined with Lorlatinib. Lorpiprazole The metabolism of Ponatinib can be decreased when combined with Lorpiprazole. Losartan The metabolism of Ponatinib can be decreased when combined with Losartan. Lovastatin The metabolism of Ponatinib can be decreased when combined with Lovastatin. Lumacaftor The metabolism of Ponatinib can be increased when combined with Lumacaftor. Lumefantrine The metabolism of Ponatinib can be decreased when combined with Lumefantrine. Lusutrombopag Ponatinib may decrease the excretion rate of Lusutrombopag which could result in a higher serum level. Magnesium The serum concentration of Magnesium can be decreased when it is combined with Ponatinib. Manidipine The metabolism of Ponatinib can be decreased when combined with Manidipine. Mannitol The serum concentration of Mannitol can be increased when it is combined with Ponatinib. Maprotiline The metabolism of Ponatinib can be decreased when combined with Maprotiline. Maribavir Maribavir may decrease the excretion rate of Ponatinib which could result in a higher serum level. Mavacamten The serum concentration of Ponatinib can be decreased when it is combined with Mavacamten. Measles virus The therapeutic efficacy of Measles virus vaccine live attenuated can be decreased when used in combination with Ponatinib. Mechlorethamine The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Ponatinib. Meclizine The metabolism of Ponatinib can be decreased when combined with Meclizine. Medroxypro The metabolism of Ponatinib can be increased when combined with Medroxyprogesterone acetate. Mefloquine The serum concentration of Mefloquine can be increased when it is combined with Ponatinib. Meloxicam The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Meloxicam. Melphalan The risk or severity of adverse effects can be increased when Melphalan is combined with Ponatinib. Meningococcal The therapeutic efficacy of Meningococcal (groups A, C, Y and W-135) oligosaccharide diphtheria CRM197 conjugate vaccine can be decreased when used in combination with Ponatinib. Meperidine The metabolism of Ponatinib can be decreased when combined with Meperidine. Mephenytoin The metabolism of Ponatinib can be decreased when combined with Mephenytoin. Mepivacaine The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Mepivacaine. Mepolizumab The risk or severity of adverse effects can be increased when Mepolizumab is combined with Ponatinib. Meprednisone The metabolism of Ponatinib can be increased when combined with Meprednisone. Mepyramine The metabolism of Ponatinib can be decreased when combined with Mepyramine. Mercaptopurine The risk or severity of adverse effects can be increased when Mercaptopurine is combined with Ponatinib. Mesoridazine The metabolism of Ponatinib can be decreased when combined with Mesoridazine. Mestranol The metabolism of Ponatinib can be decreased when combined with Mestranol. Metamfetamine The metabolism of Ponatinib can be decreased when combined with Metamfetamine. Metamizole The risk or severity of myelosuppression can be increased when Metamizole is combined with Ponatinib. Methadone The metabolism of Ponatinib can be decreased when combined with Methadone. Methimazole The metabolism of Ponatinib can be decreased when combined with Methimazole. Methotrexate The risk or severity of adverse effects can be increased when Methotrexate is combined with Ponatinib. Methotrimeprazine The metabolism of Ponatinib can be decreased when combined with Methotrimeprazine. Methoxy The risk or severity of Thrombosis can be increased when Methoxy polyethylene glycol-epoetin beta is combined with Ponatinib. Methoxyflurane The metabolism of Ponatinib can be decreased when combined with Methoxyflurane. Methylene blue The metabolism of Ponatinib can be decreased when combined with Methylene blue. Methylergometrine The metabolism of Ponatinib can be decreased when combined with Methylergometrine. Methylphenobarb The metabolism of Ponatinib can be increased when combined with Methylphenobarbital. Methylprednisolo The metabolism of Ponatinib can be increased when combined with Methylprednisolone. Methylprednisone The metabolism of Ponatinib can be decreased when combined with Methylprednisone. Methysergide The metabolism of Ponatinib can be decreased when combined with Methysergide. Metoclopramide The metabolism of Ponatinib can be decreased when combined with Metoclopramide. Metoprolol The metabolism of Ponatinib can be decreased when combined with Metoprolol. Metreleptin The metabolism of Ponatinib can be increased when combined with Metreleptin. Metronidazole The metabolism of Ponatinib can be decreased when combined with Metronidazole. Metyrapone The metabolism of Ponatinib can be increased when combined with Metyrapone. Mexiletine The metabolism of Ponatinib can be decreased when combined with Mexiletine. Mianserin The metabolism of Ponatinib can be decreased when combined with Mianserin. Miconazole The metabolism of Ponatinib can be decreased when combined with Miconazole. Midazolam The metabolism of Ponatinib can be decreased when combined with Midazolam. Midostaurin The metabolism of Ponatinib can be decreased when combined with Midostaurin. Mifepristone The serum concentration of Ponatinib can be increased when it is combined with Mifepristone. Milnacipran The metabolism of Ponatinib can be decreased when combined with Milnacipran. Minaprine The metabolism of Ponatinib can be decreased when combined with Minaprine. Miocamycin The metabolism of Ponatinib can be decreased when combined with Miocamycin. Mirabegron The serum concentration of Ponatinib can be increased when it is combined with Mirabegron. Mirtazapine The metabolism of Ponatinib can be decreased when combined with Mirtazapine. Mitapivat The metabolism of Ponatinib can be increased when combined with Mitapivat. Mitomycin The risk or severity of adverse effects can be increased when Mitomycin is combined with Ponatinib. Mitotane The metabolism of Ponatinib can be increased when combined with Mitotane. Mitoxantrone The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Ponatinib. Mobocertinib The serum concentration of Ponatinib can be decreased when it is combined with Mobocertinib. Moclobemide The metabolism of Ponatinib can be decreased when combined with Moclobemide. Modafinil The metabolism of Ponatinib can be increased when combined with Modafinil. MCOVID-19 Vac The therapeutic efficacy of Moderna COVID-19 Vaccine can be decreased when used in combination with Ponatinib. Modified vaccinia The therapeutic efficacy of Modified vaccinia ankara can be decreased when used in combination with Ponatinib. Mometasone fur The metabolism of Ponatinib can be increased when combined with Mometasone furoate. Monomethyl fum The risk or severity of adverse effects can be increased when Ponatinib is combined with Monomethyl fumarate. Montelukast The metabolism of Ponatinib can be decreased when combined with Montelukast. Morphine The metabolism of Ponatinib can be decreased when combined with Morphine. Mosunetuzumab The metabolism of Ponatinib can be decreased when combined with Mosunetuzumab. Mumps virus The therapeutic efficacy of Mumps virus strain B level jeryl lynn live antigen can be decreased when used in combination with Ponatinib. Muromonab The risk or severity of adverse effects can be increased when Muromonab is combined with Ponatinib. Mycophenolate The metabolism of Ponatinib can be decreased when combined with Mycophenolate mofetil. Mycophenolic The risk or severity of adverse effects can be increased when Mycophenolic acid is combined with Ponatinib. Nadolol The metabolism of Ponatinib can be decreased when combined with Nadolol. Nadroparin The risk or severity of bleeding can be increased when Nadroparin is combined with Ponatinib. Nafcillin The metabolism of Ponatinib can be increased when combined with Nafcillin. Naloxegol The serum concentration of Naloxegol can be increased when it is combined with Ponatinib. Naloxone The metabolism of Ponatinib can be decreased when combined with Naloxone. Naproxen The metabolism of Ponatinib can be decreased when combined with Naproxen. Natalizumab The risk or severity of adverse effects can be increased when Ponatinib is combined with Natalizumab. Nateglinide The metabolism of Ponatinib can be decreased when combined with Nateglinide. Nebivolol The metabolism of Ponatinib can be decreased when combined with Nebivolol. Nefazodone The metabolism of Ponatinib can be decreased when combined with Nefazodone. Nelarabine The risk or severity of adverse effects can be increased when Nelarabine is combined with Ponatinib. Nelfinavir The metabolism of Ponatinib can be decreased when combined with Nelfinavir. Netupitant The metabolism of Ponatinib can be decreased when combined with Netupitant. Nevirapine The metabolism of Ponatinib can be decreased when combined with Nevirapine. Niacin The metabolism of Ponatinib can be decreased when combined with Niacin. Nicardipine The metabolism of Ponatinib can be decreased when combined with Nicardipine. Nicergoline The metabolism of Ponatinib can be decreased when combined with Nicergoline. Nifedipine The metabolism of Ponatinib can be decreased when combined with Nifedipine. Nilotinib The metabolism of Ponatinib can be decreased when combined with Nilotinib. Nilutamide The metabolism of Ponatinib can be decreased when combined with Nilutamide. Nilvadipine The metabolism of Ponatinib can be decreased when combined with Nilvadipine. Nimesulide The risk or severity of bleeding can be increased when Nimesulide is combined with Ponatinib. Nintedanib The metabolism of Ponatinib can be decreased when combined with Nintedanib. Nisoldipine The metabolism of Ponatinib can be decreased when combined with Nisoldipine. Nitrendipine The metabolism of Ponatinib can be decreased when combined with Nitrendipine. Nitrofurantoin Ponatinib may decrease the excretion rate of Nitrofurantoin which could result in a higher serum level. Norethisterone The metabolism of Ponatinib can be decreased when combined with Norethisterone. Norgestimate The metabolism of Ponatinib can be increased when combined with Norgestimate. Nortriptyline The serum concentration of Nortriptyline can be increased when it is combined with Ponatinib. Noscapine The metabolism of Ponatinib can be decreased when combined with Noscapine. Novobiocin Novobiocin may decrease the excretion rate of Ponatinib which could result in a higher serum level. Nuvaxovid The therapeutic efficacy of Nuvaxovid can be decreased when used in combination with Ponatinib. Obinutuzumab The risk or severity of adverse effects can be increased when Ponatinib is combined with Obinutuzumab. Ocrelizumab The risk or severity of adverse effects can be increased when Ponatinib is combined with Ocrelizumab. Octreotide The serum concentration of Ponatinib can be increased when it is combined with Octreotide. Ofatumumab The risk or severity of adverse effects can be increased when Ofatumumab is combined with Ponatinib. Olanzapine The metabolism of Ponatinib can be decreased when combined with Olanzapine. Olaparib The metabolism of Ponatinib can be decreased when combined with Olaparib. Oliceridine The metabolism of Ponatinib can be decreased when combined with Oliceridine. Olodaterol The metabolism of Ponatinib can be decreased when combined with Olodaterol. Omadacycline The serum concentration of Omadacycline can be increased when it is combined with Ponatinib. Ombitasvir The metabolism of Ponatinib can be decreased when combined with Ombitasvir. Omeprazole The metabolism of Ponatinib can be increased when combined with Omeprazole. Ondansetron The metabolism of Ponatinib can be decreased when combined with Ondansetron. Opium The metabolism of Ponatinib can be decreased when combined with Opium. Oritavancin The metabolism of Ponatinib can be increased when combined with Oritavancin. Orphenadrine The metabolism of Ponatinib can be decreased when combined with Orphenadrine. Osilodrostat The metabolism of Ponatinib can be decreased when combined with Osilodrostat. Osimertinib The serum concentration of Osimertinib can be increased when it is combined with Ponatinib. Ospemifene The metabolism of Ponatinib can be decreased when combined with Ospemifene. Oteseconazole The serum concentration of Ponatinib can be increased when it is combined with Oteseconazole. Oxaliplatin The risk or severity of adverse effects can be increased when Oxaliplatin is combined with Ponatinib. Oxamniquine The metabolism of Ponatinib can be decreased when combined with Oxamniquine. Oxcarbazepine The metabolism of Ponatinib can be increased when combined with Oxcarbazepine. Oxetacaine The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Oxetacaine. Oxprenolol The metabolism of Ponatinib can be decreased when combined with Oxprenolol. Oxybuprocaine The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Oxybuprocaine. Oxybutynin The metabolism of Ponatinib can be decreased when combined with Oxybutynin. Oxycodone The metabolism of Ponatinib can be decreased when combined with Oxycodone. Oxymorphone The metabolism of Ponatinib can be decreased when combined with Oxymorphone. Ozanimod Ponatinib may decrease the excretion rate of Ozanimod which could result in a higher serum level. Paclitaxel The metabolism of Ponatinib can be increased when combined with Paclitaxel. Pacritinib The serum concentration of Ponatinib can be increased when it is combined with Pacritinib. Palbociclib The metabolism of Ponatinib can be decreased when combined with Palbociclib. Palifermin The therapeutic efficacy of Palifermin can be decreased when used in combination with Ponatinib. Paliperidone The metabolism of Ponatinib can be decreased when combined with Paliperidone. Palonosetron The metabolism of Ponatinib can be decreased when combined with Palonosetron. Panobinostat The metabolism of Ponatinib can be decreased when combined with Panobinostat. Pantoprazole Pantoprazole may decrease the excretion rate of Ponatinib which could result in a higher serum level. Paramethadione The metabolism of Ponatinib can be decreased when combined with Paramethadione. Parathyroid The therapeutic efficacy of Parathyroid hormone can be decreased when used in combination with Ponatinib. Paritaprevir The metabolism of Ponatinib can be decreased when combined with Paritaprevir. Parnaparin The risk or severity of bleeding can be increased when Parnaparin is combined with Ponatinib. Paroxetine The metabolism of Ponatinib can be decreased when combined with Paroxetine. Pasireotide The metabolism of Ponatinib can be decreased when combined with Pasireotide. Pazopanib The serum concentration of Pazopanib can be increased when it is combined with Ponatinib. Pegaspargase The risk or severity of adverse effects can be increased when Pegaspargase is combined with Ponatinib. Pegcetacoplan The risk or severity of adverse effects can be increased when Ponatinib is combined with Pegcetacoplan. Peginesatide The risk or severity of Thrombosis can be increased when Peginesatide is combined with Ponatinib. Peginterferon The risk or severity of adverse effects can be increased when Peginterferon alfa-2a is combined with Ponatinib. Peginterferon The metabolism of Ponatinib can be decreased when combined with Peginterferon alfa-2b. Peginterferon The risk or severity of adverse effects can be increased when Ponatinib is combined with Peginterferon beta-1a. Pemetrexed The risk or severity of adverse effects can be increased when Pemetrexed is combined with Ponatinib. Penbutolol The metabolism of Ponatinib can be decreased when combined with Penbutolol. Penicillamine The risk or severity of adverse effects can be increased when Penicillamine is combined with Ponatinib. Pentamidine The metabolism of Ponatinib can be decreased when combined with Pentamidine. Pentobarbital The metabolism of Ponatinib can be increased when combined with Pentobarbital. Pentosan polys The risk or severity of bleeding can be increased when Pentosan polysulfate is combined with Ponatinib. Pentostatin The risk or severity of adverse effects can be increased when Pentostatin is combined with Ponatinib. Pentoxifylline The risk or severity of bleeding can be increased when Pentoxifylline is combined with Ponatinib. Perampanel The metabolism of Ponatinib can be increased when combined with Perampanel. Perhexiline The metabolism of Ponatinib can be decreased when combined with Perhexiline. Perphenazine The metabolism of Ponatinib can be decreased when combined with Perphenazine. Pertussis vaccine The therapeutic efficacy of Pertussis vaccine can be decreased when used in combination with Ponatinib. Pexidartinib Ponatinib may increase the hepatotoxic activities of Pexidartinib. Phenformin The metabolism of Ponatinib can be decreased when combined with Phenformin. Phenindione The risk or severity of bleeding can be increased when Phenindione is combined with Ponatinib. Phenobarbital The metabolism of Ponatinib can be increased when combined with Phenobarbital. Phenol The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Phenol. Phenprocoumon The metabolism of Ponatinib can be decreased when combined with Phenprocoumon. Phenylalanine The risk or severity of adverse effects can be increased when Phenylalanine is combined with Ponatinib. Phenylbutazone The metabolism of Ponatinib can be increased when combined with Phenylbutazone. Phenylbutyric acid The metabolism of Ponatinib can be decreased when combined with Phenylbutyric acid. Phenytoin The metabolism of Ponatinib can be increased when combined with Phenytoin. Pibrentasvir Ponatinib may decrease the excretion rate of Pibrentasvir which could result in a higher serum level. Pimavanserin The metabolism of Ponatinib can be decreased when combined with Pimavanserin. Pimecrolimus The risk or severity of adverse effects can be increased when Pimecrolimus is combined with Ponatinib. Pimozide The metabolism of Ponatinib can be decreased when combined with Pimozide. Pindolol The metabolism of Ponatinib can be decreased when combined with Pindolol. Pioglitazone The metabolism of Ponatinib can be decreased when combined with Pioglitazone. Piperaquine The metabolism of Ponatinib can be decreased when combined with Piperaquine. Piperazine The metabolism of Ponatinib can be decreased when combined with Piperazine. Pipotiazine The metabolism of Ponatinib can be decreased when combined with Pipotiazine. Pirfenidone The metabolism of Ponatinib can be decreased when combined with Pirfenidone. Piroxicam The metabolism of Ponatinib can be decreased when combined with Piroxicam. Pitavastatin The metabolism of Ponatinib can be decreased when combined with Pitavastatin. Pitolisant The serum concentration of Ponatinib can be decreased when it is combined with Pitolisant. Polythiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Polythiazide is combined with Ponatinib. Pomalidomide The serum concentration of Pomalidomide can be increased when it is combined with Ponatinib. Ponesimod The metabolism of Ponatinib can be decreased when combined with Ponesimod. Posaconazole The metabolism of Ponatinib can be decreased when combined with Posaconazole. Potassium Iodide The therapeutic efficacy of Potassium Iodide can be decreased when used in combination with Ponatinib. Potassium The therapeutic efficacy of Potassium perchlorate can be decreased when used in combination with Ponatinib. Practolol The metabolism of Ponatinib can be decreased when combined with Practolol. Pralatrexate The risk or severity of adverse effects can be increased when Pralatrexate is combined with Ponatinib. Pralsetinib The serum concentration of Pralsetinib can be increased when it is combined with Ponatinib. Pramocaine The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Pramocaine. Prasugrel The risk or severity of bleeding can be increased when Prasugrel is combined with Ponatinib. Pravastatin Pravastatin may decrease the excretion rate of Ponatinib which could result in a higher serum level. Praziquantel The metabolism of Ponatinib can be decreased when combined with Praziquantel. Prazosin Ponatinib may decrease the excretion rate of Prazosin which could result in a higher serum level. Prednisolone The metabolism of Ponatinib can be increased when combined with Prednisolone. Prednisolone The metabolism of Ponatinib can be increased when combined with Prednisolone acetate. Prednisolone The metabolism of Ponatinib can be increased when combined with Prednisolone phosphate. Prednisone The risk or severity of adverse effects can be increased when Prednisone is combined with Ponatinib. Prednisone The metabolism of Ponatinib can be increased when combined with Prednisone acetate. Pretomanid The metabolism of Ponatinib can be decreased when combined with Pretomanid. Prilocaine The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Prilocaine. Primaquine The metabolism of Ponatinib can be decreased when combined with Primaquine. Primidone The metabolism of Ponatinib can be increased when combined with Primidone. Probenecid The metabolism of Ponatinib can be increased when combined with Probenecid. Procainamide The metabolism of Ponatinib can be decreased when combined with Procainamide. Procaine The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Procaine. Procarbazine The risk or severity of adverse effects can be increased when Procarbazine is combined with Ponatinib. Prochlorperazine The metabolism of Ponatinib can be decreased when combined with Prochlorperazine. Progesterone The metabolism of Ponatinib can be decreased when combined with Progesterone. Proguanil The metabolism of Ponatinib can be decreased when combined with Proguanil. Promazine The metabolism of Ponatinib can be decreased when combined with Promazine. Promethazine The metabolism of Ponatinib can be decreased when combined with Promethazine. Propafenone The metabolism of Ponatinib can be decreased when combined with Propafenone. Proparacaine The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Proparacaine. Propofol The metabolism of Ponatinib can be decreased when combined with Propofol. Propoxycaine The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Propoxycaine. Propranolol The metabolism of Ponatinib can be decreased when combined with Propranolol. Propylthiouracil The therapeutic efficacy of Propylthiouracil can be decreased when used in combination with Ponatinib. Protein C The risk or severity of bleeding can be increased when Protein C is combined with Ponatinib. Protein S The risk or severity of bleeding can be increased when Protein S human is combined with Ponatinib. Protirelin The therapeutic efficacy of Protirelin can be decreased when used in combination with Ponatinib. Prucalopride The serum concentration of Prucalopride can be increased when it is combined with Ponatinib. Pyrimethamine The metabolism of Ponatinib can be decreased when combined with Pyrimethamine. Quetiapine The metabolism of Ponatinib can be decreased when combined with Quetiapine. Quinidine The serum concentration of Quinidine can be increased when it is combined with Ponatinib. Quinine The metabolism of Ponatinib can be decreased when combined with Quinine. Quinupristin The metabolism of Ponatinib can be decreased when combined with Quinupristin. Rabeprazole Rabeprazole may decrease the excretion rate of Ponatinib which could result in a higher serum level. Rabies immun The therapeutic efficacy of Rabies immune globulin, human can be decreased when used in combination with Ponatinib. Rabies A The therapeutic efficacy of Rabies virus inactivated antigen, A can be decreased when used in combination with Ponatinib. Rabies B The therapeutic efficacy of Rabies virus inactivated antigen, B can be decreased when used in combination with Ponatinib. Raloxifene The metabolism of Ponatinib can be decreased when combined with Raloxifene. Raltitrexed The risk or severity of adverse effects can be increased when Raltitrexed is combined with Ponatinib. Ranitidine The metabolism of Ponatinib can be decreased when combined with Ranitidine. Ranolazine The serum concentration of Ranolazine can be increased when it is combined with Ponatinib. Ravulizumab The risk or severity of adverse effects can be increased when Ponatinib is combined with Ravulizumab. Reboxetine The metabolism of Ponatinib can be decreased when combined with Reboxetine. Regorafenib The serum concentration of Regorafenib can be increased when it is combined with Ponatinib. Relugolix The serum concentration of Relugolix can be increased when it is combined with Ponatinib. Remdesivir The metabolism of Ponatinib can be decreased when combined with Remdesivir. Remoxipride The metabolism of Ponatinib can be decreased when combined with Remoxipride. Repaglinide The metabolism of Ponatinib can be decreased when combined with Repaglinide. Reserpine The metabolism of Ponatinib can be increased when combined with Reserpine. Reteplase The risk or severity of bleeding can be increased when Reteplase is combined with Ponatinib. Revefenacin The metabolism of Ponatinib can be decreased when combined with Revefenacin. Reviparin The risk or severity of bleeding can be increased when Reviparin is combined with Ponatinib. Ribociclib The metabolism of Ponatinib can be decreased when combined with Ribociclib. Rifabutin The metabolism of Ponatinib can be increased when combined with Rifabutin. Rifampicin The metabolism of Ponatinib can be increased when combined with Rifampicin. Rifamycin The metabolism of Ponatinib can be increased when combined with Rifamycin. Rifapentine The metabolism of Ponatinib can be increased when combined with Rifapentine. Rifaximin The serum concentration of Rifaximin can be increased when it is combined with Ponatinib. Rilonacept The metabolism of Ponatinib can be increased when combined with Rilonacept. Rilpivirine The metabolism of Ponatinib can be decreased when combined with Rilpivirine. Riluzole Ponatinib may decrease the excretion rate of Riluzole which could result in a higher serum level. Rimegepant The serum concentration of Rimegepant can be increased when it is combined with Ponatinib. Riociguat The metabolism of Ponatinib can be decreased when combined with Riociguat. Ripretinib Ponatinib may decrease the excretion rate of Ripretinib which could result in a higher serum level. Risankizumab The risk or severity of adverse effects can be increased when Ponatinib is combined with Risankizumab. Risperidone The metabolism of Ponatinib can be decreased when combined with Risperidone. Ritonavir The metabolism of Ponatinib can be decreased when combined with Ritonavir. Rituximab The risk or severity of adverse effects can be increased when Rituximab is combined with Ponatinib. Rivaroxaban The metabolism of Ponatinib can be decreased when combined with Rivaroxaban. Rofecoxib The metabolism of Ponatinib can be increased when combined with Rofecoxib. Roflumilast Roflumilast may increase the immunosuppressive activities of Ponatinib. Rolapitant The metabolism of Ponatinib can be decreased when combined with Rolapitant. Romidepsin The serum concentration of Romidepsin can be increased when it is combined with Ponatinib. Ropeginterfer The metabolism of Ponatinib can be decreased when combined with Ropeginterferon alfa-2b. Ropivacaine The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Ropivacaine. Rosiglitazone The metabolism of Ponatinib can be decreased when combined with Rosiglitazone. Rosuvastatin The metabolism of Ponatinib can be decreased when combined with Rosuvastatin. Rotavirus vaccine The therapeutic efficacy of Rotavirus vaccine can be decreased when used in combination with Ponatinib. Rotigotine The metabolism of Ponatinib can be decreased when combined with Rotigotine. Roxadustat The serum concentration of Ponatinib can be increased when it is combined with Roxadustat. Roxithromycin The metabolism of Ponatinib can be decreased when combined with Roxithromycin. Rubella virus The risk or severity of infection can be increased when Rubella virus vaccine is combined with Ponatinib. Rucaparib The metabolism of Ponatinib can be decreased when combined with Rucaparib. Rufinamide The metabolism of Ponatinib can be increased when combined with Rufinamide. Rupatadine The metabolism of Ponatinib can be decreased when combined with Rupatadine. Ruxolitinib The risk or severity of adverse effects can be increased when Ruxolitinib is combined with Ponatinib. Safinamide Safinamide may decrease the excretion rate of Ponatinib which could result in a higher serum level. Salmeterol The metabolism of Ponatinib can be decreased when combined with Salmeterol. Salmon calcito The therapeutic efficacy of Salmon calcitonin can be decreased when used in combination with Ponatinib. Saquinavir The metabolism of Ponatinib can be decreased when combined with Saquinavir. Sarilumab The metabolism of Ponatinib can be increased when combined with Sarilumab. Satralizumab The serum concentration of Ponatinib can be decreased when it is combined with Satralizumab. Saxagliptin The metabolism of Ponatinib can be decreased when combined with Saxagliptin. Secobarbital The metabolism of Ponatinib can be increased when combined with Secobarbital. Secukinumab The metabolism of Ponatinib can be increased when combined with Secukinumab. Selegiline The metabolism of Ponatinib can be decreased when combined with Selegiline. Selexipag The metabolism of Ponatinib can be decreased when combined with Selexipag. Selpercatinib The serum concentration of Ponatinib can be increased when it is combined with Selpercatinib. Selumetinib The metabolism of Ponatinib can be decreased when combined with Selumetinib. Sertindole The metabolism of Ponatinib can be decreased when combined with Sertindole. Sertraline The metabolism of Ponatinib can be decreased when combined with Sertraline. Sildenafil The metabolism of Ponatinib can be decreased when combined with Sildenafil. Silodosin The excretion of Silodosin can be decreased when combined with Ponatinib. Siltuximab The metabolism of Ponatinib can be increased when combined with Siltuximab. Simeprevir The metabolism of Ponatinib can be decreased when combined with Simeprevir. Simvastatin The metabolism of Ponatinib can be decreased when combined with Simvastatin. Siponimod The risk or severity of adverse effects can be increased when Ponatinib is combined with Siponimod. Sipuleucel-T The therapeutic efficacy of Sipuleucel-T can be decreased when used in combination with Ponatinib. Sirolimus The serum concentration of Sirolimus can be increased when it is combined with Ponatinib. Sitagliptin The metabolism of Ponatinib can be decreased when combined with Sitagliptin. Sitaxentan The metabolism of Ponatinib can be decreased when combined with Sitaxentan. Smallpox The therapeutic efficacy of Smallpox (Vaccinia) Vaccine, Live can be decreased when used in combination with Ponatinib. Sodium citrate The risk or severity of bleeding can be increased when Sodium citrate is combined with Ponatinib. Sofosbuvir Ponatinib may decrease the excretion rate of Sofosbuvir which could result in a higher serum level. Solifenacin The metabolism of Ponatinib can be decreased when combined with Solifenacin. Somatostatin The metabolism of Ponatinib can be decreased when combined with Somatostatin. Somatrogon The metabolism of Ponatinib can be increased when combined with Somatrogon. Sorafenib The metabolism of Ponatinib can be decreased when combined with Sorafenib. Sotagliflozin Sotagliflozin may decrease the excretion rate of Ponatinib which could result in a higher serum level. Sotalol The metabolism of Ponatinib can be decreased when combined with Sotalol. Sotorasib The serum concentration of Ponatinib can be decreased when it is combined with Sotorasib. Spesolimab The risk or severity of adverse effects can be increased when Ponatinib is combined with Spesolimab. Spironolactone The metabolism of Ponatinib can be decreased when combined with Spironolactone. St. John's Wort The metabolism of Ponatinib can be increased when combined with St. John's Wort. Stiripentol The metabolism of Ponatinib can be decreased when combined with Stiripentol. Streptokinase The risk or severity of bleeding can be increased when Streptokinase is combined with Ponatinib. Streptozocin The risk or severity of adverse effects can be increased when Streptozocin is combined with Ponatinib. Sulfadiazine The metabolism of Ponatinib can be decreased when combined with Sulfadiazine. Sulfamethoxazole The risk or severity of myelosuppression can be increased when Sulfamethoxazole is combined with Ponatinib. Sulfaphenazole The metabolism of Ponatinib can be decreased when combined with Sulfaphenazole. Sulfasalazine The risk or severity of adverse effects can be increased when Sulfasalazine is combined with Ponatinib. Sulfinpyrazone The metabolism of Ponatinib can be increased when combined with Sulfinpyrazone. Sulodexide The risk or severity of bleeding can be increased when Sulodexide is combined with Ponatinib. Sumatriptan Ponatinib may decrease the excretion rate of Sumatriptan which could result in a higher serum level. Sunitinib The metabolism of Ponatinib can be decreased when combined with Sunitinib. Suvorexant The metabolism of Ponatinib can be decreased when combined with Suvorexant. Tacrolimus Tacrolimus may increase the immunosuppressive activities of Ponatinib. Tadalafil The metabolism of Ponatinib can be decreased when combined with Tadalafil. Tafamidis The serum concentration of Ponatinib can be increased when it is combined with Tafamidis. Tafenoquine The metabolism of Ponatinib can be decreased when combined with Tafenoquine. Talazoparib The serum concentration of Talazoparib can be increased when it is combined with Ponatinib. Tamoxifen The metabolism of Ponatinib can be increased when combined with Tamoxifen. Tamsulosin The metabolism of Ponatinib can be decreased when combined with Tamsulosin. Tasimelteon The metabolism of Ponatinib can be decreased when combined with Tasimelteon. Taurocholic acid Taurocholic acid may decrease the excretion rate of Ponatinib which could result in a higher serum level. Tazarotene The metabolism of Ponatinib can be decreased when combined with Tazarotene. Tazemetostat The metabolism of Ponatinib can be decreased when combined with Tazemetostat. Technetium The serum concentration of Technetium Tc-99m sestamibi can be increased when it is combined with Ponatinib. Tecovirimat The metabolism of Ponatinib can be increased when combined with Tecovirimat. Tedizolid The risk or severity of myelosuppression can be increased when Ponatinib is combined with Tedizolid phosphate. Tegafur The metabolism of Tegafur can be decreased when combined with Ponatinib. Tegaserod The metabolism of Ponatinib can be decreased when combined with Tegaserod. Telaprevir The metabolism of Ponatinib can be decreased when combined with Telaprevir. Telithromycin The metabolism of Ponatinib can be decreased when combined with Telithromycin. Telmisartan Telmisartan may decrease the excretion rate of Ponatinib which could result in a higher serum level. Telotristat ethyl The serum concentration of Ponatinib can be decreased when it is combined with Telotristat ethyl. Temozolomide The risk or severity of adverse effects can be increased when Temozolomide is combined with Ponatinib. Temsirolimus The serum concentration of Temsirolimus can be increased when it is combined with Ponatinib. Tenecteplase The risk or severity of bleeding can be increased when Tenecteplase is combined with Ponatinib. Teniposide The metabolism of Ponatinib can be decreased when combined with Teniposide. Tenofovir alafe The serum concentration of Tenofovir alafenamide can be increased when it is combined with Ponatinib. Tenofovir The serum concentration of Tenofovir disoproxil can be increased when it is combined with Ponatinib. Tepotinib The serum concentration of Tepotinib can be increased when it is combined with Ponatinib. Teprotumumab The risk or severity of adverse effects can be increased when Teprotumumab is combined with Ponatinib. Terbinafine The metabolism of Ponatinib can be decreased when combined with Terbinafine. Terfenadine The metabolism of Ponatinib can be decreased when combined with Terfenadine. Teriflunomide The metabolism of Ponatinib can be decreased when combined with Teriflunomide. Teriparatide The therapeutic efficacy of Teriparatide can be decreased when used in combination with Ponatinib. Testosterone The metabolism of Ponatinib can be increased when combined with Testosterone. Testosterone The metabolism of Ponatinib can be decreased when combined with Testosterone cypionate. Testosterone The metabolism of Ponatinib can be decreased when combined with Testosterone enanthate. Tetrabenazine The metabolism of Ponatinib can be decreased when combined with Tetrabenazine. Tetracaine The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Tetracaine. Tetracycline The metabolism of Ponatinib can be decreased when combined with Tetracycline. Tezacaftor The metabolism of Ponatinib can be decreased when combined with Tezacaftor. Thalidomide The risk or severity of adverse effects can be increased when Thalidomide is combined with Ponatinib. Theophylline The metabolism of Ponatinib can be decreased when combined with Theophylline. Thiamylal The metabolism of Ponatinib can be increased when combined with Thiamylal. Thioridazine The metabolism of Ponatinib can be decreased when combined with Thioridazine. Thiotepa The risk or severity of adverse effects can be increased when Thiotepa is combined with Ponatinib. Thyroid, porcine The therapeutic efficacy of Thyroid, porcine can be decreased when used in combination with Ponatinib. Thyrotropin alfa The therapeutic efficacy of Thyrotropin alfa can be decreased when used in combination with Ponatinib. Ticagrelor The metabolism of Ponatinib can be decreased when combined with Ticagrelor. Tic encephalitis The therapeutic efficacy of Tick-borne encephalitis vaccine (whole virus, inactivated) can be decreased when used in combination with Ponatinib. Ticlopidine The metabolism of Ponatinib can be decreased when combined with Ticlopidine. Timolol The metabolism of Ponatinib can be decreased when combined with Timolol. Tinzaparin The risk or severity of bleeding can be increased when Tinzaparin is combined with Ponatinib. Tioguanine The risk or severity of adverse effects can be increased when Tioguanine is combined with Ponatinib. Tiotropium The metabolism of Ponatinib can be decreased when combined with Tiotropium. Tipranavir The metabolism of Ponatinib can be decreased when combined with Tipranavir. Tirofiban The risk or severity of bleeding can be increased when Tirofiban is combined with Ponatinib. Tivozanib Tivozanib may decrease the excretion rate of Ponatinib which could result in a higher serum level. Tixocortol The risk or severity of adverse effects can be increased when Ponatinib is combined with Tixocortol. Tocilizumab The metabolism of Ponatinib can be increased when combined with Tocilizumab. Tofacitinib Ponatinib may increase the immunosuppressive activities of Tofacitinib. Tolbutamide The metabolism of Ponatinib can be decreased when combined with Tolbutamide. Tolterodine The metabolism of Ponatinib can be decreased when combined with Tolterodine. Tolvaptan The serum concentration of Tolvaptan can be increased when it is combined with Ponatinib. Topiramate The metabolism of Ponatinib can be increased when combined with Topiramate. Topotecan The serum concentration of Topotecan can be increased when it is combined with Ponatinib. Torasemide The metabolism of Ponatinib can be decreased when combined with Torasemide. Toremifene The serum concentration of Toremifene can be increased when it is combined with Ponatinib. Tositumomab The risk or severity of adverse effects can be increased when Tositumomab is combined with Ponatinib. Trabectedin The metabolism of Ponatinib can be decreased when combined with Trabectedin. Tramadol The metabolism of Ponatinib can be decreased when combined with Tramadol. Trametinib The metabolism of Ponatinib can be decreased when combined with Trametinib. Tranylcypromine The metabolism of Ponatinib can be decreased when combined with Tranylcypromine. Trastuzumab Trastuzumab may increase the neutropenic activities of Ponatinib. Trastuzumab The serum concentration of Trastuzumab emtansine can be increased when it is combined with Ponatinib. Trazodone The metabolism of Ponatinib can be decreased when combined with Trazodone. Treprostinil The metabolism of Ponatinib can be decreased when combined with Treprostinil. Tretinoin The metabolism of Ponatinib can be decreased when combined with Tretinoin. Triamcinolone The metabolism of Ponatinib can be increased when combined with Triamcinolone. Triazolam The metabolism of Ponatinib can be decreased when combined with Triazolam. Trichlormethiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Trichlormethiazide is combined with Ponatinib. Triclabendazole The metabolism of Ponatinib can be decreased when combined with Triclabendazole. Trifluridine The risk or severity of adverse effects can be increased when Trifluridine is combined with Ponatinib. Triflusal The risk or severity of bleeding can be increased when Triflusal is combined with Ponatinib. Trilaciclib Ponatinib may decrease the excretion rate of Trilaciclib which could result in a higher serum level. Trilostane The risk or severity of adverse effects can be increased when Trilostane is combined with Ponatinib. Trimethadione The metabolism of Ponatinib can be decreased when combined with Trimethadione. Trimethoprim The metabolism of Ponatinib can be decreased when combined with Trimethoprim. Trimipramine The serum concentration of Trimipramine can be increased when it is combined with Ponatinib. Tripelennamine The metabolism of Ponatinib can be decreased when combined with Tripelennamine. Troglitazone The metabolism of Ponatinib can be increased when combined with Troglitazone. Troleandomycin The metabolism of Ponatinib can be decreased when combined with Troleandomycin. Trospium The metabolism of Ponatinib can be decreased when combined with Trospium. Tucatinib The metabolism of Tucatinib can be decreased when combined with Ponatinib. Typhoid vaccine The therapeutic efficacy of Typhoid vaccine can be decreased when used in combination with Ponatinib. Typhoid Vaccine The risk or severity of infection can be increased when Typhoid Vaccine Live is combined with Ponatinib. Typhoid Vi po The therapeutic efficacy of Typhoid Vi polysaccharide vaccine can be decreased when used in combination with Ponatinib. Ubrogepant The serum concentration of Ubrogepant can be increased when it is combined with Ponatinib. Udenafil The metabolism of Ponatinib can be decreased when combined with Udenafil. Umeclidinium The metabolism of Ponatinib can be decreased when combined with Umeclidinium. Upadacitinib The risk or severity of adverse effects can be increased when Ponatinib is combined with Upadacitinib. Urokinase The risk or severity of bleeding can be increased when Urokinase is combined with Ponatinib. Valbenazine The metabolism of Ponatinib can be decreased when combined with Valbenazine. Valoctocogene The therapeutic efficacy of Valoctocogene roxaparvovec can be decreased when used in combination with Ponatinib. Valproic acid The metabolism of Ponatinib can be decreased when combined with Valproic acid. Vandetanib Vandetanib may decrease the excretion rate of Ponatinib which could result in a higher serum level. Vardenafil The metabolism of Ponatinib can be decreased when combined with Vardenafil. Varicella zoster The risk or severity of infection can be increased when Varicella zoster vaccine (live/attenuated) is combined with Ponatinib. Varicella zoster The therapeutic efficacy of Varicella zoster vaccine (recombinant) can be decreased when used in combination with Ponatinib. Vedolizumab The risk or severity of adverse effects can be increased when Ponatinib is combined with Vedolizumab. Velpatasvir The metabolism of Ponatinib can be decreased when combined with Velpatasvir. Vemurafenib The serum concentration of Vemurafenib can be increased when it is combined with Ponatinib. Venetoclax The serum concentration of Venetoclax can be increased when it is combined with Ponatinib. Venlafaxine The metabolism of Ponatinib can be decreased when combined with Venlafaxine. Verapamil The metabolism of Ponatinib can be decreased when combined with Verapamil. Vernakalant The metabolism of Ponatinib can be decreased when combined with Vernakalant. Vibrio cholerae The therapeutic efficacy of Vibrio cholerae CVD 103-HgR strain live antigen can be decreased when used in combination with Ponatinib. Vilanterol The risk or severity of adverse effects can be increased when Ponatinib is combined with Vilanterol. Vilazodone The metabolism of Ponatinib can be decreased when combined with Vilazodone. Viloxazine The metabolism of Ponatinib can be decreased when combined with Viloxazine. Vinblastine The serum concentration of Vinblastine can be increased when it is combined with Ponatinib. Vincristine The excretion of Vincristine can be decreased when combined with Ponatinib. Vindesine The risk or severity of adverse effects can be increased when Vindesine is combined with Ponatinib. Vinflunine The serum concentration of Vinflunine can be increased when it is combined with Ponatinib. Vinorelbine The metabolism of Ponatinib can be decreased when combined with Vinorelbine. Vismodegib Vismodegib may decrease the excretion rate of Ponatinib which could result in a higher serum level. Vitamin E The metabolism of Ponatinib can be increased when combined with Vitamin E. Voclosporin The risk or severity of adverse effects can be increased when Ponatinib is combined with Voclosporin. Vonoprazan The metabolism of Ponatinib can be decreased when combined with Vonoprazan. Vorapaxar The metabolism of Ponatinib can be decreased when combined with Vorapaxar. Voriconazole The metabolism of Ponatinib can be decreased when combined with Voriconazole. Vorinostat The risk or severity of adverse effects can be increased when Vorinostat is combined with Ponatinib. Vortioxetine The metabolism of Ponatinib can be decreased when combined with Vortioxetine. Voxelotor The serum concentration of Ponatinib can be increased when it is combined with Voxelotor. Voxilaprevir The metabolism of Ponatinib can be decreased when combined with Voxilaprevir. Warfarin The metabolism of Ponatinib can be increased when combined with Warfarin. Ximelagatran The risk or severity of bleeding can be increased when Ximelagatran is combined with Ponatinib. Yellow fever vaccine The risk or severity of infection can be increased when Yellow fever vaccine is combined with Ponatinib. Yohimbine The metabolism of Ponatinib can be decreased when combined with Yohimbine. Zafirlukast The metabolism of Ponatinib can be decreased when combined with Zafirlukast. Zaleplon The metabolism of Ponatinib can be decreased when combined with Zaleplon. Zidovudine The metabolism of Ponatinib can be decreased when combined with Zidovudine. Zimelidine The metabolism of Ponatinib can be decreased when combined with Zimelidine. Ziprasidone The metabolism of Ponatinib can be decreased when combined with Ziprasidone. Zolpidem The metabolism of Ponatinib can be decreased when combined with Zolpidem. Zonisamide The metabolism of Ponatinib can be decreased when combined with Zonisamide. Zopiclone The metabolism of Ponatinib can be decreased when combined with Zopiclone. Zuclopenthixol The metabolism of Ponatinib can be decreased when combined with Zuclopenthixol Pregnancy and Lactation AU TGA pregnancy category D Pregnancy Based on its mechanism of action and findings in animals, Iclusig can cause fetal harm when administered to a pregnant woman [see Data]. There are no available data on Iclusig use in pregnant women. In animal reproduction studies, oral administration of ponatinib to pregnant rats during organogenesis caused adverse developmental effects at doses lower than human exposures at the recommended human dose [see Data]. Advise pregnant women of the potential risk to a fetus Lactation No information is available on the clinical use of ponatinib during breastfeeding. Because ponatinib is more than 99% bound to plasma proteins, the amount in milk is likely to be low. However, its half-life is about 24 hours and it might accumulate in the infant. National Comprehensive Cancer Network guidelines recommend avoiding breastfeeding during ponatinib therapy and the manufacturer recommends withholding breastfeeding for 6 days following the last dose.[1] How should this medicine be used?

Ponatinib comes as a tablet to take by mouth. It is usually taken once a day with or without food. Take ponatinib 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 ponatinib exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Swallow the tablets whole; do not…

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