Midostaurin – Uses, Dosage, Side Effects, Interaction Midostaurin is an orally available small molecule inhibitor of FMS-like tyrosine kinase 3 (FLT3) which is used as an antineoplastic agent in the treatment of acute myeloid leukemia with FLT3 mutations. Midostaurin is associated with a moderate rate of serum aminotransferase elevations during therapy and is suspected to cause rare instances of clinically apparent acute liver injury. Midostaurin is a synthetic indolocarbazole multikinase inhibitor with potential antiangiogenic and antineoplastic activities. Midostaurin inhibits protein kinase C alpha (PKCalpha), vascular endothelial growth factor receptor 2 (VEGFR2), c-kit, platelet-derived growth factor receptor (PDGFR), and FMS-like tyrosine kinase 3 (FLT3) tyrosine kinases, which may result in disruption of the cell cycle, inhibition of proliferation, apoptosis, and inhibition of angiogenesis in susceptible tumors. Midostaurin is an organic heterooctacyclic compound that is the N-benzoyl derivative of staurosporine. It has a role as an EC 2.7.11.13 (protein kinase C) inhibitor and an antineoplastic agent. It is an indolocarbazole, an organic heterooctacyclic compound, a member of benzamides, and a gamma-lactam. It is functionally related to staurosporine. Mechanism of Action It potently inhibits multiple receptor tyrosine kinases. Midostaurin and its major active metabolites CGP62221 and CGP52421 inhibit the activity of protein kinase C alpha (PKCalpha), VEGFR2, KIT, PDGFR, and WT and/or mutant FLT3 tyrosine kinases. Inhibition of FLT3 receptor signaling cascades induces apoptosis of target leukemia cells expressing target receptors and mast cells, in addition to its antiproliferative activity toward multiple cancer cell lines. Midostaurin also interacts with organic anion transporter (OATP) 1A1 and multidrug resistance protein (MRP)-2 according to preliminary in vitro studies. It targets multiple WT and mutated kinases that, when activated, constitutively stimulate aberrant signaling cascades that lead to malignancies such as AML and ASM. The alternative pharmacodynamic effect of midostaurin in prolonging QTc intervals was not clinically significant in patients with advanced SM or AML when compared to the placebo. Midostaurin is therapeutically beneficial as a combination therapy for patients undergoing chemotherapy. Midostaurin (as Rydapt) is a multitarget kinase inhibitor for the treatment of adult patients with newly diagnosed acute myeloid leukemia (AML) who have a specific genetic mutation called FLT3. It was initially characterized as a potential broad-spectrum antineoplastic agent, with activity toward diverse solid and hematopoietic tumors. It was approved on April 28, 2017, and has been shown to increase the overall survival rate in patients with AML as an adjunct therapy along with chemotherapeutic agents. Indications Investigated for use/treatment in adult patients with high-risk acute myeloid leukemia (AML) who are FLT3 mutation-positive, aggressive systemic mastocytosis (ASM), systemic mastocytosis with associated hematological neoplasm (SM-AHN), or mast cell leukemia (MCL). Midostaurin is an antineoplastic agent used to treat high-risk acute myeloid leukemia (AML) with specific mutations, aggressive systemic mastocytosis (ASM), systemic mastocytosis with associated hematologic neoplasm (SM-AHN), or mast cell leukemia (MCL). Rydapt is indicated: in combination with standard daunorubicin and cytarabine induction and high dose cytarabine consolidation chemotherapy, and for patients in complete response followed by Rydapt single agent maintenance therapy, for adult patients with newly diagnosed acute myeloid leukemia (AML) who are FLT3 mutation-positive as monotherapy for the treatment of adult patients with aggressive systemic mastocytosis (ASM), systemic mastocytosis with associated hematological neoplasm (SM AHN), or mast cell leukemia (MCL). Midostaurin is an orally available small molecule inhibitor of FMS-like tyrosine kinase 3 (FLT3) which is used as an antineoplastic agent in the treatment of acute myeloid leukemia with FLT3 mutations. In combination with standard cytarabine and daunorubicin induction and cytarabine consolidation chemotherapy, for the treatment of adult patients with newly diagnosed acute myeloid leukemia (AML) who are FLT3 mutation-positive, as detected by an FDA-approved test. Acute Myeloid Leukemia Aggressive Systemic Mastocytosis Mast Cell Leukemia (MCL) Systemic Mastocytosis Use in Cancer Midostaurin is approved to treat: Acute myeloid leukemia (AML). It is used with cytarabine and daunorubicin hydrochloride in newly diagnosed adults whose cancer has a mutation in the FLT3 gene. Aggressive systemic mastocytosis, systemic mastocytosis with associated hematologic neoplasm (SM-AHN), or mast cell leukemia in adults. Midostaurin is also being studied in the treatment of other conditions and types of cancer. Contraindications abnormal EKG with QT changes from birth pregnancy a patient who is producing milk and breastfeeding lung tissue problem Dosage Strengths: 25 mg Acute Myeloid Leukemia 50 mg orally twice a day at approximately 12-hour intervals on Days 8 to 21 of each cycle of induction AND on Days 8 to 21 of each cycle of consolidation. This drug is not indicated as single-agent induction therapy for acute myeloid leukemia (AML) patients. Information on FDA-approved tests for the detection of FLT3 mutation in AML is available at: http://www.fda.gov/CompanionDiagnostics Systemic Mastocytosis 100 mg orally twice a day at approximately 12-hour intervals Monitor for toxicity at least weekly for the first 4 weeks, every other week for the next 8 weeks, and monthly thereafter while on treatment. Treatment should be continued until the disease progresses or has unacceptable toxicity. For the treatment of adult patients with aggressive systemic mastocytosis (ASM), systemic mastocytosis with associated hematological neoplasm (SM-AHN), or mast cell leukemia (MCL) Leukemia 100 mg orally twice a day at approximately 12-hour intervals Monitor for toxicity at least weekly for the first 4 weeks, every other week for the next 8 weeks, and monthly thereafter while on treatment. Treatment should be continued until the disease progresses or has unacceptable toxicity. For the treatment of adult patients with aggressive systemic mastocytosis (ASM), systemic mastocytosis with associated hematological neoplasm (SM-AHN), or mast cell leukemia (MCL) Dose Adjustments FOR PATIENTS WITH SYSTEMIC MASTOCYTOSIS: ABSOLUTE NEUTROPHIL COUNT (ANC) LESS THAN 1 x 10(9)/L WITHOUT MCL OR ANC LESS THAN 0.5 x 10(9)/L WITH BASELINE ANC VALUE of 0.5 to 1.5 x 10(9)/L: Interrupt treatment until ANC 1 x 10(9)/L or greater, then resume treatment at 50 mg twice a day; increase to 100 mg twice a day if tolerated. Discontinue treatment if low ANC persists for more than 21 days and is suspected to be drug-related. PLATELET COUNT LESS THAN 50 X 10(9)/L WITHOUT MCL OR PLATELET COUNT LESS THAN 25 x 10(9)/L WITH BASELINE PLATELET COUNT of 25 to 75 x 10(9)/L: Interrupt treatment until platelet count 50 x 10(9)/L or greater, then resume treatment at 50 mg twice a day; increase to 100 mg twice a day if tolerated. Discontinue treatment if low platelet count persists for more than 21 days and is suspected to be drug-related. HEMOGLOBIN LESS THAN 8 g/L WITHOUT MCL OR LIFE-THREATENING ANEMIA WITH BASELINE HEMOGLOBIN VALUE of 8 to 10 g/L: Interrupt treatment until hemoglobin 8 g/L or greater, then resume treatment at 50 mg twice a day; increase to 100 mg twice a day if tolerated. Discontinue treatment if low hemoglobin persists for more than 21 days and is suspected to be drug-related. GRADE 3/4 NAUSEA AND/OR VOMITING DESPITE OPTIMAL ANTI-EMETIC THERAPY: Interrupt treatment for 3 days (6 doses), then resume treatment at 50 mg twice a day; increase to 100 mg twice a day if tolerated. OTHER GRADE 3/4 NON-HEMATOLOGICAL TOXICITIES: Interrupt treatment until the event has resolved to Grade 2 or less, then resume treatment at 50 mg twice a day; increase to 100 mg twice a day if tolerated. Side Effects The Most Common nausea vomiting diarrhea headache nosebleeds tiredness weakness dizziness constipation hemorrhoids increased sweating stomach pain white patches or sores on the lips or in the mouth and throat swelling of the hands, feet, ankles, or lower legs back, bone, joint, limb, or muscle pain difficulty falling asleep or staying asleep fever, cough, sore throat, chills, and other signs of infection rapid, irregular, or pounding heartbeat shortness of breath chest pain flushing swelling of the lips, tongue, or throat difficulty breathing or swallowing hives rash itching new or worsening cough wheezing vomiting blood or vomiting material that looks like coffee grounds unusual bleeding or bruising burning or pain when urinating More common Black, tarry stools bloody urine body aches or pain bone, joint, or muscle pain chest pain or tightness cough decreased frequency or amount of urine dizziness ear congestion fever or chills headache increased thirst loss of appetite loss of voice lower back or side pain nausea painful or difficult urination pale skin runny or stuffy nose sneezing sore throat stomach pain swelling of the face, fingers, or lower legs trouble breathing ulcers, sores, or white spots in the mouth unusual bleeding or bruising unusual tiredness or weakness vomiting weight gain Rare Chills general feeling of discomfort or illness thickening of bronchial secretions Bloody nose blurred vision cracked lips diarrhea difficulty having a bowel movement (stool) difficulty with moving difficulty with swallowing dry mouth flushed, dry skin fruit-like breath odor headache increased hunger increased sweating increased thirst increased urination muscle stiffness small red or purple spots on the skin sores, ulcers, or white spots on the lips, tongue, or inside the mouth sweating trouble sleeping unexplained weight loss Drug Interactions DRUG INTERACTION 1,2-Benzodiazepine The metabolism of 1,2-Benzodiazepine can be decreased when combined with Midostaurin. Abametapir The serum concentration of Midostaurin can be increased when it is combined with Abametapir. Abatacept The metabolism of Midostaurin can be increased when combined with Abatacept. Abemaciclib The metabolism of Abemaciclib can be decreased when combined with Midostaurin. Abiraterone The metabolism of Abiraterone can be increased when combined with Midostaurin. Acalabrutinib The metabolism of Acalabrutinib can be decreased when combined with Midostaurin. Acenocoumarol The metabolism of Acenocoumarol can be decreased when combined with Midostaurin. Acetaminophen The metabolism of Acetaminophen can be decreased when combined with Midostaurin. Acetazolamide The metabolism of Midostaurin can be decreased when combined with Acetazolamide. Adagrasib The serum concentration of Adagrasib can be decreased when it is combined with Midostaurin. Adalimumab The metabolism of Midostaurin can be increased when combined with Adalimumab. Albendazole The metabolism of Albendazole can be decreased when combined with Midostaurin. Aldesleukin The metabolism of Midostaurin can be decreased when combined with Aldesleukin. Alectinib The metabolism of Alectinib can be decreased when combined with Midostaurin. Alfentanil The metabolism of Alfentanil can be decreased when combined with Midostaurin. Alfuzosin The metabolism of Alfuzosin can be decreased when combined with Midostaurin. Aliskiren The metabolism of Aliskiren can be decreased when combined with Midostaurin. Almotriptan The metabolism of Almotriptan can be decreased when combined with Midostaurin. Alogliptin The metabolism of Alogliptin can be decreased when combined with Midostaurin. Alosetron The metabolism of Alosetron can be decreased when combined with Midostaurin. Alpelisib The serum concentration of Alpelisib can be decreased when it is combined with Midostaurin. Alprazolam The metabolism of Alprazolam can be decreased when combined with Midostaurin. Ambrisentan The metabolism of Ambrisentan can be decreased when combined with Midostaurin. Ambroxol The metabolism of Ambroxol can be decreased when combined with Midostaurin. Aminoglutethimide The metabolism of Midostaurin can be increased when combined with Aminoglutethimide. Aminophenazone The metabolism of Aminophenazone can be decreased when combined with Midostaurin. Aminophylline The metabolism of Aminophylline can be decreased when combined with Midostaurin. Amiodarone The metabolism of Midostaurin can be decreased when combined with Amiodarone. Amitriptyline The metabolism of Amitriptyline can be decreased when combined with Midostaurin. Amlodipine The metabolism of Amlodipine can be decreased when combined with Midostaurin. Amobarbital The metabolism of Midostaurin can be increased when combined with Amobarbital. Amprenavir The metabolism of Midostaurin can be decreased when combined with Amprenavir. Anakinra The metabolism of Midostaurin can be increased when combined with Anakinra. Antipyrine The metabolism of Antipyrine can be decreased when combined with Midostaurin. Apalutamide The metabolism of Apalutamide can be decreased when combined with Midostaurin. Apixaban The metabolism of Apixaban can be decreased when combined with Midostaurin. Apomorphine The metabolism of Apomorphine can be increased when combined with Midostaurin. Apremilast The metabolism of Apremilast can be decreased when combined with Midostaurin. Aprepitant The metabolism of Aprepitant can be decreased when combined with Midostaurin. Aripiprazole The metabolism of Aripiprazole can be decreased when combined with Midostaurin. Aripiprazole lau The serum concentration of aripiprazole, an active metabolite of Midostaurin, can be decreased when used in combination with Aripiprazole lauroxil. Armodafinil The metabolism of Midostaurin can be increased when combined with Armodafinil. Artemether The metabolism of Artemether can be decreased when combined with Midostaurin. Articaine The risk or severity of methemoglobinemia can be increased when Midostaurin is combined with Articaine. Asciminib The serum concentration of Asciminib can be increased when it is combined with Midostaurin. Asenapine The metabolism of Asenapine can be decreased when combined with Midostaurin. Astemizole The metabolism of Astemizole can be decreased when combined with Midostaurin. Asunaprevir The metabolism of Asunaprevir can be decreased when combined with Midostaurin. Atazanavir The metabolism of Midostaurin can be decreased when combined with Atazanavir. Atogepant The serum concentration of Atogepant can be increased when it is combined with Midostaurin. Atorvastatin The metabolism of Atorvastatin can be decreased when combined with Midostaurin. Atovaquone The metabolism of Atovaquone can be decreased when combined with Midostaurin. Avacopan The metabolism of Avacopan can be decreased when combined with Midostaurin. Avanafil The metabolism of Avanafil can be decreased when combined with Midostaurin. Avapritinib The metabolism of Avapritinib can be decreased when combined with Midostaurin. Axitinib The metabolism of Axitinib can be decreased when combined with Midostaurin. Azelastine The metabolism of Azelastine can be decreased when combined with Midostaurin. Azithromycin The metabolism of Azithromycin can be decreased when combined with Midostaurin. Baricitinib The metabolism of Baricitinib can be decreased when combined with Midostaurin. Beclomethasone The metabolism of Beclomethasone dipropionate can be decreased when combined with Midostaurin. Bedaquiline The metabolism of Bedaquiline can be decreased when combined with Midostaurin. Belumosudil The serum concentration of Belumosudil can be decreased when it is combined with Midostaurin. Belzutifan The serum concentration of Midostaurin can be decreased when it is combined with Belzutifan. Benzocaine The risk or severity of methemoglobinemia can be increased when Midostaurin is combined with Benzocaine. Benzphetamine The metabolism of Benzphetamine can be decreased when combined with Midostaurin. Benzyl alcohol The risk or severity of methemoglobinemia can be increased when Midostaurin is combined with Benzyl alcohol. Bepridil The metabolism of Bepridil can be decreased when combined with Midostaurin. Berotralstat The serum concentration of Midostaurin can be increased when it is combined with Berotralstat. Betamethasone The metabolism of Betamethasone can be decreased when combined with Midostaurin. Betamethasone The metabolism of Betamethasone phosphate can be decreased when combined with Midostaurin. Bexarotene The metabolism of Bexarotene can be decreased when combined with Midostaurin. Bezafibrate The metabolism of Bezafibrate can be decreased when combined with Midostaurin. Bicalutamide The metabolism of Bicalutamide can be decreased when combined with Midostaurin. Bictegravir The metabolism of Bictegravir can be decreased when combined with Midostaurin. Bifonazole The metabolism of Midostaurin can be decreased when combined with Bifonazole. Bimekizumab The metabolism of Midostaurin can be increased when combined with Bimekizumab. Bisoprolol The metabolism of Bisoprolol can be decreased when combined with Midostaurin. Boceprevir The metabolism of Midostaurin can be decreased when combined with Boceprevir. Bortezomib The metabolism of Bortezomib can be increased when combined with Midostaurin. Bosentan The metabolism of Bosentan can be decreased when combined with Midostaurin. Bosutinib The metabolism of Bosutinib can be decreased when combined with Midostaurin. Brentuximab vedo The metabolism of Brentuximab vedotin can be decreased when combined with Midostaurin. Brexpiprazole The metabolism of Brexpiprazole can be decreased when combined with Midostaurin. Brigatinib The metabolism of Brigatinib can be decreased when combined with Midostaurin. Brivaracetam The metabolism of Brivaracetam can be decreased when combined with Midostaurin. Bromocriptine The serum concentration of Bromocriptine can be increased when it is combined with Midostaurin. Budesonide The metabolism of Budesonide can be decreased when combined with Midostaurin. Bupivacaine The metabolism of Bupivacaine can be decreased when combined with Midostaurin. Buprenorphine The metabolism of Buprenorphine can be decreased when combined with Midostaurin. Buspirone The metabolism of Buspirone can be decreased when combined with Midostaurin. Busulfan The metabolism of Busulfan can be decreased when combined with Midostaurin. Butacaine The risk or severity of methemoglobinemia can be increased when Midostaurin is combined with Butacaine. Butalbital The metabolism of Midostaurin can be increased when combined with Butalbital. Butamben The risk or severity of methemoglobinemia can be increased when Midostaurin is combined with Butamben. Cabazitaxel The metabolism of Cabazitaxel can be decreased when combined with Midostaurin. Cabergoline The metabolism of Cabergoline can be decreased when combined with Midostaurin. Cabozantinib The metabolism of Cabozantinib can be decreased when combined with Midostaurin. Calcitriol The metabolism of Calcitriol can be decreased when combined with Midostaurin. Canagliflozin The metabolism of Canagliflozin can be decreased when combined with Midostaurin. Canakinumab The metabolism of Midostaurin can be increased when combined with Canakinumab. Candicidin The metabolism of Midostaurin can be decreased when combined with Candicidin. Cannabidiol The metabolism of Cannabidiol can be decreased when combined with Midostaurin. Capmatinib The serum concentration of Capmatinib can be decreased when it is combined with Midostaurin. Capsaicin The risk or severity of methemoglobinemia can be increased when Midostaurin is combined with Capsaicin. Carbamazepine The metabolism of Carbamazepine can be decreased when combined with Midostaurin. Carbimazole The therapeutic efficacy of Carbimazole can be decreased when used in combination with Midostaurin. Cariprazine The metabolism of Cariprazine can be decreased when combined with Midostaurin. Carvedilol The metabolism of Carvedilol can be decreased when combined with Midostaurin. Cefradine The metabolism of Midostaurin can be increased when combined with Cefradine. Celecoxib The metabolism of Celecoxib can be decreased when combined with Midostaurin. Cenobamate The serum concentration of Midostaurin can be decreased when it is combined with Cenobamate. Cephalexin The metabolism of Cephalexin can be decreased when combined with Midostaurin. Ceritinib The metabolism of Ceritinib can be decreased when combined with Midostaurin. Cerivastatin The metabolism of Cerivastatin can be decreased when combined with Midostaurin. Certolizumab The metabolism of Midostaurin can be increased when combined with Certolizumab pegol. Cevimeline The metabolism of Cevimeline can be decreased when combined with Midostaurin. Chenodeoxycholic The metabolism of Chenodeoxycholic acid can be decreased when combined with Midostaurin. Chloramphenicol The metabolism of Midostaurin can be decreased when combined with Chloramphenicol. Chloroprocaine The risk or severity of methemoglobinemia can be increased when Midostaurin is combined with Chloroprocaine. Chloroquine The metabolism of Chloroquine can be decreased when combined with Midostaurin. Chlorpheniramine The metabolism of Chlorpheniramine can be decreased when combined with Midostaurin. Chlorpromazine The metabolism of Chlorpromazine can be decreased when combined with Midostaurin. Chlorzoxazone The metabolism of Chlorzoxazone can be decreased when combined with Midostaurin. Cholecalciferol The metabolism of Cholecalciferol can be decreased when combined with Midostaurin. Ciclesonide The metabolism of Ciclesonide can be decreased when combined with Midostaurin. Cilostazol The metabolism of Cilostazol can be decreased when combined with Midostaurin. Cimetidine The metabolism of Midostaurin can be decreased when combined with Cimetidine. Cinacalcet The metabolism of Cinacalcet can be decreased when combined with Midostaurin. Cinchocaine The risk or severity of methemoglobinemia can be increased when Midostaurin is combined with Cinchocaine. Cinnarizine The metabolism of Cinnarizine can be decreased when combined with Midostaurin. Ciprofloxacin The metabolism of Midostaurin can be decreased when combined with Ciprofloxacin. Cisapride The metabolism of Cisapride can be decreased when combined with Midostaurin. Citalopram The metabolism of Citalopram can be decreased when combined with Midostaurin. Clarithromycin The metabolism of Midostaurin can be decreased when combined with Clarithromycin. Clevidipine The metabolism of Clevidipine can be decreased when combined with Midostaurin. Clindamycin The metabolism of Clindamycin can be increased when combined with Midostaurin. Clobazam The metabolism of Clobazam can be decreased when combined with Midostaurin. Clobetasol prop The metabolism of Clobetasol propionate can be decreased when combined with Midostaurin. Clofazimine The metabolism of Midostaurin can be decreased when combined with Clofazimine. Clofibrate The metabolism of Clofibrate can be decreased when combined with Midostaurin. Clomipramine The metabolism of Clomipramine can be decreased when combined with Midostaurin. Clonazepam The metabolism of Clonazepam can be increased when combined with Midostaurin. Clonidine The metabolism of Clonidine can be decreased when combined with Midostaurin. Clopidogrel The metabolism of Clopidogrel can be decreased when combined with Midostaurin. Clorazepic acid The metabolism of Clorazepic acid can be decreased when combined with Midostaurin. Clotiazepam The metabolism of Clotiazepam can be decreased when combined with Midostaurin. Clozapine The serum concentration of Clozapine can be increased when it is combined with Midostaurin. Cobicistat The metabolism of Midostaurin can be decreased when combined with Cobicistat. Cobimetinib The serum concentration of Cobimetinib can be increased when it is combined with Midostaurin. Cocaine The risk or severity of methemoglobinemia can be increased when Midostaurin is combined with Cocaine. Codeine The metabolism of Codeine can be decreased when combined with Midostaurin. Colchicine The metabolism of Colchicine can be decreased when combined with Midostaurin. Conivaptan The metabolism of Midostaurin can be decreased when combined with Conivaptan. Conju estrogens The metabolism of Conjugated estrogens can be decreased when combined with Midostaurin. Copanlisib The metabolism of Copanlisib can be decreased when combined with Midostaurin. Corticotropin The metabolism of Corticotropin can be decreased when combined with Midostaurin. Cortisone acetate The metabolism of Cortisone acetate can be decreased when combined with Midostaurin. Crizotinib The metabolism of Midostaurin can be decreased when combined with Crizotinib. Curcumin The metabolism of Midostaurin can be decreased when combined with Curcumin. Cyclandelate The metabolism of Cyclandelate can be decreased when combined with Midostaurin. Cyclobenzaprine The metabolism of Cyclobenzaprine can be decreased when combined with Midostaurin. Cyclophosphamide The metabolism of Cyclophosphamide can be decreased when combined with Midostaurin. Cyclosporine The metabolism of Cyclosporine can be decreased when combined with Midostaurin. Cyproterone acetate The metabolism of Cyproterone acetate can be decreased when combined with Midostaurin. Dabrafenib The serum concentration of Dabrafenib can be increased when it is combined with Midostaurin. Daclatasvir The metabolism of Daclatasvir can be decreased when combined with Midostaurin. Dacomitinib The metabolism of Dacomitinib can be decreased when combined with Midostaurin. Dalfopristin The metabolism of Midostaurin can be decreased when combined with Dalfopristin. Danazol The metabolism of Midostaurin can be decreased when combined with Danazol. Dapagliflozin The metabolism of Dapagliflozin can be decreased when combined with Midostaurin. Dapsone The metabolism of Dapsone can be decreased when combined with Midostaurin. Darbepoetin alfa The risk or severity of Thrombosis can be increased when Darbepoetin alfa is combined with Midostaurin. Daridorexant The metabolism of Daridorexant can be decreased when combined with Midostaurin. Darifenacin The metabolism of Darifenacin can be decreased when combined with Midostaurin. Darolutamide The serum concentration of Darolutamide can be decreased when it is combined with Midostaurin. Darunavir The serum concentration of Midostaurin can be increased when it is combined with Darunavir. Dasabuvir The metabolism of Dasabuvir can be decreased when combined with Midostaurin. Dasatinib The therapeutic efficacy of Dasatinib can be decreased when used in combination with Midostaurin. Daunorubicin The metabolism of Midostaurin can be decreased when combined with Daunorubicin. Deferasirox The metabolism of Midostaurin can be increased when combined with Deferasirox. Deflazacort The serum concentration of Deflazacort can be decreased when it is combined with Midostaurin. Delamanid The metabolism of Delamanid can be decreased when combined with Midostaurin. Delavirdine The metabolism of Midostaurin can be decreased when combined with Delavirdine. Desipramine The metabolism of Midostaurin can be decreased when combined with Desipramine. Desogestrel The metabolism of Desogestrel can be decreased when combined with Midostaurin. Desoxycorticoster The metabolism of Desoxycorticosterone acetate can be decreased when combined with Midostaurin. Desvenlafaxine The metabolism of Desvenlafaxine can be decreased when combined with Midostaurin. Deutetrabenazine The metabolism of Deutetrabenazine can be decreased when combined with Midostaurin. Dexamethasone The metabolism of Dexamethasone can be decreased when combined with Midostaurin. Dexamethasone The metabolism of Dexamethasone acetate can be decreased when combined with Midostaurin. Dexchlorpheniramine The metabolism of Dexchlorpheniramine maleate can be decreased when combined with Midostaurin. Dexlansoprazole The metabolism of Dexlansoprazole can be decreased when combined with Midostaurin. Dextromethorphan The metabolism of Dextromethorphan can be decreased when combined with Midostaurin. Dextropropoxyphene The metabolism of Dextropropoxyphene can be decreased when combined with Midostaurin. Diazepam The metabolism of Diazepam can be decreased when combined with Midostaurin. Diclofenac The metabolism of Diclofenac can be decreased when combined with Midostaurin. Dicloxacillin The metabolism of Midostaurin can be increased when combined with Dicloxacillin. Dienogest The metabolism of Dienogest can be increased when combined with Midostaurin. Diethylstilbestrol The metabolism of Diethylstilbestrol can be decreased when combined with Midostaurin. Difluocortolone The metabolism of Difluocortolone can be decreased when combined with Midostaurin. Digitoxin The metabolism of Digitoxin can be decreased when combined with Midostaurin. Dihy ergocryptine The metabolism of Dihydro-alpha-ergocryptine can be decreased when combined with Midostaurin. Dihydrocodeine The metabolism of Dihydrocodeine can be decreased when combined with Midostaurin. Dihydroergocornine The serum concentration of Dihydroergocornine can be increased when it is combined with Midostaurin. Dihydroergocristine The serum concentration of Dihydroergocristine can be increased when it is combined with Midostaurin. Dihydroergotamine The metabolism of Dihydroergotamine can be decreased when combined with Midostaurin. Diltiazem The metabolism of Diltiazem can be decreased when combined with Midostaurin. Dimethyl sulfoxide The metabolism of Midostaurin can be decreased when combined with Dimethyl sulfoxide. Diosmin The metabolism of Midostaurin can be decreased when combined with Diosmin. Diphenhydramine The risk or severity of methemoglobinemia can be increased when Midostaurin is combined with Diphenhydramine. Disopyramide The metabolism of Disopyramide can be decreased when combined with Midostaurin. Disulfiram The metabolism of Disulfiram can be decreased when combined with Midostaurin. Docetaxel The metabolism of Docetaxel can be decreased when combined with Midostaurin. Dofetilide The metabolism of Dofetilide can be decreased when combined with Midostaurin. Dolasetron The metabolism of Dolasetron can be decreased when combined with Midostaurin. Domperidone The metabolism of Domperidone can be decreased when combined with Midostaurin. Donepezil The metabolism of Donepezil can be decreased when combined with Midostaurin. Doravirine The metabolism of Doravirine can be decreased when combined with Midostaurin. Doxazosin The metabolism of Doxazosin can be decreased when combined with Midostaurin. Doxepin The metabolism of Doxepin can be decreased when combined with Midostaurin. Doxorubicin The serum concentration of Doxorubicin can be increased when it is combined with Midostaurin. Dronabinol The serum concentration of Dronabinol can be increased when it is combined with Midostaurin. Dronedarone The metabolism of Dronedarone can be decreased when combined with Midostaurin. Drospirenone The metabolism of Drospirenone can be decreased when combined with Midostaurin. Dutasteride The metabolism of Dutasteride can be increased when combined with Midostaurin. Duvelisib The metabolism of Duvelisib can be decreased when combined with Midostaurin. Dyclonine The risk or severity of methemoglobinemia can be increased when Midostaurin is combined with Dyclonine. Dydrogesterone The metabolism of Dydrogesterone can be decreased when combined with Midostaurin. Ebastine The metabolism of Ebastine can be decreased when combined with Midostaurin. Echinacea The metabolism of Midostaurin can be increased when combined with Echinacea. Efavirenz The metabolism of Midostaurin can be decreased when combined with Efavirenz. Elacestrant The serum concentration of Elacestrant can be increased when it is combined with Midostaurin. Elbasvir The metabolism of Elbasvir can be decreased when combined with Midostaurin. Eletriptan The metabolism of Eletriptan can be decreased when combined with Midostaurin. Elexacaftor The serum concentration of Elexacaftor can be decreased when it is combined with Midostaurin. Eliglustat The metabolism of Eliglustat can be decreased when combined with Midostaurin. Elvitegravir The metabolism of Midostaurin can be decreased when combined with Elvitegravir. Emapalumab The metabolism of Midostaurin can be increased when combined with Emapalumab. Enasidenib The metabolism of Enasidenib can be decreased when combined with Midostaurin. Encorafenib The metabolism of Encorafenib can be decreased when combined with Midostaurin. Enfortumab ved The serum concentration of Enfortumab vedotin can be increased when it is combined with Midostaurin. Entrectinib The metabolism of Entrectinib can be increased when combined with Midostaurin. Enzalutamide The serum concentration of Midostaurin can be decreased when it is combined with Enzalutamide. Epinastine The metabolism of Epinastine can be decreased when combined with Midostaurin. Epinephrine The metabolism of Midostaurin can be decreased when combined with Epinephrine. Eplerenone The metabolism of Eplerenone can be decreased when combined with Midostaurin. Eravacycline The metabolism of Eravacycline can be decreased when combined with Midostaurin. Erdafitinib The metabolism of Erdafitinib can be decreased when combined with Midostaurin. Ergoloid mesylate The serum concentration of Ergoloid mesylate can be increased when it is combined with Midostaurin. Ergometrine The serum concentration of Ergometrine can be increased when it is combined with Midostaurin. Ergotamine The metabolism of Midostaurin can be decreased when combined with Ergotamine. Erlotinib The metabolism of Erlotinib can be decreased when combined with Midostaurin. Erythromycin The metabolism of Erythromycin can be decreased when combined with Midostaurin. Erythropoietin The risk or severity of Thrombosis can be increased when Erythropoietin is combined with Midostaurin. Escitalopram The metabolism of Escitalopram can be decreased when combined with Midostaurin. Esketamine The metabolism of Esketamine can be decreased when combined with Midostaurin. Eslicarbazepine The metabolism of Midostaurin can be increased when combined with Eslicarbazepine. Eslicarbazepine The metabolism of Midostaurin can be increased when combined with Eslicarbazepine acetate. Esomeprazole The metabolism of Esomeprazole can be decreased when combined with Midostaurin. Estazolam The metabolism of Estazolam can be decreased when combined with Midostaurin. Esterified estrogens The metabolism of Esterified estrogens can be decreased when combined with Midostaurin. Estetrol The metabolism of Estetrol can be decreased when combined with Midostaurin. Estradiol The metabolism of Estradiol can be decreased when combined with Midostaurin. Estradiol acetate The metabolism of Estradiol acetate can be decreased when combined with Midostaurin. Estradiol benzoate The metabolism of Estradiol benzoate can be decreased when combined with Midostaurin. Estradiol cypionate The metabolism of Estradiol cypionate can be decreased when combined with Midostaurin. Estradiol diena The metabolism of Estradiol dienanthate can be decreased when combined with Midostaurin. Estradiol valerate The metabolism of Estradiol valerate can be decreased when combined with Midostaurin. Estramustine The metabolism of Estramustine can be decreased when combined with Midostaurin. Estrone sulfate The metabolism of Estrone sulfate can be decreased when combined with Midostaurin. Eszopiclone The serum concentration of Eszopiclone can be increased when it is combined with Midostaurin. Etanercept The metabolism of Midostaurin can be increased when combined with Etanercept. Ethambutol The metabolism of Midostaurin can be decreased when combined with Ethambutol. Ethanol The metabolism of Ethanol can be decreased when combined with Midostaurin. Ethinylestradiol The metabolism of Ethinylestradiol can be decreased when combined with Midostaurin. Ethosuximide The metabolism of Ethosuximide can be decreased when combined with Midostaurin. Ethyl chloride The risk or severity of methemoglobinemia can be increased when Midostaurin is combined with Ethyl chloride. Ethynodiol diac The metabolism of Ethynodiol diacetate can be decreased when combined with Midostaurin. Etidocaine The risk or severity of methemoglobinemia can be increased when Midostaurin is combined with Etidocaine. Etonogestrel The metabolism of Etonogestrel can be decreased when combined with Midostaurin. Etoposide The metabolism of Etoposide can be decreased when combined with Midostaurin. Etoricoxib The metabolism of Etoricoxib can be decreased when combined with Midostaurin. Etravirine The metabolism of Etravirine can be decreased when combined with Midostaurin. Everolimus The metabolism of Everolimus can be increased when combined with Midostaurin. Exemestane The metabolism of Exemestane can be increased when combined with Midostaurin. Fedratinib The metabolism of Fedratinib can be decreased when combined with Midostaurin. Felbamate The metabolism of Felbamate can be decreased when combined with Midostaurin. Felodipine The metabolism of Felodipine can be decreased when combined with Midostaurin. Fenofibrate The metabolism of Fenofibrate can be decreased when combined with Midostaurin. Fentanyl The metabolism of Fentanyl can be decreased when combined with Midostaurin. Fesoterodine The metabolism of Fesoterodine can be decreased when combined with Midostaurin. Fexinidazole The metabolism of Fexinidazole can be decreased when combined with Midostaurin. Finasteride The metabolism of Finasteride can be decreased when combined with Midostaurin. Finerenone The serum concentration of the active metabolites of Finerenone can be increased when Finerenone is used in combination with Midostaurin. Fish oil The metabolism of Fish oil can be decreased when combined with Midostaurin. Flibanserin The metabolism of Flibanserin can be decreased when combined with Midostaurin. Flucloxacillin The metabolism of Midostaurin can be increased when combined with Flucloxacillin. Fluconazole The metabolism of Midostaurin can be decreased when combined with Fluconazole. Fludrocortisone The metabolism of Fludrocortisone can be decreased when combined with Midostaurin. Flumethasone The metabolism of Flumethasone can be decreased when combined with Midostaurin. Flunarizine The metabolism of Flunarizine can be decreased when combined with Midostaurin. Flunisolide The metabolism of Flunisolide can be decreased when combined with Midostaurin. Flunitrazepam The metabolism of Flunitrazepam can be decreased when combined with Midostaurin. Fluocinolone The metabolism of Fluocinolone acetonide can be decreased when combined with Midostaurin. Fluocinonide The metabolism of Fluocinonide can be decreased when combined with Midostaurin. Fluocortolone The metabolism of Fluocortolone can be decreased when combined with Midostaurin. Fluoxetine The metabolism of Midostaurin can be decreased when combined with Fluoxetine. Fluprednisolone The metabolism of Fluprednisolone can be decreased when combined with Midostaurin. Flurazepam The metabolism of Flurazepam can be decreased when combined with Midostaurin. Fluspirilene The metabolism of Fluspirilene can be decreased when combined with Midostaurin. Flutamide The metabolism of Flutamide can be decreased when combined with Midostaurin. Fluticasone The metabolism of Midostaurin can be increased when combined with Fluticasone. Fluticasone fu The metabolism of Fluticasone furoate can be decreased when combined with Midostaurin. Fluticasone pr The serum concentration of Fluticasone propionate can be increased when it is combined with Midostaurin. Fluvastatin The metabolism of Fluvastatin can be decreased when combined with Midostaurin. Fluvoxamine The metabolism of Fluvoxamine can be decreased when combined with Midostaurin. Follitropin The therapeutic efficacy of Follitropin can be decreased when used in combination with Midostaurin. Formestane The metabolism of Midostaurin can be increased when combined with Formestane. Fosamprenavir The metabolism of Fosamprenavir can be decreased when combined with Midostaurin. Fosaprepitant The metabolism of Fosaprepitant can be decreased when combined with Midostaurin. Fosnetupitant The metabolism of Fosnetupitant can be decreased when combined with Midostaurin. Fosphenytoin The metabolism of Fosphenytoin can be decreased when combined with Midostaurin. Fostamatinib The metabolism of Fostamatinib can be decreased when combined with Midostaurin. Fostemsavir The serum concentration of Fostemsavir can be decreased when it is combined with Midostaurin. Fusidic acid The metabolism of Fusidic acid can be decreased when combined with Midostaurin. Futibatinib The metabolism of Futibatinib can be decreased when combined with Midostaurin. Galantamine The metabolism of Galantamine can be decreased when combined with Midostaurin. Ganaxolone The metabolism of Ganaxolone can be increased when combined with Midostaurin. Gefitinib The metabolism of Gefitinib can be increased when combined with Midostaurin. Gemfibrozil The metabolism of Gemfibrozil can be decreased when combined with Midostaurin. Gestrinone The metabolism of Gestrinone can be decreased when combined with Midostaurin. Gilteritinib The metabolism of Gilteritinib can be decreased when combined with Midostaurin. Ginkgo biloba The metabolism of Midostaurin can be decreased when combined with Ginkgo biloba. Glasdegib The serum concentration of Glasdegib can be increased when it is combined with Midostaurin. Glecaprevir The metabolism of Midostaurin can be decreased when combined with Glecaprevir. Glyburide The metabolism of Glyburide can be decreased when combined with Midostaurin. Glycerol phen The metabolism of Midostaurin can be increased when combined with Glycerol phenylbutyrate. Golimumab The metabolism of Midostaurin can be increased when combined with Golimumab. Granisetron The metabolism of Granisetron can be decreased when combined with Midostaurin. Grapefruit The metabolism of Midostaurin can be decreased when combined with Grapefruit. Grazoprevir The metabolism of Grazoprevir can be decreased when combined with Midostaurin. Grepafloxacin The metabolism of Grepafloxacin can be decreased when combined with Midostaurin. Griseofulvin The metabolism of Midostaurin can be increased when combined with Griseofulvin. Guanfacine The metabolism of Guanfacine can be decreased when combined with Midostaurin. Halofantrine The metabolism of Halofantrine can be decreased when combined with Midostaurin. Haloperidol The serum concentration of Haloperidol can be increased when it is combined with Midostaurin. Hydralazine The metabolism of Midostaurin can be decreased when combined with Hydralazine. Hydrocodone The metabolism of Hydrocodone can be increased when combined with Midostaurin. Hydrocortamate The metabolism of Midostaurin can be increased when combined with Hydrocortamate. Hydrocortisone The metabolism of Hydrocortisone can be decreased when combined with Midostaurin. Hydrocortisone ace The metabolism of Hydrocortisone acetate can be decreased when combined with Midostaurin. Hydrocortisone buty The metabolism of Hydrocortisone butyrate can be decreased when combined with Midostaurin. Hydrocortisone cypi The metabolism of Hydrocortisone cypionate can be decreased when combined with Midostaurin. Hydrocortisone pho The metabolism of Hydrocortisone phosphate can be decreased when combined with Midostaurin. Hydrocortisone succi The metabolism of Hydrocortisone succinate can be decreased when combined with Midostaurin. Hydroxychloroquine The metabolism of Hydroxychloroquine can be decreased when combined with Midostaurin. Hydroxyprogesterone The metabolism of Hydroxyprogesterone caproate can be decreased when combined with Midostaurin. Hydroxyzine The metabolism of Hydroxyzine can be decreased when combined with Midostaurin. Ibrexafungerp The serum concentration of Ibrexafungerp can be decreased when it is combined with Midostaurin. Ibrutinib The metabolism of Ibrutinib can be decreased when combined with Midostaurin. Ibuprofen The metabolism of Ibuprofen can be decreased when combined with Midostaurin. Idelalisib The metabolism of Idelalisib can be decreased when combined with Midostaurin. Ifosfamide The metabolism of Ifosfamide can be increased when combined with Midostaurin. Iloperidone The metabolism of Iloperidone can be decreased when combined with Midostaurin. Imatinib The metabolism of Imatinib can be increased when combined with Midostaurin. Imipramine The metabolism of Imipramine can be decreased when combined with Midostaurin. Indacaterol The metabolism of Indacaterol can be decreased when combined with Midostaurin. Indapamide The metabolism of Indapamide can be decreased when combined with Midostaurin. Indinavir The metabolism of Midostaurin can be decreased when combined with Indinavir. Infigratinib The metabolism of Infigratinib can be decreased when combined with Midostaurin. Infliximab The metabolism of Midostaurin can be increased when combined with Infliximab. Ipecac The metabolism of Ipecac can be decreased when combined with Midostaurin. Irbesartan The metabolism of Midostaurin can be decreased when combined with Irbesartan. Irinotecan The serum concentration of SN-38, an active metabolite of Irinotecan, can be increased when used in combination with Midostaurin. Isavuconazole The metabolism of Isavuconazole can be decreased when combined with Midostaurin. Isavuconazonium The metabolism of Isavuconazonium can be decreased when combined with Midostaurin. Isoniazid The metabolism of Midostaurin can be decreased when combined with Isoniazid. Isotretinoin The metabolism of Isotretinoin can be decreased when combined with Midostaurin. Isradipine The metabolism of Isradipine can be decreased when combined with Midostaurin. Istradefylline The metabolism of Istradefylline can be decreased when combined with Midostaurin. Itraconazole The metabolism of Midostaurin can be decreased when combined with Itraconazole. Ivabradine The metabolism of Ivabradine can be decreased when combined with Midostaurin. Ivacaftor The serum concentration of Ivacaftor can be decreased when it is combined with Midostaurin. Ivermectin The metabolism of Ivermectin can be decreased when combined with Midostaurin. Ivosidenib The metabolism of Ivosidenib can be increased when combined with Midostaurin. Ixabepilone The metabolism of Ixabepilone can be increased when combined with Midostaurin. Ixazomib The metabolism of Ixazomib can be decreased when combined with Midostaurin. Ketamine The metabolism of Ketamine can be decreased when combined with Midostaurin. Ketazolam The metabolism of Ketazolam can be decreased when combined with Midostaurin. Ketoconazole The metabolism of Midostaurin can be decreased when combined with Ketoconazole. Lacidipine The metabolism of Lacidipine can be decreased when combined with Midostaurin. Lacosamide The metabolism of Lacosamide can be decreased when combined with Midostaurin. Lanreotide The metabolism of Midostaurin can be decreased when combined with Lanreotide. Lansoprazole The metabolism of Lansoprazole can be decreased when combined with Midostaurin. Lapatinib The metabolism of Lapatinib can be decreased when combined with Midostaurin. Larotrectinib The metabolism of Larotrectinib can be decreased when combined with Midostaurin. Lefamulin The serum concentration of Lefamulin can be increased when it is combined with Midostaurin. Lemborexant The serum concentration of Lemborexant can be decreased when it is combined with Midostaurin. Lercanidipine The metabolism of Lercanidipine can be decreased when combined with Midostaurin. Lesinurad The metabolism of Midostaurin can be increased when combined with Lesinurad. Letermovir The metabolism of Midostaurin can be decreased when combined with Letermovir. Letrozole The metabolism of Letrozole can be decreased when combined with Midostaurin. Levacetylmethadol The metabolism of Levacetylmethadol can be decreased when combined with Midostaurin. Levamlodipine The serum concentration of Levamlodipine can be increased when it is combined with Midostaurin. Levobupivacaine The risk or severity of methemoglobinemia can be increased when Midostaurin is combined with Levobupivacaine. Levocetirizine The metabolism of Levocetirizine can be decreased when combined with Midostaurin. Levoketoconazole The metabolism of Midostaurin can be decreased when combined with Levoketoconazole. Levomenthol The metabolism of Levomenthol can be decreased when combined with Midostaurin. Levomilnacipran The metabolism of Levomilnacipran can be decreased when combined with Midostaurin. Levonorgestrel The metabolism of Levonorgestrel can be decreased when combined with Midostaurin. Levothyroxine The therapeutic efficacy of Levothyroxine can be decreased when used in combination with Midostaurin. Lidocaine The metabolism of Lidocaine can be decreased when combined with Midostaurin. Lidoflazine The metabolism of Lidoflazine can be decreased when combined with Midostaurin. Linagliptin The metabolism of Linagliptin can be decreased when combined with Midostaurin. Liothyronine The therapeutic efficacy of Liothyronine can be decreased when used in combination with Midostaurin. Liotrix The metabolism of Liotrix can be decreased when combined with Midostaurin. Lisuride The serum concentration of Lisuride can be increased when it is combined with Midostaurin. Lomitapide The metabolism of Lomitapide can be decreased when combined with Midostaurin. Lonafarnib The metabolism of Midostaurin can be decreased when combined with Lonafarnib. Loperamide The metabolism of Loperamide can be decreased when combined with Midostaurin. Lopinavir The metabolism of Midostaurin can be decreased when combined with Lopinavir. Loratadine The metabolism of Loratadine can be decreased when combined with Midostaurin. Lorazepam The metabolism of Lorazepam can be decreased when combined with Midostaurin. Lorcaserin The metabolism of Lorcaserin can be decreased when combined with Midostaurin. Lorlatinib The metabolism of Lorlatinib can be decreased when combined with Midostaurin. Lorpiprazole The metabolism of Lorpiprazole can be decreased when combined with Midostaurin. Losartan The metabolism of Losartan can be decreased when combined with Midostaurin. Lovastatin The serum concentration of Lovastatin can be increased when it is combined with Midostaurin. Lumacaftor The serum concentration of Lumacaftor can be increased when it is combined with Midostaurin. Lumateperone The serum concentration of Lumateperone can be decreased when it is combined with Midostaurin. Lumefantrine The metabolism of Lumefantrine can be decreased when combined with Midostaurin. Lurasidone The metabolism of Lurasidone can be decreased when combined with Midostaurin. Lurbinectedin The serum concentration of Lurbinectedin can be decreased when it is combined with Midostaurin. Lynestrenol The metabolism of Lynestrenol can be decreased when combined with Midostaurin. Macimorelin The metabolism of Macimorelin can be decreased when combined with Midostaurin. Macitentan The metabolism of Macitentan can be decreased when combined with Midostaurin. Manidipine The metabolism of Manidipine can be decreased when combined with Midostaurin. Maraviroc The metabolism of Maraviroc can be decreased when combined with Midostaurin. Maribavir The serum concentration of Maribavir can be decreased when it is combined with Midostaurin. Mavacamten The serum concentration of Mavacamten can be increased when it is combined with Midostaurin. Medrogestone The metabolism of Medrogestone can be decreased when combined with Midostaurin. Medroxyprogestero The metabolism of Medroxyprogesterone acetate can be decreased when combined with Midostaurin. Mefloquine The metabolism of Mefloquine can be decreased when combined with Midostaurin. Megestrol acetate The metabolism of Megestrol acetate can be decreased when combined with Midostaurin. Meloxicam The metabolism of Meloxicam can be decreased when combined with Midostaurin. Meperidine The metabolism of Meperidine can be decreased when combined with Midostaurin. Mepivacaine The risk or severity of methemoglobinemia can be increased when Midostaurin is combined with Mepivacaine. Meprednisone The metabolism of Meprednisone can be decreased when combined with Midostaurin. Mestranol The metabolism of Mestranol can be decreased when combined with Midostaurin. Metergoline The serum concentration of Metergoline can be increased when it is combined with Midostaurin. Methadone The metabolism of Methadone can be decreased when combined with Midostaurin. Methimazole The metabolism of Midostaurin can be decreased when combined with Methimazole. Methotrexate The metabolism of Methotrexate can be decreased when combined with Midostaurin. Methoxy polyeth The risk or severity of Thrombosis can be increased when Methoxy polyethylene glycol-epoetin beta is combined with Midostaurin. Methylene blue The metabolism of Midostaurin can be decreased when combined with Methylene blue. Methylergometrine The serum concentration of Methylergometrine can be increased when it is combined with Midostaurin. Methylphenobarbital The metabolism of Midostaurin can be increased when combined with Methylphenobarbital. Methylprednisolone The metabolism of Methylprednisolone can be decreased when combined with Midostaurin. Methylprednisone The metabolism of Methylprednisone can be decreased when combined with Midostaurin. Methyltestosterone The metabolism of Methyltestosterone can be decreased when combined with Midostaurin. Methysergide The serum concentration of Methysergide can be increased when it is combined with Midostaurin. Metoclopramide The metabolism of Metoclopramide can be decreased when combined with Midostaurin. Metreleptin The metabolism of Midostaurin can be increased when combined with Metreleptin. Metronidazole The metabolism of Midostaurin can be decreased when combined with Metronidazole. Metyrapone The metabolism of Midostaurin can be increased when combined with Metyrapone. Mexiletine The metabolism of Mexiletine can be decreased when combined with Midostaurin. Mianserin The metabolism of Mianserin can be decreased when combined with Midostaurin. Miconazole The metabolism of Midostaurin can be decreased when combined with Miconazole. Midazolam The serum concentration of Midazolam can be increased when it is combined with Midostaurin. Mifepristone The metabolism of Mifepristone can be decreased when combined with Midostaurin. Milnacipran The metabolism of Milnacipran can be decreased when combined with Midostaurin. Miocamycin The metabolism of Midostaurin can be decreased when combined with Miocamycin. Mirabegron The metabolism of Mirabegron can be decreased when combined with Midostaurin. Mirtazapine The metabolism of Mirtazapine can be decreased when combined with Midostaurin. Mirvetuximab s The serum concentration of Mirvetuximab Soravtansine can be increased when it is combined with Midostaurin. Mitapivat The metabolism of Mitapivat can be decreased when combined with Midostaurin. Mitotane The metabolism of Midostaurin can be increased when combined with Mitotane. Mobocertinib The serum concentration of Mobocertinib can be decreased when it is combined with Midostaurin. Modafinil The metabolism of Modafinil can be decreased when combined with Midostaurin. Mometasone furoate The metabolism of Mometasone furoate can be decreased when combined with Midostaurin. Montelukast The metabolism of Montelukast can be decreased when combined with Midostaurin. Morphine The metabolism of Morphine can be decreased when combined with Midostaurin. Mosunetuzumab The metabolism of Midostaurin can be decreased when combined with Mosunetuzumab. Mycophenolate mol The metabolism of Mycophenolate mofetil can be decreased when combined with Midostaurin. Nabilone The metabolism of Nabilone can be decreased when combined with Midostaurin. Nafcillin The metabolism of Midostaurin can be increased when combined with Nafcillin. Naloxegol The metabolism of Naloxegol can be decreased when combined with Midostaurin. Nateglinide The metabolism of Nateglinide can be decreased when combined with Midostaurin. Nebivolol The metabolism of Nebivolol can be decreased when combined with Midostaurin. Nefazodone The metabolism of Midostaurin can be decreased when combined with Nefazodone. Nelfinavir The metabolism of Midostaurin can be decreased when combined with Nelfinavir. Neratinib The serum concentration of Neratinib can be increased when it is combined with Midostaurin. Netupitant The metabolism of Netupitant can be decreased when combined with Midostaurin. Nevirapine The metabolism of Nevirapine can be decreased when combined with Midostaurin. Niacin The metabolism of Midostaurin can be decreased when combined with Niacin. Nicardipine The metabolism of Nicardipine can be decreased when combined with Midostaurin. Nicergoline The serum concentration of Nicergoline can be increased when it is combined with Midostaurin. Nifedipine The metabolism of Nifedipine can be decreased when combined with Midostaurin. Nilotinib The metabolism of Nilotinib can be decreased when combined with Midostaurin. Nilvadipine The metabolism of Nilvadipine can be decreased when combined with Midostaurin. Nimesulide The metabolism of Nimesulide can be decreased when combined with Midostaurin. Nimodipine The metabolism of Nimodipine can be decreased when combined with Midostaurin. Nintedanib The metabolism of Nintedanib can be decreased when combined with Midostaurin. Nirmatrelvir The metabolism of Nirmatrelvir can be decreased when combined with Midostaurin. Nisoldipine The metabolism of Nisoldipine can be decreased when combined with Midostaurin. Nitrazepam The metabolism of Nitrazepam can be decreased when combined with Midostaurin. Nitrendipine The metabolism of Nitrendipine can be decreased when combined with Midostaurin. Nomegestrol The metabolism of Nomegestrol can be decreased when combined with Midostaurin. Nomegestrol ac The metabolism of Nomegestrol acetate can be decreased when combined with Midostaurin. Norelgestromin The metabolism of Norelgestromin can be decreased when combined with Midostaurin. Norethisterone The metabolism of Norethisterone can be decreased when combined with Midostaurin. Norethynodrel The metabolism of Norethynodrel can be decreased when combined with Midostaurin. Norgestimate The metabolism of Norgestimate can be decreased when combined with Midostaurin. Norgestrel The metabolism of Norgestrel can be decreased when combined with Midostaurin. Nortriptyline The metabolism of Nortriptyline can be decreased when combined with Midostaurin. Noscapine The metabolism of Midostaurin can be decreased when combined with Noscapine. Nylidrin The metabolism of Nylidrin can be decreased when combined with Midostaurin. Octreotide The serum concentration of Midostaurin can be increased when it is combined with Octreotide. Olaparib The metabolism of Olaparib can be increased when combined with Midostaurin. Oliceridine The serum concentration of Oliceridine can be increased when it is combined with Midostaurin. Olutasidenib The therapeutic efficacy of Olutasidenib can be decreased when used in combination with Midostaurin. Omaveloxolone The serum concentration of Omaveloxolone can be increased when it is combined with Midostaurin. Ondansetron The metabolism of Ondansetron can be decreased when combined with Midostaurin. Opium The metabolism of Opium can be decreased when combined with Midostaurin. Oritavancin The metabolism of Midostaurin can be increased when combined with Oritavancin. Orphenadrine The metabolism of Orphenadrine can be decreased when combined with Midostaurin. Osilodrostat The serum concentration of Osilodrostat can be increased when it is combined with Midostaurin. Osimertinib The metabolism of Osimertinib can be increased when combined with Midostaurin. Ospemifene The metabolism of Ospemifene can be decreased when combined with Midostaurin. Oxcarbazepine The metabolism of Midostaurin can be increased when combined with Oxcarbazepine. Oxetacaine The risk or severity of methemoglobinemia can be increased when Midostaurin is combined with Oxetacaine. Oxybuprocaine The risk or severity of methemoglobinemia can be increased when Midostaurin is combined with Oxybuprocaine. Oxybutynin The metabolism of Oxybutynin can be decreased when combined with Midostaurin. Oxycodone The metabolism of Oxycodone can be decreased when combined with Midostaurin. Oxymorphone The metabolism of Oxymorphone can be decreased when combined with Midostaurin. Paclitaxel The metabolism of Paclitaxel can be decreased when combined with Midostaurin. Pacritinib The serum concentration of Pacritinib can be increased when it is combined with Midostaurin. Palbociclib The metabolism of Palbociclib can be decreased when combined with Midostaurin. Paliperidone The metabolism of Paliperidone can be decreased when combined with Midostaurin. Palonosetron The metabolism of Palonosetron can be decreased when combined with Midostaurin. Palovarotene The serum concentration of Palovarotene can be increased when it is combined with Midostaurin. Panobinostat The metabolism of Panobinostat can be decreased when combined with Midostaurin. Pantoprazole The metabolism of Pantoprazole can be decreased when combined with Midostaurin. Paramethadione The metabolism of Paramethadione can be decreased when combined with Midostaurin. Parathyroid ho The therapeutic efficacy of Parathyroid hormone can be decreased when used in combination with Midostaurin. Parecoxib The metabolism of Parecoxib can be decreased when combined with Midostaurin. Paricalcitol The metabolism of Paricalcitol can be decreased when combined with Midostaurin. Paritaprevir The metabolism of Paritaprevir can be decreased when combined with Midostaurin. Paroxetine The metabolism of Paroxetine can be decreased when combined with Midostaurin. Pasireotide The metabolism of Midostaurin can be decreased when combined with Pasireotide. Pazopanib The metabolism of Pazopanib can be decreased when combined with Midostaurin. Peginesatide The risk or severity of Thrombosis can be increased when Peginesatide is combined with Midostaurin. Pemigatinib The metabolism of Pemigatinib can be increased when combined with Midostaurin. Pentamidine The metabolism of Pentamidine can be increased when combined with Midostaurin. Pentobarbital The metabolism of Midostaurin can be increased when combined with Pentobarbital. Perampanel The metabolism of Perampanel can be increased when combined with Midostaurin. Pergolide The serum concentration of Pergolide can be increased when it is combined with Midostaurin. Perhexiline The metabolism of Perhexiline can be decreased when combined with Midostaurin. Pexidartinib The metabolism of Pexidartinib can be increased when combined with Midostaurin. Phenobarbital The metabolism of Midostaurin can be increased when combined with Phenobarbital. Phenol The risk or severity of methemoglobinemia can be increased when Midostaurin is combined with Phenol. Phenprocoumon The metabolism of Phenprocoumon can be decreased when combined with Midostaurin. Phentermine The metabolism of Phentermine can be decreased when combined with Midostaurin. Phenylbutazone The metabolism of Midostaurin can be increased when combined with Phenylbutazone. Phenytoin The metabolism of Phenytoin can be decreased when combined with Midostaurin. Pimavanserin The metabolism of Pimavanserin can be increased when combined with Midostaurin. Pimozide The metabolism of Pimozide can be decreased when combined with Midostaurin. Pinacidil The metabolism of Pinacidil can be decreased when combined with Midostaurin. Pinaverium The metabolism of Pinaverium can be decreased when combined with Midostaurin. Pioglitazone The metabolism of Pioglitazone can be decreased when combined with Midostaurin. Piperaquine The metabolism of Piperaquine can be decreased when combined with Midostaurin. Pipotiazine The metabolism of Pipotiazine can be decreased when combined with Midostaurin. Pirtobrutinib The serum concentration of Pirtobrutinib can be increased when it is combined with Midostaurin. Pitolisant The metabolism of Pitolisant can be increased when combined with Midostaurin. Polatuzumab ve The risk or severity of adverse effects can be increased when Midostaurin is combined with Polatuzumab vedotin. Pomalidomide The metabolism of Pomalidomide can be decreased when combined with Midostaurin. Ponatinib The metabolism of Ponatinib can be decreased when combined with Midostaurin. Ponesimod The metabolism of Ponesimod can be decreased when combined with Midostaurin. Posaconazole The metabolism of Midostaurin can be decreased when combined with Posaconazole. Potassium Iodide The therapeutic efficacy of Potassium Iodide can be decreased when used in combination with Midostaurin. Potassium perch The therapeutic efficacy of Potassium perchlorate can be decreased when used in combination with Midostaurin. Pralsetinib The serum concentration of Pralsetinib can be increased when it is combined with Midostaurin. Pramocaine The risk or severity of methemoglobinemia can be increased when Midostaurin is combined with Pramocaine. Prazepam The metabolism of Prazepam can be decreased when combined with Midostaurin. Praziquantel The metabolism of Praziquantel can be increased when combined with Midostaurin. Prednisolone The metabolism of Prednisolone can be decreased when combined with Midostaurin. Prednisolone acet The metabolism of Prednisolone acetate can be decreased when combined with Midostaurin. Prednisolone pho The metabolism of Prednisolone phosphate can be decreased when combined with Midostaurin. Prednisone The metabolism of Prednisone can be decreased when combined with Midostaurin. Prednisone acetate The metabolism of Midostaurin can be increased when combined with Prednisone acetate. Pregnenolone The metabolism of Pregnenolone can be decreased when combined with Midostaurin. Prenylamine The metabolism of Prenylamine can be decreased when combined with Midostaurin. Pretomanid The serum concentration of Pretomanid can be decreased when it is combined with Midostaurin. Prilocaine The risk or severity of methemoglobinemia can be increased when Midostaurin is combined with Prilocaine. Primaquine The metabolism of Primaquine can be decreased when combined with Midostaurin. Primidone The metabolism of Midostaurin can be increased when combined with Primidone. Probenecid The metabolism of Midostaurin can be increased when combined with Probenecid. Procaine The risk or severity of methemoglobinemia can be increased when Midostaurin is combined with Procaine. Prochlorperazine The metabolism of Prochlorperazine can be decreased when combined with Midostaurin. Progesterone The metabolism of Progesterone can be decreased when combined with Midostaurin. Promazine The metabolism of Promazine can be decreased when combined with Midostaurin. Propafenone The metabolism of Propafenone can be decreased when combined with Midostaurin. Proparacaine The risk or severity of methemoglobinemia can be increased when Midostaurin is combined with Proparacaine. Propiverine The metabolism of Propiverine can be decreased when combined with Midostaurin. Propofol The metabolism of Midostaurin can be decreased when combined with Propofol. Propoxycaine The risk or severity of methemoglobinemia can be increased when Midostaurin is combined with Propoxycaine. Propranolol The metabolism of Propranolol can be decreased when combined with Midostaurin. Propylthiouracil The therapeutic efficacy of Propylthiouracil can be decreased when used in combination with Midostaurin. Protirelin The therapeutic efficacy of Protirelin can be decreased when used in combination with Midostaurin. Prucalopride The metabolism of Prucalopride can be decreased when combined with Midostaurin. Quazepam The metabolism of Quazepam can be decreased when combined with Midostaurin. Quetiapine The serum concentration of Quetiapine can be increased when it is combined with Midostaurin. Quinidine The metabolism of Quinidine can be decreased when combined with Midostaurin. Quinine The metabolism of Quinine can be decreased when combined with Midostaurin. Quinupristin The metabolism of Midostaurin can be decreased when combined with Quinupristin. Raloxifene The metabolism of Midostaurin can be decreased when combined with Raloxifene. Ramelteon The metabolism of Ramelteon can be decreased when combined with Midostaurin. Ranolazine The metabolism of Ranolazine can be decreased when combined with Midostaurin. Reboxetine The metabolism of Reboxetine can be decreased when combined with Midostaurin. Regorafenib The metabolism of Regorafenib can be decreased when combined with Midostaurin. Relugolix The serum concentration of Relugolix can be decreased when it is combined with Midostaurin. Remdesivir The metabolism of Remdesivir can be decreased when combined with Midostaurin. Repaglinide The metabolism of Repaglinide can be decreased when combined with Midostaurin. Retapamulin The metabolism of Retapamulin can be decreased when combined with Midostaurin. Ribociclib The metabolism of Ribociclib can be decreased when combined with Midostaurin. Rifabutin The metabolism of Rifabutin can be decreased when combined with Midostaurin. Rifampicin The metabolism of Midostaurin can be increased when combined with Rifampicin. Rifamycin The metabolism of Midostaurin can be increased when combined with Rifamycin. Rifapentine The metabolism of Rifapentine can be decreased when combined with Midostaurin. Rilonacept The metabolism of Midostaurin can be increased when combined with Rilonacept. Rilpivirine The serum concentration of Rilpivirine can be decreased when it is combined with Midostaurin. Rimegepant The metabolism of Rimegepant can be decreased when combined with Midostaurin. Rimonabant The metabolism of Rimonabant can be decreased when combined with Midostaurin. Riociguat The serum concentration of Riociguat can be increased when it is combined with Midostaurin. Ripretinib The serum concentration of Ripretinib can be decreased when it is combined with Midostaurin. Risperidone The metabolism of Risperidone can be decreased when combined with Midostaurin. Ritonavir The serum concentration of Midostaurin can be increased when it is combined with Ritonavir. Rivaroxaban The metabolism of Rivaroxaban can be decreased when combined with Midostaurin. Rofecoxib The metabolism of Rofecoxib can be decreased when combined with Midostaurin. Roflumilast The serum concentration of Roflumilast can be increased when it is combined with Midostaurin. Rolapitant The metabolism of Rolapitant can be decreased when combined with Midostaurin. Romidepsin The metabolism of Romidepsin can be decreased when combined with Midostaurin. Ropivacaine The risk or severity of methemoglobinemia can be increased when Midostaurin is combined with Ropivacaine. Rosiglitazone The metabolism of Rosiglitazone can be decreased when combined with Midostaurin. Rosuvastatin The metabolism of Rosuvastatin can be decreased when combined with Midostaurin. Rotigotine The metabolism of Rotigotine can be decreased when combined with Midostaurin. Roxithromycin The metabolism of Roxithromycin can be decreased when combined with Midostaurin. Rucaparib The metabolism of Midostaurin can be decreased when combined with Rucaparib. Rufinamide The metabolism of Midostaurin can be increased when combined with Rufinamide. Rupatadine The metabolism of Rupatadine can be decreased when combined with Midostaurin. Ruxolitinib The metabolism of Ruxolitinib can be decreased when combined with Midostaurin. Safinamide The metabolism of Safinamide can be decreased when combined with Midostaurin. Salmeterol The metabolism of Salmeterol can be decreased when combined with Midostaurin. Salmon calcit The therapeutic efficacy of Salmon calcitonin can be decreased when used in combination with Midostaurin. Samidorphan The metabolism of Samidorphan can be decreased when combined with Midostaurin. Saquinavir The metabolism of Midostaurin can be decreased when combined with Saquinavir. Sarilumab The metabolism of Midostaurin can be increased when combined with Sarilumab. Satralizumab The serum concentration of Midostaurin can be decreased when it is combined with Satralizumab. Saxagliptin The metabolism of Saxagliptin can be decreased when combined with Midostaurin. Scopolamine The metabolism of Scopolamine can be decreased when combined with Midostaurin. Secobarbital The metabolism of Midostaurin can be increased when combined with Secobarbital. Secukinumab The metabolism of Midostaurin can be increased when combined with Secukinumab. Segesterone aceta The metabolism of Segesterone acetate can be increased when combined with Midostaurin. Selegiline The metabolism of Selegiline can be decreased when combined with Midostaurin. Selexipag The metabolism of Selexipag can be decreased when combined with Midostaurin. Selinexor The metabolism of Selinexor can be decreased when combined with Midostaurin. Selpercatinib The serum concentration of Selpercatinib can be decreased when it is combined with Midostaurin. Selumetinib The serum concentration of Selumetinib can be increased when it is combined with Midostaurin. Sertindole The metabolism of Sertindole can be decreased when combined with Midostaurin. Sertraline The metabolism of Sertraline can be decreased when combined with Midostaurin. Sibutramine The metabolism of Sibutramine can be decreased when combined with Midostaurin. Sildenafil The metabolism of Sildenafil can be decreased when combined with Midostaurin. Silodosin The metabolism of Silodosin can be decreased when combined with Midostaurin. Siltuximab The metabolism of Midostaurin can be increased when combined with Siltuximab. Simeprevir The metabolism of Simeprevir can be decreased when combined with Midostaurin. Simvastatin The risk or severity of myopathy and rhabdomyolysis can be increased when Midostaurin is combined with Simvastatin. Siponimod The risk or severity of adverse effects can be increased when Midostaurin is combined with Siponimod. Sirolimus The metabolism of Sirolimus can be decreased when combined with Midostaurin. Sitagliptin The metabolism of Sitagliptin can be decreased when combined with Midostaurin. Sitaxentan The metabolism of Midostaurin can be decreased when combined with Sitaxentan. Solifenacin The metabolism of Solifenacin can be decreased when combined with Midostaurin. Somatostatin The metabolism of Midostaurin can be decreased when combined with Somatostatin. Somatrogon The metabolism of Midostaurin can be increased when combined with Somatrogon. Sonidegib The metabolism of Sonidegib can be decreased when combined with Midostaurin. Sorafenib The metabolism of Sorafenib can be increased when combined with Midostaurin. Sotagliflozin The serum concentration of Sotagliflozin can be decreased when it is combined with Midostaurin. Sotorasib The serum concentration of Sotorasib can be decreased when it is combined with Midostaurin. Sparsentan The serum concentration of Sparsentan can be increased when it is combined with Midostaurin. St. John’s Wort The metabolism of St. John’s Wort can be decreased when combined with Midostaurin. Stiripentol The metabolism of Midostaurin can be decreased when combined with Stiripentol. Sufentanil The metabolism of Sufentanil can be decreased when combined with Midostaurin. Sulfadiazine The metabolism of Sulfadiazine can be decreased when combined with Midostaurin. Sulfamethoxazole The metabolism of Midostaurin can be decreased when combined with Sulfamethoxazole. Sulfinpyrazone The metabolism of Sulfinpyrazone can be decreased when combined with Midostaurin. Sunitinib The metabolism of Sunitinib can be decreased when combined with Midostaurin. Suvorexant The metabolism of Suvorexant can be decreased when combined with Midostaurin. Syn Estrogens, A The metabolism of Synthetic Conjugated Estrogens, A can be decreased when combined with Midostaurin. Synth Estrogens, B The metabolism of Synthetic Conjugated Estrogens, B can be decreased when combined with Midostaurin. Tacrolimus The serum concentration of Tacrolimus can be increased when it is combined with Midostaurin. Tadalafil The serum concentration of Tadalafil can be increased when it is combined with Midostaurin. Tamoxifen The metabolism of Tamoxifen can be decreased when combined with Midostaurin. Tamsulosin The metabolism of Tamsulosin can be decreased when combined with Midostaurin. Tasimelteon The metabolism of Tasimelteon can be decreased when combined with Midostaurin. Tazemetostat The metabolism of Tazemetostat can be decreased when combined with Midostaurin. Tecovirimat The metabolism of Midostaurin can be increased when combined with Tecovirimat. Tegafur The metabolism of Tegafur can be increased when combined with Midostaurin. Telaprevir The metabolism of Midostaurin can be decreased when combined with Telaprevir. Telithromycin The metabolism of Midostaurin can be decreased when combined with Telithromycin. Telotristat ethyl The serum concentration of Midostaurin can be decreased when it is combined with Telotristat ethyl. Temsirolimus The metabolism of Temsirolimus can be decreased when combined with Midostaurin. Teniposide The metabolism of Teniposide can be decreased when combined with Midostaurin. Tenofovir alaf The metabolism of Tenofovir alafenamide can be decreased when combined with Midostaurin. Tepotinib The serum concentration of Tepotinib can be increased when it is combined with Midostaurin. Terbinafine The metabolism of Terbinafine can be decreased when combined with Midostaurin. Terfenadine The metabolism of Midostaurin can be decreased when combined with Terfenadine. Teriparatide The therapeutic efficacy of Teriparatide can be decreased when used in combination with Midostaurin. Testosterone The metabolism of Testosterone can be decreased when combined with Midostaurin. Testosterone cypi The metabolism of Testosterone cypionate can be decreased when combined with Midostaurin. Testosterone enan The metabolism of Testosterone enanthate can be decreased when combined with Midostaurin. Testosterone prop The metabolism of Testosterone propionate can be decreased when combined with Midostaurin. Tetracaine The risk or severity of methemoglobinemia can be increased when Midostaurin is combined with Tetracaine. Tetracycline The metabolism of Tetracycline can be decreased when combined with Midostaurin. Tezacaftor The metabolism of Tezacaftor can be decreased when combined with Midostaurin. Thalidomide The metabolism of Thalidomide can be decreased when combined with Midostaurin. Theophylline The metabolism of Theophylline can be decreased when combined with Midostaurin. Thiamylal The metabolism of Thiamylal can be decreased when combined with Midostaurin. Thiotepa The metabolism of Thiotepa can be decreased when combined with Midostaurin. Thyroid, porcine The therapeutic efficacy of Thyroid, porcine can be decreased when used in combination with Midostaurin. Thyrotropin alfa The therapeutic efficacy of Thyrotropin alfa can be decreased when used in combination with Midostaurin. Tiagabine The metabolism of Tiagabine can be decreased when combined with Midostaurin. Ticagrelor The metabolism of Ticagrelor can be increased when combined with Midostaurin. Tinidazole The metabolism of Tinidazole can be decreased when combined with Midostaurin. Tiotropium The metabolism of Tiotropium can be decreased when combined with Midostaurin. Tipranavir The metabolism of Midostaurin can be decreased when combined with Tipranavir. Tisotumab vedotin The metabolism of Tisotumab vedotin can be decreased when combined with Midostaurin. Tivozanib The metabolism of Tivozanib can be increased when combined with Midostaurin. Tocilizumab The metabolism of Midostaurin can be increased when combined with Tocilizumab. Tocofersolan The metabolism of Tocofersolan can be decreased when combined with Midostaurin. Tocopherol The metabolism of Tocopherol can be decreased when combined with Midostaurin. Tofacitinib The metabolism of Tofacitinib can be decreased when combined with Midostaurin. Tolfenamic acid The metabolism of Tolfenamic acid can be decreased when combined with Midostaurin. Tolterodine The serum concentration of Tolterodine can be increased when it is combined with Midostaurin. Tolvaptan The metabolism of Tolvaptan can be decreased when combined with Midostaurin. Topiramate The metabolism of Midostaurin can be increased when combined with Topiramate. Toremifene The metabolism of Toremifene can be decreased when combined with Midostaurin. Trabectedin The metabolism of Trabectedin can be decreased when combined with Midostaurin. Tramadol The metabolism of Tramadol can be decreased when combined with Midostaurin. Trastuzumab emta The metabolism of Trastuzumab emtansine can be decreased when combined with Midostaurin. Trazodone The serum concentration of Trazodone can be increased when it is combined with Midostaurin. Tretinoin The metabolism of Tretinoin can be decreased when combined with Midostaurin. Triamcinolone The metabolism of Triamcinolone can be decreased when combined with Midostaurin. Triazolam The metabolism of Triazolam can be decreased when combined with Midostaurin. Triclabendazole The metabolism of Triclabendazole can be decreased when combined with Midostaurin. Trilostane The metabolism of Trilostane can be decreased when combined with Midostaurin. Trimebutine The metabolism of Trimebutine can be decreased when combined with Midostaurin. Trimethadione The metabolism of Trimethadione can be decreased when combined with Midostaurin. Trimethoprim The metabolism of Trimethoprim can be decreased when combined with Midostaurin. Trofinetide The metabolism of Midostaurin can be decreased when combined with Trofinetide. Troglitazone The metabolism of Midostaurin can be increased when combined with Troglitazone. Troleandomycin The metabolism of Midostaurin can be decreased when combined with Troleandomycin. Tucatinib The metabolism of Tucatinib can be increased when combined with Midostaurin. Ubrogepant The serum concentration of Ubrogepant can be increased when it is combined with Midostaurin. Udenafil The metabolism of Udenafil can be decreased when combined with Midostaurin. Ulipristal The metabolism of Ulipristal can be increased when combined with Midostaurin. Upadacitinib The metabolism of Upadacitinib can be increased when combined with Midostaurin. Valbenazine The metabolism of Valbenazine can be decreased when combined with Midostaurin. Valdecoxib The metabolism of Valdecoxib can be decreased when combined with Midostaurin. Valproic acid The metabolism of Midostaurin can be decreased when combined with Valproic acid. Vandetanib The metabolism of Vandetanib can be decreased when combined with Midostaurin. Vardenafil The metabolism of Vardenafil can be decreased when combined with Midostaurin. Velpatasvir The metabolism of Velpatasvir can be decreased when combined with Midostaurin. Vemurafenib The metabolism of Vemurafenib can be decreased when combined with Midostaurin. Venetoclax The metabolism of Venetoclax can be decreased when combined with Midostaurin. Venlafaxine The metabolism of Venlafaxine can be decreased when combined with Midostaurin. Verapamil The metabolism of Verapamil can be decreased when combined with Midostaurin. Vilanterol The metabolism of Vilanterol can be decreased when combined with Midostaurin. Vilazodone The metabolism of Vilazodone can be decreased when combined with Midostaurin. Viloxazine The metabolism of Midostaurin can be decreased when combined with Viloxazine. Vinblastine The metabolism of Vinblastine can be decreased when combined with Midostaurin. Vincristine The metabolism of Vincristine can be decreased when combined with Midostaurin. Vindesine The metabolism of Vindesine can be decreased when combined with Midostaurin. Vinflunine The metabolism of Vinflunine can be decreased when combined with Midostaurin. Vinorelbine The metabolism of Vinorelbine can be decreased when combined with Midostaurin. Vismodegib The metabolism of Vismodegib can be decreased when combined with Midostaurin. Vitamin D The metabolism of Vitamin D can be decreased when combined with Midostaurin. Vitamin E The metabolism of Vitamin E can be decreased when combined with Midostaurin. Voclosporin The metabolism of Voclosporin can be decreased when combined with Midostaurin. Vonoprazan The therapeutic efficacy of Vonoprazan can be decreased when used in combination with Midostaurin. Vorapaxar The metabolism of Vorapaxar can be decreased when combined with Midostaurin. Voriconazole The serum concentration of Midostaurin can be increased when it is combined with Voriconazole. Vortioxetine The metabolism of Vortioxetine can be increased when combined with Midostaurin. Voxelotor The serum concentration of Midostaurin can be increased when it is combined with Voxelotor. Voxilaprevir The metabolism of Voxilaprevir can be decreased when combined with Midostaurin. Warfarin The metabolism of Warfarin can be decreased when combined with Midostaurin. Yohimbine The metabolism of Yohimbine can be decreased when combined with Midostaurin. Zafirlukast The metabolism of Midostaurin can be decreased when combined with Zafirlukast. Zaleplon The metabolism of Zaleplon can be decreased when combined with Midostaurin. Zanubrutinib The metabolism of Zanubrutinib can be increased when combined with Midostaurin. Zidovudine The metabolism of Zidovudine can be decreased when combined with Midostaurin. Zileuton The metabolism of Zileuton can be decreased when combined with Midostaurin. Drug-Food Interactions Avoid St. John’s Wort. This herb induces the CYP3A4 metabolism of midostaurin and may reduce its serum concentration. Exercise caution with grapefruit products. Grapefruit inhibits the CYP3A4 metabolism of midostaurin, which may increase its serum concentration. Take with food. Taking midostaurin with food increases the AUC, but it also prolongs the Tmax and reduces Cmax. Pregnancy and Lactations AU TGA pregnancy category: D US FDA pregnancy category: Not Assigned Pregnancy Lactation No information is available on the clinical use of midostaurin during breastfeeding. Because midostaurin and its active metabolites are 99.8% bound to plasma proteins, the amount in milk is likely to be low. The manufacturer recommends that breastfeeding be discontinued during midostaurin therapy and for at least 4 months after the last dose. Avoiding breastfeeding is particularly important when midostaurin is given with other cancer chemotherapy agents. Why is this medication prescribed? Midostaurin is used with other chemotherapy drugs to treat certain types of acute myeloid leukemia (AML; a type of cancer of the white blood cells). Midostaurin is also used to certain types of mastocytosis (a blood disorder in which there are too many mast cells [a certain kind of white blood cell]). Midostaurin is in a class of medications called kinase inhibitors. It works by blocking the action of the abnormal protein that signals cancer cells to multiply. This helps stop the spread of mast and cancer cells. How should this medicine be used? Midostaurin comes as a capsule to take by mouth. It is usually taken with food twice a day. Take midostaurin at around the same times 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 midostaurin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Swallow the capsules whole; do not open or crush them. If you vomit after taking midostaurin, do not take another dose. Continue your regular dosing schedule. Your doctor may decrease your dose of midostaurin or tell you to stop taking midostaurin for a period of time or permanently during your treatment. This depends on the side effects you experience. Talk to your doctor about how you are feeling during your treatment. Continue to take midostaurin even if you feel well. Do not stop taking midostaurin without talking to your doctor. Your doctor may tell you to take medication to prevent nausea and vomiting before each dose of midostaurin. Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient. Other uses for this medicine This medication may be prescribed for other uses; ask your doctor or pharmacist for more information. What special precautions should I follow? Before taking midostaurin, tell your doctor and pharmacist if you are allergic to midostaurin, any other medications, or any of the ingredients in midostaurin capsules. Ask your pharmacist for a list of the ingredients. tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take. Be sure to mention any of the following: boceprevir (no longer available in the U.S.; Victrelis); carbamazepine (Carbatrol, Equetro, Tegretol, others); clarithromycin (Biaxin, in Prevpac); diltiazem (Cardizem, Cartia, Tiazac, others); enzalutamide (Xtandi); idelalisib (Zydelig); itraconazole (Onmel, Sporanox); ketoconazole (Nizoral); medications used to treat human immunodeficiency virus (HIV) such as cobicistat (Tybost, in Evotaz, in Genvoya, in Prezcobix, in Stribild), elvitegravir (Vitekta), indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir, in Kaletra, in Technivie, in Viekira), saquinavir (Invirase) and tipranavir (Aptivus); mitotane (Lysodren); nefazodone; phenytoin (Dilantin, Phenytek); posaconazole (Noxafil); rifampin (Rifadin, Rimactane, in Rifamate, in Rifater); troleandomycin (not available in the U.S.); and voriconazole (Vfend). 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 midostaurin, 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 what herbal products you are taking, especially St. John’s wort. tell your doctor if you have or have ever had an irregular heartbeat, QT prolongation (a heart problem that may cause irregular heartbeat, fainting, or sudden death), lung, liver, or kidney disease. tell your doctor if you are pregnant or plan to become pregnant. If you are a female, you should not become pregnant while you are taking midostaurin and for up to 4 months after your final dose. You will need to have a negative pregnancy test within 7 days before you start taking midostaurin. Talk to your doctor about birth control methods that will work for you. If you are male, you and your female partner should use birth control during your treatment and continue to use birth control for 4 months after your final dose. If you or your partner become pregnant while taking midostaurin, call your doctor immediately. Midostaurin may harm the fetus. tell your doctor if you are breastfeeding. You should not breastfeed while you are taking midostaurin and for 4 months after your final dose. you should know that this medication may decrease fertility in men and women. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/207997s000lbl.pdf https://www.fda.gov/drugs/resources-information-approved-drugs/midostaurin https://www.accessdata.fda.gov/drugsatfda_docs/nda/2017/207997Orig1Orig2s000MedR.pdf https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/207997Orig1Orig2s000ClinPharmR.pdf https://www.accessdata.fda.gov/drugsatfda_docs/nda/2021/207997Orig1Orig2s000PharmR.pdf https://pubchem.ncbi.nlm.nih.gov/compound/Midostaurin https://pubchem.ncbi.nlm.nih.gov/compound/Midostaurin-hydrate https://www.cancer.gov/about-cancer/treatment/drugs/midostaurin https://go.drugbank.com/drugs/DB06595 https://en.wikipedia.org/wiki/Midostaurin https://medlineplus.gov/druginfo/meds/a617033.html https://www.mayoclinic.org/drugs-supplements/midostaurin-oral-route/precautions/drg-20406228?p=1 https://www.drugs.com/pregnancy/midostaurin.html https://www.webmd.com/drugs/2/drug-173575/midostaurin-oral/details/list-contraindications ChEBI http://www.ebi.ac.uk/chebi/searchId.do?chebiId=CHEBI:63452 http://www.ebi.ac.uk/chebi/userManualForward.do#ChEBI%20Ontology DrugBank https://www.drugbank.ca/legal/terms_of_use https://www.drugbank.ca/drugs/DB06595 FDA Pharm Classes https://www.fda.gov/about-fda/about-website/website-policies#linking https://dailymed.nlm.nih.gov/dailymed/browse-drug-classes.cfm https://www.fda.gov/ForIndustry/DataStandards/StructuredProductLabeling/ucm162549.htm LiverTox https://www.nlm.nih.gov/copyright.html https://www.ncbi.nlm.nih.gov/books/n/livertox/Midostaurin/ NCI Thesaurus (NCIt) https://www.cancer.gov/policies/copyright-reuse https://ncithesaurus.nci.nih.gov/ncitbrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&ns=ncit&code=C1872 https://ncit.nci.nih.gov ChEMBL http://www.ebi.ac.uk/Information/termsofuse.html https://www.ebi.ac.uk/chembl/compound_report_card/CHEMBL608533/ https://www.ebi.ac.uk/chembl/g/#browse/targets Comparative Toxicogenomics Database (CTD) http://ctdbase.org/about/legal.jsp https://ctdbase.org/detail.go?type=chem&acc=C059539 Drug Gene Interaction database (DGIdb) http://www.dgidb.org/downloads https://www.dgidb.org/drugs/MIDOSTAURIN IUPHAR/BPS Guide to PHARMACOLOGY https://www.guidetopharmacology.org/about.jsp#license https://www.guidetopharmacology.org/GRAC/LigandDisplayForward?ligandId=5702 https://www.guidetopharmacology.org/targets.jsp Therapeutic Target Database (TTD) https://idrblab.net/ttd/data/drug/details/D07NVU ChemIDplus https://www.nlm.nih.gov/copyright.html https://pubchem.ncbi.nlm.nih.gov/substance/?source=chemidplus&sourceid=0120685112 https://pubchem.ncbi.nlm.nih.gov/source/ChemIDplus European Chemicals Agency (ECHA) https://echa.europa.eu/web/guest/legal-notice https://echa.europa.eu/information-on-chemicals https://echa.europa.eu/information-on-chemicals/cl-inventory-database/-/discli/details/294191 FDA Global Substance Registration System (GSRS) https://www.fda.gov/about-fda/about-website/website-policies#linking https://gsrs.ncats.nih.gov/ginas/app/beta/substances/ID912S5VON ClinicalTrials.gov https://clinicaltrials.gov/ct2/about-site/terms-conditions#Use https://clinicaltrials.gov/ DailyMed https://www.nlm.nih.gov/copyright.html https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=MIDOSTAURIN European Medicines Agency (EMA) https://www.ema.europa.eu/en/about-us/legal-notice https://www.ema.europa.eu/en/medicines/human/EPAR/rydapt Drugs and Lactation Database (LactMed) https://www.nlm.nih.gov/copyright.html https://www.ncbi.nlm.nih.gov/books/n/lactmed/LM1319/ EU Clinical Trials Register https://www.clinicaltrialsregister.eu/ FDA Orange Book https://www.fda.gov/about-fda/about-website/website-policies#linking https://www.fda.gov/drugs/drug-approvals-and-databases/approved-drug-products-therapeutic-equivalence-evaluations-orange-book WHO Anatomical Therapeutic Chemical (ATC) Classification https://www.whocc.no/copyright_disclaimer/ https://www.whocc.no/atc_ddd_index/?code=L01EX10 https://www.whocc.no/atc_ddd_index/ National Drug Code (NDC) Directory https://www.fda.gov/about-fda/about-website/website-policies#linking https://www.fda.gov/drugs/drug-approvals-and-databases/national-drug-code-directory Japan Chemical Substance Dictionary (Nikkaji) http://jglobal.jst.go.jp/en/redirect?Nikkaji_No=J1.312.230J Metabolomics Workbench https://www.metabolomicsworkbench.org/data/StructureData.php?RegNo=62790 Natural Product Activity and Species Source (NPASS) https://bidd.group/NPASS/compound.php?compoundID=NPC484828 NCI Cancer Drugs https://www.cancer.gov/policies/copyright-reuse https://www.cancer.gov/about-cancer/treatment/drugs/midostaurin NLM RxNorm Terminology https://www.nlm.nih.gov/research/umls/rxnorm/docs/termsofservice.html https://rxnav.nlm.nih.gov/id/rxnorm/1919083 Pharos https://pharos.nih.gov/about https://pharos.nih.gov/ligands/GKJ653JJL4Q5 Protein Data Bank in Europe (PDBe) http://www.ebi.ac.uk/pdbe-srv/pdbechem/chemicalCompound/show/2K2 RCSB Protein Data Bank (RCSB PDB) https://www.rcsb.org/pages/policies https://www.rcsb.org/ Springer Nature https://pubchem.ncbi.nlm.nih.gov/substance/?source=15745&sourceid=43071258-453396404 Thieme Chemistry https://creativecommons.org/licenses/by-nc-nd/4.0/ https://pubchem.ncbi.nlm.nih.gov/substance/?source=22163&sourceid=43071258-453397039 Wikidata https://creativecommons.org/publicdomain/zero/1.0/ https://www.wikidata.org/wiki/Q6842945 Wikipedia https://en.wikipedia.org/wiki/Midostaurin https://pubchem.ncbi.nlm.nih.gov Medical Subject Headings (MeSH) https://www.nlm.nih.gov/copyright.html https://www.ncbi.nlm.nih.gov/mesh/67059539 http://www.nlm.nih.gov/mesh/meshhome.html https://www.ncbi.nlm.nih.gov/mesh/68000970 https://www.ncbi.nlm.nih.gov/mesh/68047428 KEGG https://www.kegg.jp/kegg/legal.html http://www.genome.jp/kegg-bin/get_htext?br08302.keg http://www.genome.jp/kegg-bin/get_htext?br08303.keg http://www.genome.jp/kegg-bin/get_htext?br08310.keg http://www.genome.jp/kegg-bin/get_htext?br08330.keg UN Globally Harmonized System of Classification and Labelling of Chemicals (GHS) http://www.unece.org/trans/danger/publi/ghs/ghs_welcome_e.html NORMAN Suspect List Exchange https://creativecommons.org/licenses/by/4.0/ https://www.norman-network.com/nds/SLE/ PATENTSCOPE (WIPO) https://pubchem.ncbi.nlm.nih.gov/substance/388803032 References