Alpelisib is an oral selective inhibitor of the phosphoinositol-3-kinase (PIK3) which is mutated in several forms of solid tumors and is approved for use in specific forms of advanced or metastatic breast cancer. Serum aminotransferase elevations are common during alpelisib therapy but clinically apparent liver injury with jaundice has not been reported with its use and must be rare if it occurs at all.
Alpelisib is an orally bioavailable phosphatidylinositol 3-kinase (PI3K) inhibitor with potential antineoplastic activity. Alpelisib specifically inhibits PI3K in the PI3K/AKT kinase (or protein kinase B) signaling pathway, thereby inhibiting the activation of the PI3K signaling pathway. This may result in the inhibition of tumor cell growth and survival in susceptible tumor cell populations. Activation of the PI3K signaling pathway is frequently associated with tumorigenesis. Dysregulated PI3K signaling may contribute to tumor resistance to a variety of antineoplastic agents.
Alpelisib is a phosphatidylinositol 3-kinase (PI3K) inhibitor with potent antitumor activity. It works by selectively inhibiting class I PI3K p110α, which is the catalytic subunit of PI3K, a lipid kinase that plays a role in various biological processes, including proliferation, survival, differentiation, and metabolism. Alpelisib was designed to target this enzyme that appears to be mutated at a rate of nearly 30% in human cancers, leading to hyperactivation. There are several isoform-specific PI3K inhibitors that are under clinical development or currently approved, such as [idelalisib] used for chronic lymphocytic leukemia (CLL). Approved by the FDA in May 2019, alpelisib is the first approved PI3K inhibitor indicated for the treatment of hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative, PIK3CA-mutated, advanced or metastatic breast cancer in combination with [fulvestrant] for postmenopausal women and male patients. To initiate alpelisib therapy, it is required that the presence of a PIK3CA mutation in the tissue and/or liquid biopsy sample collection should be confirmed via FDA-approved diagnostic tests. Alpelisib is marketed under the trade name Piqray and is available as oral tablets. Studies evaluating the therapeutic effectiveness of alpelisib in other cancers, such as ovarian cancer and colorectal cancer, are under ongoing investigation. Alpelisib was granted FDA approval on 24 May 2019.
Mechanism of Action
Phosphatidylinositol-3-kinase-α (PI3Kα) is responsible for cell proliferation in response to growth factor-tyrosine kinase pathway activation. In some cancers, PI3Kα’s p110α catalytic subunit is mutated making it hyperactive. Alpelisib inhibits (PI3K), with the highest specificity for PI3Kα. Alpelisib does not prolong the QTcF interval. Patients taking alpelisib experience a dose-dependent benefit from treatment with a 51% advantage of a 200mg daily dose over a 100mg dose and a 22% advantage of 300mg once daily over 150mg twice daily. This suggests patients requiring a lower dose may benefit from twice daily dosing.
Indication
- Alpelisib is indicated in combination with fulvestrant to treat postmenopausal women, and men, with advanced or metastatic breast cancer. This cancer must be hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative, and PIK3CA mutated. Cancer must be detected by an FDA-approved test following progression on or after an endocrine-based regimen.
- Treatment of breast cancer – Piqray is indicated in combination with fulvestrant for the treatment of postmenopausal women, and men, with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative, locally advanced or metastatic breast cancer with a PIK3CA mutation after disease progression following endocrine therapy as monotherapy (see section 5.1).,
- Treatment of PIK3CA-related overgrowth spectrum – Treatment of Fallopian tube carcinoma (excluding rhabdomyosarcoma and germ cell tumors), Treatment of ovarian carcinoma (excluding rhabdomyosarcoma and germ cell tumors), Treatment of peritoneal carcinoma (excluding blastomas and sarcomas)
- PIK3CA-Related Overgrowth Spectrum (PROS)
- Advanced HR + HER2 – breast cancer
- Metastatic HR + HER2 – breast cancer
Use in Cancer
Alpelisib is approved to treat:
- Breast cancer that is hormone receptor-positive and HER2 negative and has a mutation in the PIK3CA gene. It is used with fulvestrant to treat postmenopausal women, and men, whose breast cancer is advanced or metastatic and has gotten worse during or after treatment with hormone therapy.
Alpelisib is also being studied in the treatment of other types of cancer.
Contraindications
The following conditions are contraindicated with this drug. Check with your physician if you have any of the following:
- diabetes
- dehydration
- a type of inflammation of the lung called interstitial pneumonitis
- inflammation of the large intestine
- excessive diarrhea
- high blood sugar
- pregnancy
- a patient who is producing milk and breastfeeding
- lung tissue problem
Dosage
Strengths: 200 mg; 150 mg; 200 mg-50 mg; 50 mg; 125 mg
Breast Cancer
- 300 mg orally once a day with food until disease progression or unacceptable toxicity; when given with this drug, the recommended dose of fulvestrant is 500 mg orally on Days 1, 15, and 29, and once monthly thereafter
Renal Dose Adjustments
Mild to moderate renal impairment (CrCl 30 to less than 90 mL/min): No adjustment recommended.
Severe renal impairment (CrCl less than 30 mL/min): Data not available
Dose Adjustments
DOSE MODIFICATIONS FOR ADVERSE REACTIONS:
- Starting dose: 300 mg orally once a day
- First dose reduction: 250 mg orally once a day
- Second dose reduction: 200 mg orally once a day
- If further dose reduction below 200 mg once daily is required, discontinue therapy.
NOTE: Only one dose reduction is permitted for pancreatitis.
DOSE MODIFICATIONS FOR HYPERGLYCEMIA:
- GRADE 1 (FPG greater than ULN minus 160 mg/dL or greater than ULN minus 8.9 mmol/L): No adjustment required; initiate or intensify antidiabetic treatment (*2).
- GRADE 2 (FPG greater than 160 to 250 mg/dL or greater than 8.9 to 13.9 mmol/L): No adjustment required; initiate or intensify antidiabetic treatment (*2); if FPG does not decrease to 160 mg/dL or less or 8.9 mmol/L or less within 21 days with antidiabetic treatment, reduce the dose of this drug by 1 dose level and follow FPG value specific recommendations.
- GRADE 3 (greater than 250 to 500 mg/dL or greater than 13.9 to 27.8 mmol/L): Interrupt this drug; initiate or intensify antidiabetic treatment (*2) and consider additional antidiabetic medications (*3) for 1 to 2 days until hyperglycemia improves. Administer IV hydration and consider treatment (e.g., intervention for electrolyte/ketoacidosis/hyperosmolar disturbances). If FPG decreases to 160 mg/dL or less or 8.9 mmol/L or less within 3 to 5 days under antidiabetic treatment, resume this drug at 1 lower dose level. If FPG does not decrease to 160 mg/dL or less or 8.9 mmol/L or less within 3 to 5 days under antidiabetic treatment, consultation with a physician with expertise in the treatment of hyperglycemia is recommended. If FPG does not decrease to 160 mg/dL or less or 8.9 mmol/L or less within 21 days following antidiabetic treatment (*2), permanently discontinue this drug.
- GRADE 4 (greater than 500 mg/dL or greater than 27.8 mmol/L): Interrupt this drug; initiate or intensify antidiabetic treatment (*2) and consider additional antidiabetic treatment (administer IV hydration and consider treatment (e.g., intervention for electrolyte/ketoacidosis/hyperosmolar disturbances)), re-check FPG within 24 hours and as clinically indicated. If FPG decreases to 500 mg/dL or less or 27.8 mmol/L or less, follow FPG value specific recommendations for Grade 3. If FPG is confirmed at greater than 500 mg/dL or greater than 27.8 mmol/L, permanently discontinue this drug.
Side Effects
The Most Common
- nausea
- vomiting
- extreme tiredness
- decreased appetite
- change in the way things taste
- weight loss
- abdominal pain
- heartburn
- hair loss
- headache
- itching
- dry skin
- dry mouth
- vaginal dryness
- fever
- swelling of the arms or legs
- trouble swallowing or breathing; swelling of the face, mouth, lips, tongue, or throat; rash; flushing; fever; or fast heartbeat
- rash; blistering, peeling, or reddened skin; blistering or sores on the lips, eyes, or in the mouth; fever; flu-like symptoms
- shortness of breath, cough, chest pain, difficulty breathing
- severe diarrhea, dry mouth, cramps, weakness, decreased urination, swelling of legs or ankles
- watery or bloody diarrhea, stomach pain
- frequent, painful, or urgent urination
More Common
- blurred vision
- changed sense of taste
- chapped lips
- decreased appetite
- diarrhea
- dry eyes
- dry, cracked skin
- fatigue
- feeling bloated
- hair loss
- headache
- heartburn
- mouth sores
- muscle pain or cramps
- nausea
- red, sore, or swollen mouth, lips, and gums
- signs of ketoacidosis (e.g., confusion, extreme thirst, loss of appetite, stomach pain, trouble breathing, nausea, vomiting, or unusual tiredness)
- signs of kidney problems (e.g., change in urinating – more or less than usual, swollen ankles and feet or around the eyes, tiredness, confusion, nausea, seizures, chest pain)
- signs of pancreatitis (e.g., abdominal pain on the upper left side, back pain, nausea, fever, chills, rapid heartbeat, swollen abdomen)
- signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
- signs of a severe skin reaction such as blistering, peeling, a rash covering a large area of the body, a rash that spreads quickly, or a rash combined with fever or discomfort
- stomach pain
- toothache
- trouble sleeping
- vomiting
Rare
- burning foot pain
- high blood pressure (e.g., headache, fatigue, dizziness, ringing of the ears, fast or pounding heartbeat)
- problems with the jaw bone (e.g., jaw pain, loosened tooth, jaw numbness)
- reddening or swelling and peeling on the palms and soles
- signs of anemia (low red blood cells; e.g., dizziness, pale skin, unusual tiredness or weakness, shortness of breath)
- signs of clotting problems (e.g., unusual nosebleeds, bruising, blood in urine, coughing blood, bleeding gums, cuts that don’t stop bleeding)
- signs of dehydration (e.g., decreased urine, dry skin, dry and sticky mouth, sleepiness, dizziness, headache, thirst, confusion)
- signs of infection (fever, severe chills, sore throat, mouth ulcers)
- signs of low potassium levels in the blood (e.g., weakness, fatigue, muscle cramps, irregular heartbeat)
- signs of lung inflammation (e.g., difficult, painful, rapid breathing; blue colour to the lips, tongue, or skin)
- symptoms of high blood sugar (e.g., frequent urination, increased thirst, excessive eating, unexplained weight loss, poor wound healing, infections, fruity breath odour)
- symptoms of a urinary tract infection (e.g. pain when urinating, urinating more often than usual, low back or flank pain)
Drug Interactions
| DRUG | INTERACTION |
|---|---|
| Abametapir | The serum concentration of Alpelisib can be increased when it is combined with Abametapir. |
| Abatacept | The metabolism of Alpelisib can be increased when combined with Abatacept. |
| Abemaciclib | The serum concentration of Alpelisib can be increased when it is combined with Abemaciclib. |
| Abrocitinib | The serum concentration of Abrocitinib can be decreased when it is combined with Alpelisib. |
| Acalabrutinib | The metabolism of Acalabrutinib can be increased when combined with Alpelisib. |
| Acenocoumarol | The serum concentration of Acenocoumarol can be decreased when it is combined with Alpelisib. |
| Acetaminophen | The metabolism of Alpelisib can be increased when combined with Acetaminophen. |
| Acetazolamide | The metabolism of Alpelisib can be decreased when combined with Acetazolamide. |
| Acetohexamide | The serum concentration of Acetohexamide can be decreased when it is combined with Alpelisib. |
| Acetylsalicylic acid | The serum concentration of Acetylsalicylic acid can be decreased when it is combined with Alpelisib. |
| Adalimumab | The metabolism of Alpelisib can be increased when combined with Adalimumab. |
| Afatinib | The serum concentration of Alpelisib can be increased when it is combined with Afatinib. |
| Albendazole | The metabolism of Alpelisib can be decreased when combined with Albendazole. |
| Aldesleukin | The metabolism of Alpelisib can be decreased when combined with Aldesleukin. |
| Alectinib | The serum concentration of Alpelisib can be increased when it is combined with Alectinib. |
| Alfuzosin | The metabolism of Alfuzosin can be decreased when combined with Alpelisib. |
| Almotriptan | The metabolism of Almotriptan can be decreased when combined with Alpelisib. |
| Alosetron | The serum concentration of Alosetron can be decreased when it is combined with Alpelisib. |
| Alprazolam | The metabolism of Alprazolam can be decreased when combined with Alpelisib. |
| Aminoglutethimide | The metabolism of Alpelisib can be increased when combined with Aminoglutethimide. |
| Aminophenazone | The serum concentration of Aminophenazone can be decreased when it is combined with Alpelisib. |
| Aminophylline | The metabolism of Aminophylline can be increased when combined with Alpelisib. |
| Amiodarone | The metabolism of Alpelisib can be decreased when combined with Amiodarone. |
| Amitriptyline | The serum concentration of Amitriptyline can be decreased when it is combined with Alpelisib. |
| Amobarbital | The metabolism of Alpelisib can be increased when combined with Amobarbital. |
| Amodiaquine | The metabolism of Amodiaquine can be decreased when combined with Alpelisib. |
| Amprenavir | The serum concentration of Amprenavir can be decreased when it is combined with Alpelisib. |
| Anakinra | The metabolism of Alpelisib can be increased when combined with Anakinra. |
| Anastrozole | The metabolism of Anastrozole can be decreased when combined with Alpelisib. |
| Antipyrine | The serum concentration of Antipyrine can be decreased when it is combined with Alpelisib. |
| Apalutamide | The serum concentration of Alpelisib can be decreased when it is combined with Apalutamide. |
| Apixaban | The serum concentration of Apixaban can be decreased when it is combined with Alpelisib. |
| Apomorphine | The metabolism of Apomorphine can be decreased when combined with Alpelisib. |
| Apremilast | The metabolism of Alpelisib can be increased when combined with Apremilast. |
| Aprepitant | The metabolism of Alpelisib can be decreased when combined with Aprepitant. |
| Arformoterol | The serum concentration of Arformoterol can be decreased when it is combined with Alpelisib. |
| Aripiprazole | The metabolism of Aripiprazole can be increased when combined with Alpelisib. |
| Aripiprazole lauroxil | The metabolism of Aripiprazole lauroxil can be increased when combined with Alpelisib. |
| Armodafinil | The metabolism of Alpelisib can be increased when combined with Armodafinil. |
| Artemether | The serum concentration of Artemether can be decreased when it is combined with Alpelisib. |
| Articaine | The risk or severity of methemoglobinemia can be increased when Alpelisib is combined with Articaine. |
| Asciminib | The serum concentration of Alpelisib can be increased when it is combined with Asciminib. |
| Astemizole | The metabolism of Astemizole can be increased when combined with Alpelisib. |
| Asunaprevir | The serum concentration of Asunaprevir can be decreased when it is combined with Alpelisib. |
| Atazanavir | The serum concentration of Atazanavir can be decreased when it is combined with Alpelisib. |
| Atorvastatin | The metabolism of Atorvastatin can be decreased when combined with Alpelisib. |
| Avacopan | The metabolism of Alpelisib can be decreased when combined with Avacopan. |
| Avanafil | The serum concentration of Alpelisib can be increased when it is combined with Avanafil. |
| Avapritinib | The serum concentration of Avapritinib can be decreased when it is combined with Alpelisib. |
| Avatrombopag | The serum concentration of Alpelisib can be increased when it is combined with Avatrombopag. |
| Axitinib | The metabolism of Axitinib can be increased when combined with Alpelisib. |
| Azelastine | The serum concentration of Azelastine can be decreased when it is combined with Alpelisib. |
| Azithromycin | The metabolism of Alpelisib can be decreased when combined with Azithromycin. |
| Beclomethasone dipropionate | The serum concentration of Alpelisib can be increased when it is combined with Beclomethasone dipropionate. |
| Belumosudil | The serum concentration of Alpelisib can be increased when it is combined with Belumosudil. |
| Belzutifan | The serum concentration of Alpelisib can be decreased when it is combined with Belzutifan. |
| Benzocaine | The risk or severity of methemoglobinemia can be increased when Alpelisib is combined with Benzocaine. |
| Benzphetamine | The metabolism of Benzphetamine can be increased when combined with Alpelisib. |
| Benzyl alcohol | The risk or severity of methemoglobinemia can be increased when Alpelisib is combined with Benzyl alcohol. |
| Berotralstat | The serum concentration of Alpelisib can be increased when it is combined with Berotralstat. |
| Betamethasone | The metabolism of Alpelisib can be increased when combined with Betamethasone. |
| Betamethasone phosphate | The metabolism of Alpelisib can be increased when combined with Betamethasone phosphate. |
| Bexarotene | The serum concentration of Bexarotene can be decreased when it is combined with Alpelisib. |
| Bicalutamide | The metabolism of Bicalutamide can be increased when combined with Alpelisib. |
| Bifonazole | The metabolism of Alpelisib can be decreased when combined with Bifonazole. |
| Bimekizumab | The metabolism of Alpelisib can be increased when combined with Bimekizumab. |
| Boceprevir | The metabolism of Alpelisib can be decreased when combined with Boceprevir. |
| Bortezomib | The serum concentration of Bortezomib can be decreased when it is combined with Alpelisib. |
| Bosentan | The serum concentration of Bosentan can be decreased when it is combined with Alpelisib. |
| Bosutinib | The metabolism of Bosutinib can be increased when combined with Alpelisib. |
| Brentuximab vedotin | The metabolism of Brentuximab vedotin can be increased when combined with Alpelisib. |
| Brigatinib | The serum concentration of Alpelisib can be increased when it is combined with Brigatinib. |
| Brivaracetam | The serum concentration of Brivaracetam can be decreased when it is combined with Alpelisib. |
| Brompheniramine | The metabolism of Brompheniramine can be increased when combined with Alpelisib. |
| Budesonide | The metabolism of Alpelisib can be increased when combined with Budesonide. |
| Bupivacaine | The risk or severity of methemoglobinemia can be increased when Alpelisib is combined with Bupivacaine. |
| Buprenorphine | The serum concentration of Alpelisib can be increased when it is combined with Buprenorphine. |
| Bupropion | The serum concentration of Bupropion can be decreased when it is combined with Alpelisib. |
| Busulfan | The metabolism of Busulfan can be increased when combined with Alpelisib. |
| Butacaine | The risk or severity of methemoglobinemia can be increased when Alpelisib is combined with Butacaine. |
| Butalbital | The metabolism of Alpelisib can be increased when combined with Butalbital. |
| Butamben | The risk or severity of methemoglobinemia can be increased when Alpelisib is combined with Butamben. |
| Cabazitaxel | The serum concentration of Alpelisib can be increased when it is combined with Cabazitaxel. |
| Cabergoline | The metabolism of Cabergoline can be increased when combined with Alpelisib. |
| Cabozantinib | The serum concentration of Cabozantinib can be decreased when it is combined with Alpelisib. |
| Caffeine | The serum concentration of Alpelisib can be increased when it is combined with Caffeine. |
| Calcitriol | The metabolism of Alpelisib can be increased when combined with Calcitriol. |
| Canakinumab | The metabolism of Alpelisib can be increased when combined with Canakinumab. |
| Candesartan cilexetil | The serum concentration of Candesartan cilexetil can be decreased when it is combined with Alpelisib. |
| Candicidin | The metabolism of Alpelisib can be decreased when combined with Candicidin. |
| Cannabidiol | The serum concentration of Alpelisib can be increased when it is combined with Cannabidiol. |
| Capecitabine | The metabolism of Capecitabine can be increased when combined with Alpelisib. |
| Capmatinib | The serum concentration of Capmatinib can be decreased when it is combined with Alpelisib. |
| Capsaicin | The risk or severity of methemoglobinemia can be increased when Alpelisib is combined with Capsaicin. |
| Carbamazepine | The serum concentration of Alpelisib can be decreased when it is combined with Carbamazepine. |
| Carisoprodol | The metabolism of Carisoprodol can be decreased when combined with Alpelisib. |
| Carvedilol | The serum concentration of Carvedilol can be decreased when it is combined with Alpelisib. |
| Cefradine | The metabolism of Alpelisib can be increased when combined with Cefradine. |
| Celecoxib | The serum concentration of Celecoxib can be decreased when it is combined with Alpelisib. |
| Cenobamate | The serum concentration of Alpelisib can be decreased when it is combined with Cenobamate. |
| Cephalexin | The metabolism of Alpelisib can be decreased when combined with Cephalexin. |
| Ceritinib | The metabolism of Ceritinib can be increased when combined with Alpelisib. |
| Cerivastatin | The metabolism of Alpelisib can be increased when combined with Cerivastatin. |
| Certolizumab pegol | The metabolism of Alpelisib can be increased when combined with Certolizumab pegol. |
| Chloramphenicol | The metabolism of Alpelisib can be decreased when combined with Chloramphenicol. |
| Chloroprocaine | The risk or severity of methemoglobinemia can be increased when Alpelisib is combined with Chloroprocaine. |
| Chloroquine | The metabolism of Chloroquine can be decreased when combined with Alpelisib. |
| Chlorpromazine | The metabolism of Alpelisib can be increased when combined with Chlorpromazine. |
| Chlorpropamide | The serum concentration of Chlorpropamide can be decreased when it is combined with Alpelisib. |
| Cholesterol | Cholesterol may increase the excretion rate of Alpelisib which could result in a lower serum level and potentially a reduction in efficacy. |
| Cilostazol | The metabolism of Cilostazol can be decreased when combined with Alpelisib. |
| Cimetidine | The metabolism of Alpelisib can be decreased when combined with Cimetidine. |
| Cinchocaine | The risk or severity of methemoglobinemia can be increased when Alpelisib is combined with Cinchocaine. |
| Cinnarizine | The serum concentration of Cinnarizine can be decreased when it is combined with Alpelisib. |
| Ciprofloxacin | The metabolism of Alpelisib can be decreased when combined with Ciprofloxacin. |
| Cisapride | The metabolism of Alpelisib can be decreased when combined with Cisapride. |
| Citalopram | Alpelisib may increase the QTc-prolonging activities of Citalopram. |
| Clarithromycin | The metabolism of Alpelisib can be decreased when combined with Clarithromycin. |
| Clevidipine | The metabolism of Alpelisib can be increased when combined with Clevidipine. |
| Clindamycin | The metabolism of Clindamycin can be increased when combined with Alpelisib. |
| Clobazam | The metabolism of Alpelisib can be increased when combined with Clobazam. |
| Clobetasol propionate | The metabolism of Alpelisib can be increased when combined with Clobetasol propionate. |
| Clofazimine | The serum concentration of Alpelisib can be increased when it is combined with Clofazimine. |
| Clofibrate | The metabolism of Alpelisib can be increased when combined with Clofibrate. |
| Clomipramine | The metabolism of Clomipramine can be increased when combined with Alpelisib. |
| Clonazepam | The metabolism of Clonazepam can be increased when combined with Alpelisib. |
| Clonidine | The metabolism of Clonidine can be increased when combined with Alpelisib. |
| Clopidogrel | The serum concentration of Clopidogrel can be decreased when it is combined with Alpelisib. |
| Clotiazepam | The metabolism of Clotiazepam can be increased when combined with Alpelisib. |
| Clozapine | The serum concentration of Clozapine can be decreased when it is combined with Alpelisib. |
| Cobicistat | The serum concentration of Alpelisib can be increased when it is combined with Cobicistat. |
| Cobimetinib | The metabolism of Cobimetinib can be increased when combined with Alpelisib. |
| Cocaine | The risk or severity of methemoglobinemia can be increased when Alpelisib is combined with Cocaine. |
| Colchicine | The metabolism of Colchicine can be decreased when combined with Alpelisib. |
| Conivaptan | The metabolism of Alpelisib can be decreased when combined with Conivaptan. |
| Copanlisib | The metabolism of Copanlisib can be increased when combined with Alpelisib. |
| Corticotropin | The metabolism of Alpelisib can be increased when combined with Corticotropin. |
| Cortisone acetate | The metabolism of Alpelisib can be increased when combined with Cortisone acetate. |
| Crizotinib | The metabolism of Alpelisib can be decreased when combined with Crizotinib. |
| Curcumin | The metabolism of Alpelisib can be decreased when combined with Curcumin. |
| Cyclophosphamide | The serum concentration of Cyclophosphamide can be decreased when it is combined with Alpelisib. |
| Cyclosporine | The serum concentration of Alpelisib can be increased when it is combined with Cyclosporine. |
| Cyproterone acetate | The metabolism of Alpelisib can be decreased when combined with Cyproterone acetate. |
| Dabrafenib | The serum concentration of Alpelisib can be increased when it is combined with Dabrafenib. |
| Daclatasvir | The serum concentration of Alpelisib can be increased when it is combined with Daclatasvir. |
| Dacomitinib | The serum concentration of Alpelisib can be increased when it is combined with Dacomitinib. |
| Dalfopristin | The metabolism of Alpelisib can be decreased when combined with Dalfopristin. |
| Danazol | The metabolism of Alpelisib can be decreased when combined with Danazol. |
| Dapagliflozin | The serum concentration of Dapagliflozin can be decreased when it is combined with Alpelisib. |
| Dapsone | The serum concentration of Dapsone can be decreased when it is combined with Alpelisib. |
| Darbepoetin alfa | The risk or severity of Thrombosis can be increased when Darbepoetin alfa is combined with Alpelisib. |
| Darolutamide | The serum concentration of Alpelisib can be increased when it is combined with Darolutamide. |
| Darunavir | The serum concentration of Alpelisib can be increased when it is combined with Darunavir. |
| Dasabuvir | The serum concentration of Alpelisib can be increased when it is combined with Dasabuvir. |
| Dasatinib | The serum concentration of Alpelisib can be increased when it is combined with Dasatinib. |
| Daunorubicin | The metabolism of Alpelisib can be decreased when combined with Daunorubicin. |
| Deferasirox | The metabolism of Alpelisib can be increased when combined with Deferasirox. |
| Deflazacort | The metabolism of Alpelisib can be increased when combined with Deflazacort. |
| Delavirdine | The metabolism of Alpelisib can be decreased when combined with Delavirdine. |
| Desipramine | The metabolism of Alpelisib can be decreased when combined with Desipramine. |
| Desogestrel | The serum concentration of Desogestrel can be decreased when it is combined with Alpelisib. |
| Desvenlafaxine | The metabolism of Alpelisib can be decreased when combined with Desvenlafaxine. |
| Dexamethasone | The serum concentration of Alpelisib can be decreased when it is combined with Dexamethasone. |
| Dexamethasone acetate | The serum concentration of Alpelisib can be increased when it is combined with Dexamethasone acetate. |
| Dexibuprofen | The serum concentration of Dexibuprofen can be decreased when it is combined with Alpelisib. |
| Dexlansoprazole | The metabolism of Dexlansoprazole can be decreased when combined with Alpelisib. |
| Dextromethorphan | The serum concentration of Dextromethorphan can be decreased when it is combined with Alpelisib. |
| Dextropropoxyphene | The metabolism of Alpelisib can be decreased when combined with Dextropropoxyphene. |
| Diazepam | The serum concentration of Diazepam can be decreased when it is combined with Alpelisib. |
| Diclofenac | The serum concentration of Diclofenac can be decreased when it is combined with Alpelisib. |
| Dicloxacillin | The metabolism of Alpelisib can be increased when combined with Dicloxacillin. |
| Dicoumarol | The serum concentration of Dicoumarol can be decreased when it is combined with Alpelisib. |
| Dienogest | The metabolism of Dienogest can be increased when combined with Alpelisib. |
| Diethylstilbestrol | The serum concentration of Alpelisib can be increased when it is combined with Diethylstilbestrol. |
| Difluocortolone | The metabolism of Alpelisib can be increased when combined with Difluocortolone. |
| Digitoxin | The metabolism of Digitoxin can be increased when combined with Alpelisib. |
| Dihydroergocornine | The metabolism of Alpelisib can be decreased when combined with Dihydroergocornine. |
| Dihydroergocristine | The metabolism of Alpelisib can be decreased when combined with Dihydroergocristine. |
| Dihydroergotamine | The metabolism of Dihydroergotamine can be increased when combined with Alpelisib. |
| Diltiazem | The serum concentration of Diltiazem can be decreased when it is combined with Alpelisib. |
| Dimethyl sulfoxide | The metabolism of Alpelisib can be decreased when combined with Dimethyl sulfoxide. |
| Diosmin | The metabolism of Alpelisib can be decreased when combined with Diosmin. |
| Diphenhydramine | The serum concentration of Diphenhydramine can be decreased when it is combined with Alpelisib. |
| Docetaxel | The metabolism of Docetaxel can be increased when combined with Alpelisib. |
| Doconexent | The serum concentration of Doconexent can be decreased when it is combined with Alpelisib. |
| Dofetilide | The metabolism of Dofetilide can be increased when combined with Alpelisib. |
| Domperidone | The metabolism of Domperidone can be decreased when combined with Alpelisib. |
| Donepezil | The serum concentration of Donepezil can be decreased when it is combined with Alpelisib. |
| Dosulepin | The metabolism of Dosulepin can be increased when combined with Alpelisib. |
| Doxazosin | The serum concentration of Doxazosin can be decreased when it is combined with Alpelisib. |
| Doxepin | The serum concentration of Doxepin can be decreased when it is combined with Alpelisib. |
| Doxorubicin | The metabolism of Doxorubicin can be increased when combined with Alpelisib. |
| Dronabinol | The serum concentration of Dronabinol can be increased when it is combined with Alpelisib. |
| Dronedarone | The serum concentration of Alpelisib can be increased when it is combined with Dronedarone. |
| Drospirenone | The metabolism of Alpelisib can be decreased when combined with Drospirenone. |
| Duloxetine | The serum concentration of Duloxetine can be decreased when it is combined with Alpelisib. |
| Duvelisib | The metabolism of Alpelisib can be decreased when combined with Duvelisib. |
| Dyclonine | The risk or severity of methemoglobinemia can be increased when Alpelisib is combined with Dyclonine. |
| Ebastine | The metabolism of Alpelisib can be decreased when combined with Ebastine. |
| Eletriptan | The serum concentration of Eletriptan can be decreased when it is combined with Alpelisib. |
| Elexacaftor | The metabolism of Alpelisib can be decreased when combined with Elexacaftor. |
| Eliglustat | The metabolism of Eliglustat can be decreased when combined with Alpelisib. |
| Eltrombopag | The serum concentration of Alpelisib can be increased when it is combined with Eltrombopag. |
| Elvitegravir | The metabolism of Alpelisib can be decreased when combined with Elvitegravir. |
| Emapalumab | The metabolism of Alpelisib can be increased when combined with Emapalumab. |
| Enasidenib | The serum concentration of Alpelisib can be increased when it is combined with Enasidenib. |
| Entrectinib | The metabolism of Entrectinib can be increased when combined with Alpelisib. |
| Enzalutamide | The serum concentration of Alpelisib can be decreased when it is combined with Enzalutamide. |
| Epinastine | The metabolism of Epinastine can be increased when combined with Alpelisib. |
| Epinephrine | The metabolism of Alpelisib can be decreased when combined with Epinephrine. |
| Erdafitinib | The metabolism of Erdafitinib can be increased when combined with Alpelisib. |
| Ergotamine | The metabolism of Alpelisib can be decreased when combined with Ergotamine. |
| Erlotinib | The serum concentration of Erlotinib can be decreased when it is combined with Alpelisib. |
| Erythromycin | The metabolism of Alpelisib can be decreased when combined with Erythromycin. |
| Erythropoietin | The risk or severity of Thrombosis can be increased when Erythropoietin is combined with Alpelisib. |
| Escitalopram | The metabolism of Escitalopram can be decreased when combined with Alpelisib. |
| Esketamine | The serum concentration of Esketamine can be decreased when it is combined with Alpelisib. |
| Eslicarbazepine | The metabolism of Alpelisib can be increased when combined with Eslicarbazepine. |
| Eslicarbazepine acetate | The metabolism of Alpelisib can be increased when combined with Eslicarbazepine acetate. |
| Esomeprazole | The metabolism of Esomeprazole can be decreased when combined with Alpelisib. |
| Estetrol | The metabolism of Alpelisib can be decreased when combined with Estetrol. |
| Estradiol | The serum concentration of Alpelisib can be increased when it is combined with Estradiol. |
| Estradiol acetate | The serum concentration of Alpelisib can be increased when it is combined with Estradiol acetate. |
| Estradiol benzoate | The serum concentration of Alpelisib can be increased when it is combined with Estradiol benzoate. |
| Estradiol cypionate | The serum concentration of Alpelisib can be increased when it is combined with Estradiol cypionate. |
| Estradiol dienanthate | The serum concentration of Alpelisib can be increased when it is combined with Estradiol dienanthate. |
| Estradiol valerate | The serum concentration of Alpelisib can be increased when it is combined with Estradiol valerate. |
| Estrone sulfate | The serum concentration of Estrone sulfate can be decreased when it is combined with Alpelisib. |
| Eszopiclone | The serum concentration of Eszopiclone can be decreased when it is combined with Alpelisib. |
| Etanercept | The metabolism of Alpelisib can be increased when combined with Etanercept. |
| Ethambutol | The metabolism of Alpelisib can be decreased when combined with Ethambutol. |
| Ethanol | The metabolism of Alpelisib can be increased when combined with Ethanol. |
| Ethinylestradiol | The serum concentration of Ethinylestradiol can be decreased when it is combined with Alpelisib. |
| Ethyl chloride | The risk or severity of methemoglobinemia can be increased when Alpelisib is combined with Ethyl chloride. |
| Ethynodiol diacetate | The metabolism of Ethynodiol diacetate can be increased when combined with Alpelisib. |
| Etidocaine | The risk or severity of methemoglobinemia can be increased when Alpelisib is combined with Etidocaine. |
| Etodolac | The serum concentration of Etodolac can be decreased when it is combined with Alpelisib. |
| Etonogestrel | The metabolism of Etonogestrel can be increased when combined with Alpelisib. |
| Etoposide | The metabolism of Etoposide can be increased when combined with Alpelisib. |
| Etoricoxib | The serum concentration of Etoricoxib can be decreased when it is combined with Alpelisib. |
| Etravirine | The serum concentration of Etravirine can be decreased when it is combined with Alpelisib. |
| Everolimus | The metabolism of Everolimus can be increased when combined with Alpelisib. |
| Febuxostat | The serum concentration of Alpelisib can be increased when it is combined with Febuxostat. |
| Fedratinib | The serum concentration of Alpelisib can be increased when it is combined with Fedratinib. |
| Felbamate | The metabolism of Alpelisib can be increased when combined with Felbamate. |
| Fenfluramine | The metabolism of Fenfluramine can be increased when combined with Alpelisib. |
| Fenofibrate | The metabolism of Alpelisib can be decreased when combined with Fenofibrate. |
| Fentanyl | The metabolism of Fentanyl can be decreased when combined with Alpelisib. |
| Fexinidazole | The metabolism of Alpelisib can be decreased when combined with Fexinidazole. |
| Finerenone | The serum concentration of Finerenone can be increased when it is combined with Alpelisib. |
| Flucloxacillin | The metabolism of Alpelisib can be increased when combined with Flucloxacillin. |
| Fluconazole | The metabolism of Alpelisib can be decreased when combined with Fluconazole. |
| Fluindione | The serum concentration of Fluindione can be decreased when it is combined with Alpelisib. |
| Flunarizine | The serum concentration of Flunarizine can be decreased when it is combined with Alpelisib. |
| Flunisolide | The metabolism of Alpelisib can be increased when combined with Flunisolide. |
| Flunitrazepam | The serum concentration of Flunitrazepam can be decreased when it is combined with Alpelisib. |
| Fluocinolone acetonide | The metabolism of Alpelisib can be increased when combined with Fluocinolone acetonide. |
| Fluocinonide | The metabolism of Alpelisib can be increased when combined with Fluocinonide. |
| Fluocortolone | The metabolism of Alpelisib can be increased when combined with Fluocortolone. |
| Fluorouracil | The metabolism of Fluorouracil can be decreased when combined with Alpelisib. |
| Fluoxetine | The serum concentration of Fluoxetine can be decreased when it is combined with Alpelisib. |
| Flurbiprofen | The serum concentration of Flurbiprofen can be decreased when it is combined with Alpelisib. |
| Fluticasone | The metabolism of Alpelisib can be increased when combined with Fluticasone. |
| Fluticasone furoate | The metabolism of Alpelisib can be increased when combined with Fluticasone furoate. |
| Fluticasone propionate | The metabolism of Alpelisib can be decreased when combined with Fluticasone propionate. |
| Fluvastatin | The serum concentration of Fluvastatin can be decreased when it is combined with Alpelisib. |
| Fluvoxamine | The metabolism of Alpelisib can be decreased when combined with Fluvoxamine. |
| Formestane | The metabolism of Alpelisib can be increased when combined with Formestane. |
| Formoterol | The serum concentration of Formoterol can be decreased when it is combined with Alpelisib. |
| Fosamprenavir | The metabolism of Alpelisib can be decreased when combined with Fosamprenavir. |
| Fosaprepitant | The metabolism of Alpelisib can be increased when combined with Fosaprepitant. |
| Fosnetupitant | The metabolism of Alpelisib can be decreased when combined with Fosnetupitant. |
| Fosphenytoin | The serum concentration of Alpelisib can be decreased when it is combined with Fosphenytoin. |
| Fostamatinib | The serum concentration of Alpelisib can be increased when it is combined with Fostamatinib. |
| Fostemsavir | The serum concentration of Alpelisib can be increased when it is combined with Fostemsavir. |
| Fusidic acid | The serum concentration of Alpelisib can be increased when it is combined with Fusidic acid. |
| Gefitinib | The serum concentration of Alpelisib can be increased when it is combined with Gefitinib. |
| Gestrinone | The metabolism of Gestrinone can be increased when combined with Alpelisib. |
| Gilteritinib | The serum concentration of Alpelisib can be increased when it is combined with Gilteritinib. |
| Ginkgo biloba | The metabolism of Alpelisib can be decreased when combined with Ginkgo biloba. |
| Glasdegib | The serum concentration of Alpelisib can be increased when it is combined with Glasdegib. |
| Glecaprevir | The serum concentration of Alpelisib can be increased when it is combined with Glecaprevir. |
| Gliclazide | The serum concentration of Gliclazide can be decreased when it is combined with Alpelisib. |
| Glimepiride | The serum concentration of Glimepiride can be decreased when it is combined with Alpelisib. |
| Glipizide | The serum concentration of Glipizide can be decreased when it is combined with Alpelisib. |
| Gliquidone | The serum concentration of Gliquidone can be decreased when it is combined with Alpelisib. |
| Glyburide | The serum concentration of Glyburide can be decreased when it is combined with Alpelisib. |
| Glycerol phenylbutyrate | The metabolism of Alpelisib can be increased when combined with Glycerol phenylbutyrate. |
| Golimumab | The metabolism of Alpelisib can be increased when combined with Golimumab. |
| Grazoprevir | The serum concentration of Alpelisib can be increased when it is combined with Grazoprevir. |
| Griseofulvin | The metabolism of Alpelisib can be increased when combined with Griseofulvin. |
| Halofantrine | The metabolism of Halofantrine can be decreased when combined with Alpelisib. |
| Haloperidol | The serum concentration of Haloperidol can be increased when it is combined with Alpelisib. |
| Halothane | The serum concentration of Halothane can be decreased when it is combined with Alpelisib. |
| Hydralazine | The metabolism of Alpelisib can be decreased when combined with Hydralazine. |
| Hydrocodone | The metabolism of Hydrocodone can be increased when combined with Alpelisib. |
| Hydrocortisone | The metabolism of Alpelisib can be increased when combined with Hydrocortisone. |
| Hydrocortisone acetate | The metabolism of Alpelisib can be increased when combined with Hydrocortisone acetate. |
| Hydrocortisone butyrate | The metabolism of Alpelisib can be increased when combined with Hydrocortisone butyrate. |
| Hydrocortisone succinate | The metabolism of Alpelisib can be increased when combined with Hydrocortisone succinate. |
| Hydromorphone | The serum concentration of Hydromorphone can be decreased when it is combined with Alpelisib. |
| Hydroxychloroquine | The metabolism of Hydroxychloroquine can be decreased when combined with Alpelisib. |
| Hydroxyprogesterone caproate | The metabolism of Hydroxyprogesterone caproate can be increased when combined with Alpelisib. |
| Ibrutinib | The metabolism of Ibrutinib can be decreased when combined with Alpelisib. |
| Ibuprofen | The serum concentration of Ibuprofen can be decreased when it is combined with Alpelisib. |
| Idarubicin | The serum concentration of Idarubicin can be decreased when it is combined with Alpelisib. |
| Idelalisib | The metabolism of Idelalisib can be increased when combined with Alpelisib. |
| Ifosfamide | The metabolism of Ifosfamide can be increased when combined with Alpelisib. |
| Iloperidone | The metabolism of Iloperidone can be decreased when combined with Alpelisib. |
| Imatinib | The serum concentration of Alpelisib can be increased when it is combined with Imatinib. |
| Imipramine | The metabolism of Imipramine can be decreased when combined with Alpelisib. |
| Indinavir | The metabolism of Alpelisib can be decreased when combined with Indinavir. |
| Indomethacin | The serum concentration of Indomethacin can be decreased when it is combined with Alpelisib. |
| Infigratinib | The metabolism of Alpelisib can be decreased when combined with Infigratinib. |
| Infliximab | The metabolism of Alpelisib can be increased when combined with Infliximab. |
| Irbesartan | The serum concentration of Irbesartan can be decreased when it is combined with Alpelisib. |
| Irinotecan | The metabolism of Irinotecan can be increased when combined with Alpelisib. |
| Isavuconazole | The serum concentration of Alpelisib can be increased when it is combined with Isavuconazole. |
| Isavuconazonium | The metabolism of Alpelisib can be increased when combined with Isavuconazonium. |
| Isoflurane | The metabolism of Isoflurane can be increased when combined with Alpelisib. |
| Isoniazid | The metabolism of Alpelisib can be decreased when combined with Isoniazid. |
| Isradipine | The metabolism of Alpelisib can be decreased when combined with Isradipine. |
| Istradefylline | The serum concentration of Alpelisib can be increased when it is combined with Istradefylline. |
| Itraconazole | The serum concentration of Alpelisib can be increased when it is combined with Itraconazole. |
| Ivacaftor | The metabolism of Alpelisib can be decreased when combined with Ivacaftor. |
| Ivosidenib | The metabolism of Alpelisib can be increased when combined with Ivosidenib. |
| Ixabepilone | The metabolism of Ixabepilone can be increased when combined with Alpelisib. |
| Ixazomib | The metabolism of Ixazomib can be increased when combined with Alpelisib. |
| Ketamine | The serum concentration of Ketamine can be decreased when it is combined with Alpelisib. |
| Ketazolam | The metabolism of Alpelisib can be decreased when combined with Ketazolam. |
| Ketoconazole | The metabolism of Alpelisib can be decreased when combined with Ketoconazole. |
| Ketorolac | The serum concentration of Ketorolac can be decreased when it is combined with Alpelisib. |
| Labetalol | The metabolism of Labetalol can be decreased when combined with Alpelisib. |
| Lacosamide | The serum concentration of Lacosamide can be decreased when it is combined with Alpelisib. |
| Lanreotide | The metabolism of Alpelisib can be decreased when combined with Lanreotide. |
| Lansoprazole | The serum concentration of Alpelisib can be increased when it is combined with Lansoprazole. |
| Lapatinib | The metabolism of Alpelisib can be decreased when combined with Lapatinib. |
| Lasmiditan | The serum concentration of Alpelisib can be increased when it is combined with Lasmiditan. |
| Ledipasvir | The serum concentration of Alpelisib can be increased when it is combined with Ledipasvir. |
| Lefamulin | The serum concentration of Alpelisib can be increased when it is combined with Lefamulin. |
| Leflunomide | The serum concentration of Leflunomide can be decreased when it is combined with Alpelisib. |
| Lemborexant | The serum concentration of Lemborexant can be decreased when it is combined with Alpelisib. |
| Lesinurad | The serum concentration of Lesinurad can be decreased when it is combined with Alpelisib. |
| Letermovir | The serum concentration of Alpelisib can be increased when it is combined with Letermovir. |
| Levacetylmethadol | The metabolism of Levacetylmethadol can be increased when combined with Alpelisib. |
| Levamlodipine | The serum concentration of Levamlodipine can be increased when it is combined with Alpelisib. |
| Levobupivacaine | The risk or severity of methemoglobinemia can be increased when Alpelisib is combined with Levobupivacaine. |
| Levoketoconazole | The metabolism of Alpelisib can be decreased when combined with Levoketoconazole. |
| Levomilnacipran | The metabolism of Levomilnacipran can be increased when combined with Alpelisib. |
| Levonorgestrel | The metabolism of Levonorgestrel can be increased when combined with Alpelisib. |
| Lidocaine | The risk or severity of methemoglobinemia can be increased when Alpelisib is combined with Lidocaine. |
| Linagliptin | The metabolism of Alpelisib can be decreased when combined with Linagliptin. |
| Lomitapide | The metabolism of Lomitapide can be decreased when combined with Alpelisib. |
| Lonafarnib | The serum concentration of Lonafarnib can be decreased when it is combined with Alpelisib. |
| Loperamide | The metabolism of Loperamide can be decreased when combined with Alpelisib. |
| Lopinavir | The metabolism of Alpelisib can be decreased when combined with Lopinavir. |
| Lorcaserin | The metabolism of Lorcaserin can be increased when combined with Alpelisib. |
| Lorlatinib | The metabolism of Alpelisib can be increased when combined with Lorlatinib. |
| Lornoxicam | The serum concentration of Lornoxicam can be decreased when it is combined with Alpelisib. |
| Losartan | The serum concentration of Losartan can be decreased when it is combined with Alpelisib. |
| Lovastatin | The metabolism of Lovastatin can be decreased when combined with Alpelisib. |
| Lumacaftor | The serum concentration of Alpelisib can be decreased when it is combined with Lumacaftor. |
| Lumateperone | The serum concentration of Lumateperone can be decreased when it is combined with Alpelisib. |
| Lumiracoxib | The serum concentration of Lumiracoxib can be decreased when it is combined with Alpelisib. |
| Lynestrenol | The serum concentration of Lynestrenol can be decreased when it is combined with Alpelisib. |
| Manidipine | The metabolism of Alpelisib can be decreased when combined with Manidipine. |
| Maribavir | The serum concentration of Alpelisib can be increased when it is combined with Maribavir. |
| Mavacamten | The serum concentration of Alpelisib can be decreased when it is combined with Mavacamten. |
| Medroxyprogesterone acetate | The metabolism of Alpelisib can be increased when combined with Medroxyprogesterone acetate. |
| Mefenamic acid | The serum concentration of Mefenamic acid can be decreased when it is combined with Alpelisib. |
| Megestrol acetate | The metabolism of Megestrol acetate can be increased when combined with Alpelisib. |
| Meloxicam | The serum concentration of Meloxicam can be decreased when it is combined with Alpelisib. |
| Meperidine | The metabolism of Alpelisib can be decreased when combined with Meperidine. |
| Mephenytoin | The serum concentration of Mephenytoin can be decreased when it is combined with Alpelisib. |
| Mepivacaine | The risk or severity of methemoglobinemia can be increased when Alpelisib is combined with Mepivacaine. |
| Meprednisone | The metabolism of Alpelisib can be increased when combined with Meprednisone. |
| Mestranol | The serum concentration of Mestranol can be decreased when it is combined with Alpelisib. |
| Methadone | The serum concentration of Methadone can be decreased when it is combined with Alpelisib. |
| Methimazole | The metabolism of Alpelisib can be decreased when combined with Methimazole. |
| Methotrexate | The metabolism of Methotrexate can be increased when combined with Alpelisib. |
| Methoxy polyethylene glycol-epoetin beta | The risk or severity of Thrombosis can be increased when Methoxy polyethylene glycol-epoetin beta is combined with Alpelisib. |
| Methoxyflurane | The serum concentration of Methoxyflurane can be decreased when it is combined with Alpelisib. |
| Methsuximide | The metabolism of Methsuximide can be decreased when combined with Alpelisib. |
| Methylene blue | The metabolism of Alpelisib can be decreased when combined with Methylene blue. |
| Methylergometrine | The metabolism of Alpelisib can be decreased when combined with Methylergometrine. |
| Methylphenobarbital | The metabolism of Alpelisib can be increased when combined with Methylphenobarbital. |
| Methylprednisolone | The metabolism of Alpelisib can be increased when combined with Methylprednisolone. |
| Methylprednisone | The metabolism of Alpelisib can be decreased when combined with Methylprednisone. |
| Methyltestosterone | The metabolism of Methyltestosterone can be increased when combined with Alpelisib. |
| Methysergide | The metabolism of Alpelisib can be decreased when combined with Methysergide. |
| Metreleptin | The metabolism of Alpelisib can be increased when combined with Metreleptin. |
| Metronidazole | The metabolism of Alpelisib can be decreased when combined with Metronidazole. |
| Metyrapone | The metabolism of Alpelisib can be increased when combined with Metyrapone. |
| Mexiletine | The metabolism of Mexiletine can be increased when combined with Alpelisib. |
| Mianserin | The metabolism of Mianserin can be increased when combined with Alpelisib. |
| Miconazole | The metabolism of Alpelisib can be decreased when combined with Miconazole. |
| Midazolam | The serum concentration of Midazolam can be increased when it is combined with Alpelisib. |
| Midostaurin | The serum concentration of Alpelisib can be decreased when it is combined with Midostaurin. |
| Mifepristone | The metabolism of Alpelisib can be increased when combined with Mifepristone. |
| Milnacipran | The metabolism of Milnacipran can be increased when combined with Alpelisib. |
| Miocamycin | The metabolism of Alpelisib can be decreased when combined with Miocamycin. |
| Mirtazapine | The metabolism of Alpelisib can be decreased when combined with Mirtazapine. |
| Mitapivat | The metabolism of Alpelisib can be increased when combined with Mitapivat. |
| Mitotane | The serum concentration of Alpelisib can be decreased when it is combined with Mitotane. |
| Mobocertinib | The serum concentration of Alpelisib can be decreased when it is combined with Mobocertinib. |
| Moclobemide | The metabolism of Moclobemide can be decreased when combined with Alpelisib. |
| Modafinil | The metabolism of Alpelisib can be increased when combined with Modafinil. |
| Mometasone furoate | The metabolism of Alpelisib can be increased when combined with Mometasone furoate. |
| Montelukast | The serum concentration of Montelukast can be decreased when it is combined with Alpelisib. |
| Morphine | The metabolism of Morphine can be decreased when combined with Alpelisib. |
| Mosunetuzumab | The metabolism of Alpelisib can be decreased when combined with Mosunetuzumab. |
| Mycophenolate mofetil | The metabolism of Mycophenolate mofetil can be decreased when combined with Alpelisib. |
| Nabilone | The serum concentration of Nabilone can be decreased when it is combined with Alpelisib. |
| Nabumetone | The serum concentration of Nabumetone can be decreased when it is combined with Alpelisib. |
| Nafcillin | The metabolism of Alpelisib can be increased when combined with Nafcillin. |
| Naloxone | The metabolism of Alpelisib can be decreased when combined with Naloxone. |
| Naproxen | The serum concentration of Naproxen can be decreased when it is combined with Alpelisib. |
| Nateglinide | The serum concentration of Nateglinide can be decreased when it is combined with Alpelisib. |
| Nebivolol | The metabolism of Nebivolol can be decreased when combined with Alpelisib. |
| Nefazodone | The metabolism of Alpelisib can be decreased when combined with Nefazodone. |
| Nelfinavir | The serum concentration of Alpelisib can be increased when it is combined with Nelfinavir. |
| Neratinib | The metabolism of Neratinib can be increased when combined with Alpelisib. |
| Netupitant | The serum concentration of Netupitant can be decreased when it is combined with Alpelisib. |
| Nevirapine | The serum concentration of Nevirapine can be decreased when it is combined with Alpelisib. |
| Niacin | The metabolism of Alpelisib can be decreased when combined with Niacin. |
| Nicardipine | The metabolism of Alpelisib can be decreased when combined with Nicardipine. |
| Niclosamide | The serum concentration of Niclosamide can be decreased when it is combined with Alpelisib. |
| Nicotine | The metabolism of Nicotine can be increased when combined with Alpelisib. |
| Nilotinib | The serum concentration of Alpelisib can be increased when it is combined with Nilotinib. |
| Nilutamide | The metabolism of Nilutamide can be decreased when combined with Alpelisib. |
| Nilvadipine | The metabolism of Alpelisib can be decreased when combined with Nilvadipine. |
| Nintedanib | The metabolism of Alpelisib can be decreased when combined with Nintedanib. |
| Nomegestrol | The metabolism of Nomegestrol can be increased when combined with Alpelisib. |
| Nomegestrol acetate | The metabolism of Nomegestrol acetate can be increased when combined with Alpelisib. |
| Norelgestromin | The metabolism of Norelgestromin can be increased when combined with Alpelisib. |
| Norethisterone | The metabolism of Alpelisib can be decreased when combined with Norethisterone. |
| Norethynodrel | The metabolism of Norethynodrel can be increased when combined with Alpelisib. |
| Norgestimate | The serum concentration of Norgestimate can be decreased when it is combined with Alpelisib. |
| Norgestrel | The metabolism of Norgestrel can be increased when combined with Alpelisib. |
| Nortriptyline | The metabolism of Nortriptyline can be increased when combined with Alpelisib. |
| Noscapine | The metabolism of Alpelisib can be decreased when combined with Noscapine. |
| Novobiocin | The serum concentration of Alpelisib can be increased when it is combined with Novobiocin. |
| Octreotide | The serum concentration of Alpelisib can be increased when it is combined with Octreotide. |
| Olaparib | The metabolism of Olaparib can be increased when combined with Alpelisib. |
| Oliceridine | The serum concentration of Oliceridine can be decreased when it is combined with Alpelisib. |
| Olodaterol | The serum concentration of Olodaterol can be decreased when it is combined with Alpelisib. |
| Ombitasvir | The metabolism of Ombitasvir can be decreased when combined with Alpelisib. |
| Omeprazole | The serum concentration of Alpelisib can be increased when it is combined with Omeprazole. |
| Ondansetron | The serum concentration of Ondansetron can be decreased when it is combined with Alpelisib. |
| Oritavancin | The metabolism of Alpelisib can be increased when combined with Oritavancin. |
| Orphenadrine | The metabolism of Alpelisib can be decreased when combined with Orphenadrine. |
| Osilodrostat | The metabolism of Alpelisib can be decreased when combined with Osilodrostat. |
| Osimertinib | The serum concentration of Alpelisib can be increased when it is combined with Osimertinib. |
| Ospemifene | The serum concentration of Ospemifene can be decreased when it is combined with Alpelisib. |
| Oteseconazole | The serum concentration of Alpelisib can be increased when it is combined with Oteseconazole. |
| Oxcarbazepine | The metabolism of Alpelisib can be increased when combined with Oxcarbazepine. |
| Oxetacaine | The risk or severity of methemoglobinemia can be increased when Alpelisib is combined with Oxetacaine. |
| Oxybuprocaine | The risk or severity of methemoglobinemia can be increased when Alpelisib is combined with Oxybuprocaine. |
| Oxybutynin | The metabolism of Alpelisib can be decreased when combined with Oxybutynin. |
| Ozanimod | The metabolism of Ozanimod can be decreased when combined with Alpelisib. |
| Paclitaxel | The metabolism of Paclitaxel can be increased when combined with Alpelisib. |
| Pacritinib | The serum concentration of Alpelisib can be increased when it is combined with Pacritinib. |
| Palbociclib | The serum concentration of Alpelisib can be increased when it is combined with Palbociclib. |
| Panobinostat | The metabolism of Panobinostat can be increased when combined with Alpelisib. |
| Pantoprazole | The serum concentration of Alpelisib can be increased when it is combined with Pantoprazole. |
| Paramethadione | The serum concentration of Paramethadione can be decreased when it is combined with Alpelisib. |
| Parecoxib | The serum concentration of Parecoxib can be decreased when it is combined with Alpelisib. |
| Paritaprevir | The serum concentration of Alpelisib can be increased when it is combined with Paritaprevir. |
| Paroxetine | The metabolism of Paroxetine can be decreased when combined with Alpelisib. |
| Pasireotide | The metabolism of Alpelisib can be decreased when combined with Pasireotide. |
| Pazopanib | The metabolism of Pazopanib can be increased when combined with Alpelisib. |
| Peginesatide | The risk or severity of Thrombosis can be increased when Peginesatide is combined with Alpelisib. |
| Pentamidine | The metabolism of Pentamidine can be decreased when combined with Alpelisib. |
| Pentobarbital | The serum concentration of Alpelisib can be decreased when it is combined with Pentobarbital. |
| Perampanel | The metabolism of Perampanel can be increased when combined with Alpelisib. |
| Perhexiline | The metabolism of Perhexiline can be increased when combined with Alpelisib. |
| Pexidartinib | The metabolism of Pexidartinib can be increased when combined with Alpelisib. |
| Phenobarbital | The serum concentration of Alpelisib can be decreased when it is combined with Phenobarbital. |
| Phenol | The risk or severity of methemoglobinemia can be increased when Alpelisib is combined with Phenol. |
| Phenprocoumon | The serum concentration of Phenprocoumon can be decreased when it is combined with Alpelisib. |
| Phenylbutazone | The serum concentration of Phenylbutazone can be decreased when it is combined with Alpelisib. |
| Phenytoin | The serum concentration of Alpelisib can be decreased when it is combined with Phenytoin. |
| Pibrentasvir | The serum concentration of Alpelisib can be increased when it is combined with Pibrentasvir. |
| Pimavanserin | The metabolism of Alpelisib can be decreased when combined with Pimavanserin. |
| Pimozide | The metabolism of Pimozide can be increased when combined with Alpelisib. |
| Pioglitazone | The metabolism of Pioglitazone can be decreased when combined with Alpelisib. |
| Piperaquine | The serum concentration of Piperaquine can be decreased when it is combined with Alpelisib. |
| Pirfenidone | The serum concentration of Pirfenidone can be decreased when it is combined with Alpelisib. |
| Piroxicam | The serum concentration of Piroxicam can be decreased when it is combined with Alpelisib. |
| Pitavastatin | The serum concentration of Pitavastatin can be decreased when it is combined with Alpelisib. |
| Pitolisant | The serum concentration of Alpelisib can be decreased when it is combined with Pitolisant. |
| Pomalidomide | The metabolism of Pomalidomide can be increased when combined with Alpelisib. |
| Ponatinib | The serum concentration of Alpelisib can be increased when it is combined with Ponatinib. |
| Posaconazole | The metabolism of Alpelisib can be decreased when combined with Posaconazole. |
| Pralsetinib | The serum concentration of Alpelisib can be increased when it is combined with Pralsetinib. |
| Pravastatin | The serum concentration of Alpelisib can be increased when it is combined with Pravastatin. |
| Praziquantel | The metabolism of Praziquantel can be decreased when combined with Alpelisib. |
| Prednisolone | The metabolism of Alpelisib can be increased when combined with Prednisolone. |
| Prednisolone acetate | The metabolism of Alpelisib can be increased when combined with Prednisolone acetate. |
| Prednisolone phosphate | The metabolism of Alpelisib can be increased when combined with Prednisolone phosphate. |
| Prednisone acetate | The metabolism of Alpelisib can be increased when combined with Prednisone acetate. |
| Pretomanid | The metabolism of Alpelisib can be decreased when combined with Pretomanid. |
| Prilocaine | The risk or severity of methemoglobinemia can be increased when Alpelisib is combined with Prilocaine. |
| Primaquine | The metabolism of Alpelisib can be decreased when combined with Primaquine. |
| Primidone | The serum concentration of Alpelisib can be decreased when it is combined with Primidone. |
| Probenecid | The metabolism of Alpelisib can be increased when combined with Probenecid. |
| Procaine | The risk or severity of methemoglobinemia can be increased when Alpelisib is combined with Procaine. |
| Progesterone | The serum concentration of Alpelisib can be increased when it is combined with Progesterone. |
| Proguanil | The serum concentration of Proguanil can be decreased when it is combined with Alpelisib. |
| Promazine | The serum concentration of Promazine can be decreased when it is combined with Alpelisib. |
| Promethazine | The metabolism of Promethazine can be increased when combined with Alpelisib. |
| Proparacaine | The risk or severity of methemoglobinemia can be increased when Alpelisib is combined with Proparacaine. |
| Propofol | The serum concentration of Propofol can be decreased when it is combined with Alpelisib. |
| Propoxycaine | The risk or severity of methemoglobinemia can be increased when Alpelisib is combined with Propoxycaine. |
| Propranolol | The metabolism of Propranolol can be decreased when combined with Alpelisib. |
| Prucalopride | The metabolism of Prucalopride can be decreased when combined with Alpelisib. |
| Quazepam | The serum concentration of Quazepam can be decreased when it is combined with Alpelisib. |
| Quinidine | The metabolism of Quinidine can be increased when combined with Alpelisib. |
| Quinine | The serum concentration of Quinine can be decreased when it is combined with Alpelisib. |
| Quinupristin | The metabolism of Alpelisib can be decreased when combined with Quinupristin. |
| Rabeprazole | The serum concentration of Alpelisib can be increased when it is combined with Rabeprazole. |
| Raloxifene | The metabolism of Alpelisib can be decreased when combined with Raloxifene. |
| Ramelteon | The serum concentration of Ramelteon can be decreased when it is combined with Alpelisib. |
| Ranolazine | The metabolism of Ranolazine can be increased when combined with Alpelisib. |
| Regorafenib | The serum concentration of Alpelisib can be increased when it is combined with Regorafenib. |
| Remdesivir | The metabolism of Alpelisib can be decreased when combined with Remdesivir. |
| Repaglinide | The metabolism of Repaglinide can be decreased when combined with Alpelisib. |
| Retapamulin | The metabolism of Retapamulin can be decreased when combined with Alpelisib. |
| Ribociclib | The metabolism of Alpelisib can be decreased when combined with Ribociclib. |
| Rifabutin | The metabolism of Alpelisib can be increased when combined with Rifabutin. |
| Rifampicin | The serum concentration of Alpelisib can be decreased when it is combined with Rifampicin. |
| Rifamycin | The serum concentration of Alpelisib can be decreased when it is combined with Rifamycin. |
| Rifapentine | The serum concentration of Alpelisib can be decreased when it is combined with Rifapentine. |
| Rilonacept | The metabolism of Alpelisib can be increased when combined with Rilonacept. |
| Rilpivirine | The serum concentration of Alpelisib can be increased when it is combined with Rilpivirine. |
| Rimegepant | The metabolism of Rimegepant can be increased when combined with Alpelisib. |
| Riociguat | The metabolism of Riociguat can be decreased when combined with Alpelisib. |
| Ripretinib | The serum concentration of Alpelisib can be increased when it is combined with Ripretinib. |
| Ritonavir | The serum concentration of Alpelisib can be increased when it is combined with Ritonavir. |
| Rofecoxib | The serum concentration of Rofecoxib can be decreased when it is combined with Alpelisib. |
| Roflumilast | The serum concentration of Roflumilast can be increased when it is combined with Alpelisib. |
| Rolapitant | The serum concentration of Alpelisib can be increased when it is combined with Rolapitant. |
| Romidepsin | The metabolism of Romidepsin can be increased when combined with Alpelisib. |
| Ropivacaine | The risk or severity of methemoglobinemia can be increased when Alpelisib is combined with Ropivacaine. |
| Rosiglitazone | The serum concentration of Rosiglitazone can be decreased when it is combined with Alpelisib. |
| Rosuvastatin | The serum concentration of Rosuvastatin can be decreased when it is combined with Alpelisib. |
| Roxadustat | The serum concentration of Alpelisib can be increased when it is combined with Roxadustat. |
| Roxithromycin | The metabolism of Alpelisib can be decreased when combined with Roxithromycin. |
| Rucaparib | The serum concentration of Alpelisib can be increased when it is combined with Rucaparib. |
| Rufinamide | The metabolism of Alpelisib can be increased when combined with Rufinamide. |
| Rupatadine | The serum concentration of Rupatadine can be decreased when it is combined with Alpelisib. |
| Ruxolitinib | The serum concentration of Ruxolitinib can be decreased when it is combined with Alpelisib. |
| Safinamide | The serum concentration of Alpelisib can be increased when it is combined with Safinamide. |
| Salicylic acid | The serum concentration of Salicylic acid can be decreased when it is combined with Alpelisib. |
| Saquinavir | The serum concentration of Alpelisib can be increased when it is combined with Saquinavir. |
| Sarilumab | The metabolism of Alpelisib can be increased when combined with Sarilumab. |
| Satralizumab | The serum concentration of Alpelisib can be decreased when it is combined with Satralizumab. |
| Secobarbital | The metabolism of Alpelisib can be increased when combined with Secobarbital. |
| Secukinumab | The metabolism of Alpelisib can be increased when combined with Secukinumab. |
| Segesterone acetate | The metabolism of Segesterone acetate can be increased when combined with Alpelisib. |
| Selegiline | The serum concentration of Selegiline can be decreased when it is combined with Alpelisib. |
| Selexipag | The metabolism of Selexipag can be decreased when combined with Alpelisib. |
| Selpercatinib | The serum concentration of Selpercatinib can be decreased when it is combined with Alpelisib. |
| Selumetinib | The serum concentration of Selumetinib can be decreased when it is combined with Alpelisib. |
| Sertraline | The serum concentration of Sertraline can be decreased when it is combined with Alpelisib. |
| Sevoflurane | The metabolism of Sevoflurane can be increased when combined with Alpelisib. |
| Sildenafil | The serum concentration of Sildenafil can be decreased when it is combined with Alpelisib. |
| Siltuximab | The metabolism of Alpelisib can be increased when combined with Siltuximab. |
| Simeprevir | The serum concentration of Alpelisib can be increased when it is combined with Simeprevir. |
| Simvastatin | The metabolism of Simvastatin can be decreased when combined with Alpelisib. |
| Siponimod | The therapeutic efficacy of Siponimod can be decreased when used in combination with Alpelisib. |
| Sirolimus | The metabolism of Sirolimus can be increased when combined with Alpelisib. |
| Sitagliptin | The metabolism of Sitagliptin can be decreased when combined with Alpelisib. |
| Sitaxentan | The serum concentration of Sitaxentan can be decreased when it is combined with Alpelisib. |
| Somatostatin | The metabolism of Alpelisib can be decreased when combined with Somatostatin. |
| Somatrogon | The metabolism of Alpelisib can be increased when combined with Somatrogon. |
| Sonidegib | The metabolism of Sonidegib can be increased when combined with Alpelisib. |
| Sorafenib | The serum concentration of Alpelisib can be increased when it is combined with Sorafenib. |
| Sotagliflozin | The serum concentration of Alpelisib can be increased when it is combined with Sotagliflozin. |
| Sotorasib | The serum concentration of Alpelisib can be decreased when it is combined with Sotorasib. |
| St. John’s Wort | The serum concentration of Alpelisib can be decreased when it is combined with St. John’s Wort. |
| Stiripentol | The metabolism of Alpelisib can be decreased when combined with Stiripentol. |
| Sulfadiazine | The metabolism of Sulfadiazine can be decreased when combined with Alpelisib. |
| Sulfamethoxazole | The serum concentration of Sulfamethoxazole can be decreased when it is combined with Alpelisib. |
| Sulfasalazine | The serum concentration of Alpelisib can be increased when it is combined with Sulfasalazine. |
| Sulfinpyrazone | The metabolism of Alpelisib can be increased when combined with Sulfinpyrazone. |
| Sunitinib | The serum concentration of Alpelisib can be increased when it is combined with Sunitinib. |
| Suvorexant | The metabolism of Alpelisib can be decreased when combined with Suvorexant. |
| Tacrolimus | The serum concentration of Tacrolimus can be increased when it is combined with Alpelisib. |
| Tafamidis | The serum concentration of Alpelisib can be increased when it is combined with Tafamidis. |
| Tamoxifen | The serum concentration of Tamoxifen can be decreased when it is combined with Alpelisib. |
| Tasimelteon | The metabolism of Alpelisib can be decreased when combined with Tasimelteon. |
| Taurocholic acid | The serum concentration of Alpelisib can be increased when it is combined with Taurocholic acid. |
Pregnancy and Lactation
US FDA pregnancy category: Not assigned
Pregnancy
This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding
It is not known if alpelisib passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Anemia: Alpelisib may cause low levels of red blood cells. If you experience symptoms of reduced red blood cell count (anemia) such as shortness of breath, feeling unusually tired, or pale skin, contact your doctor as soon as possible.
Your doctor will do blood tests regularly to monitor the number of specific types of blood cells, including red blood cells, in your blood.
Birth control: Women who may become pregnant should use effective birth control while taking this medication and for at least 1 week after stopping alpelisib. Men taking this medication who have partners who may become pregnant should also use effective birth control while taking this medication and for at least 1 week after stopping alpelisib.
Bleeding: Alpelisib may cause a reduced number of platelets in the blood, which can make it difficult to stop cuts from bleeding. If you notice any signs of bleeding, such as frequent nosebleeds, unexplained bruising, or black and tarry stools, notify your doctor as soon as possible. Your doctor will order routine blood tests to make sure potential problems are caught early.
Dehydration: Severe dehydration can occur with the use of alpelisib. This may be due to severe or persistent diarrhea, vomiting, or decreased fluid intake. Dehydration can lead to kidney failure, if it is severe enough. During treatment with this medication, you may be encouraged to drink extra water. Your doctor will do blood tests to check the function of your kidneys.
Diabetes: Alpelisib may cause an increase in blood sugar levels (may cause a loss of blood glucose control) and glucose tolerance may change. Cases of severely increased blood sugar levels causing diabetic ketoacidosis have occurred.
If you develop symptoms of diabetic ketoacidosis such as difficulty breathing, feeling very thirsty, vomiting, abdominal pain, nausea, loss of appetite, confusion, and unusual tiredness, seek urgent medical attention.
People with diabetes may find it necessary to monitor their blood sugar more frequently while using this medication.
Deterioration of the jaw bone: People with cancer who are being treated with alpelisib and fulvestrant have reported developing osteonecrosis of the jaw (deterioration of the jaw bone). Report any pain, swelling, or infection of the jaw to your doctor, and avoid invasive dental procedures such as tooth extractions. Your doctor may recommend that you see a dentist before starting this medication. It is important to practice good oral hygiene while taking this medication.
Hypersensitivity syndrome: A severe allergic reaction called hypersensitivity syndrome has occurred for some people with the use of alpelisib. This reaction involves a number of organs in the body and may be fatal if not treated quickly. Stop taking the medication and get immediate medical attention if you have symptoms of a severe allergic reaction, including fever, swollen glands, yellowing of the skin or eyes, or flu-like symptoms with skin rash or blistering.
Infection: As well as killing cancer cells, alpelisib can reduce the number of cells that fight infection in the body (white blood cells). If possible, avoid contact with people with contagious infections.
Tell your doctor immediately if you notice signs of an infection, such as fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness. Your doctor will do blood tests regularly to monitor the number of specific types of blood cells in your blood.
Lung inflammation: Lung inflammation (interstitial lung disease), causing difficulty breathing has occurred rarely in some people taking this medication. This complication can be serious and sometimes fatal. If you experience new or worsening shortness of breath or cough (with or without fever) at any time while you are taking alpelisib, contact your doctor immediately.
Race: People of Asian heritage who take alpelisib are more likely to experience severe reactions to this medication, such allergic reactions, severe skin reactions, and pancreatitis.
Children: The safety and effectiveness of using this medication have not been established for children.
What special precautions should I follow?
Before taking alpelisib,
- tell your doctor and pharmacist if you are allergic to alpelisib, any other medications, herbal products, or any of the ingredients in alpelisib tablets. Ask your pharmacist for a list of the ingredients.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, or nutritional supplements you are taking or plan to take. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you have ever had a rash with red sores on the lips, mouth or skin, or shedding, blistering skin; or have or have ever had diabetes or kidney disease.
- tell your doctor if you or your partner are pregnant, or plan to become pregnant. You or your partner should not become pregnant during your treatment with alpelisib. If you are a female that can become pregnant, you will need to have a pregnancy test before you begin treatment, and you should use effective birth control during your treatment and for 1 week after your final dose. If you are a male with a female partner that can become pregnant, use a condom and effective birth control during your treatment and for 1 week after your final dose. If you or your partner become pregnant while taking alpelisib, call your doctor. Alpelisib may harm the fetus.
- tell your doctor if you are breast-feeding. Your doctor may tell you not to breast-feed during your treatment and for 1 week after your final dose.
- you should know that this medication may decrease fertility in men and women. Talk to your doctor about the risks of taking alpelisib.
- you should know that alpelisib may cause an increase in blood glucose. If you have diabetes or high blood sugar, check your blood sugar as often as directed by your doctor. If your blood sugar is higher than usual, call your doctor. Tell your doctor immediately if you have any of the following symptoms while you are taking alpelisib: extreme thirst, frequent urination, extreme hunger, blurred vision, confusion, or weakness. It is very important to call your doctor as soon as you have any of these symptoms, because high blood sugar that is not treated can cause a serious condition called ketoacidosis. Ketoacidosis may become life-threatening if it is not treated at an early stage. Symptoms of ketoacidosis include dry mouth, upset stomach and vomiting, shortness of breath, breath that smells fruity, and decreased consciousness. Call your doctor if you are unable to eat or drink normally due to nausea, vomiting, or diarrhea while you are taking alpelisib. Your doctor may need to change your diet or medication to help control your blood sugar while you are taking alpelisib.
References
