Ponatinib - Uses, Dosage, Side Effects, Interaction

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

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

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

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

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

Mechanism of Action

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

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

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

Indications

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

Contraindications

anemia
decreased blood platelets
low levels of a type of white blood cell called neutrophils
high blood pressure
a heart attack
acute blood clot in the heart
coronary artery disease
slow heartbeat
supraventricular arrhythmias, a type of abnormal heart rhythm
chronic heart failure
sudden and serious symptoms of heart failure called acute decompensated heart failure
a blood clot in the brain
a stroke
a localized weakening and ballooning in an artery wall called an arterial aneurysm
obstruction of a blood vessel by a blood clot
a blood clot in an artery
peripheral vascular disease
blood clot formation in vein
bleeding
blockage or closing off of blood vessels
damage to the liver and inflammation
recent operation
visible water retention
abnormal liver function tests
impaired wound healing
pregnancy
a patient who is producing milk and breastfeeding
a rupture in the wall of the stomach or intestine
reactivation of hepatitis B infection
pancreatitis
a type of brain disorder called posterior reversible encephalopathy syndrome
dissection of artery

Dosage

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

Chronic Myelogenous Leukemia

Chronic phase chronic myeloid leukemia (CP-CML):

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

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

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

Acute Lymphoblastic Leukemia

Chronic phase chronic myeloid leukemia (CP-CML):

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

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

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

Liver Dose Adjustments

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

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

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

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

Dose Adjustments

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

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

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

RECOMMENDED DOSE REDUCTION FOR ADVERSE REACTIONS:

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

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

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

ELEVATED LIPASE/PANCREATITIS:

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

MYELOSUPPRESSION:

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

ARTERIAL OCCLUSIVE EVENTS:
Cardiovascular or Cerebrovascular:

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

Peripheral vascular and other or venous thromboembolic events:

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

HEART FAILURE:

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

OTHER NON-HEMATOLOGIC ADVERSE REACTIONS:

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

Administration Advice:

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

Monitoring:

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

Patient Advice:

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

Side Effects

The Most Common

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

More common

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

Rare

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

Drug Interactions

DRUG	INTERACTION
Abaloparatide	The therapeutic efficacy of Abaloparatide can be decreased when used in combination with Ponatinib.
Abametapir	The serum concentration of Ponatinib can be increased when it is combined with Abametapir.
Abatacept	The metabolism of Ponatinib can be increased when combined with Abatacept.
Abciximab	The risk or severity of bleeding can be increased when Abciximab is combined with Ponatinib.
Abemaciclib	The serum concentration of Abemaciclib can be increased when it is combined with Ponatinib.
Abiraterone	The metabolism of Ponatinib can be decreased when combined with Abiraterone.
Acalabrutinib	The metabolism of Ponatinib can be decreased when combined with Acalabrutinib.
Acebutolol	The metabolism of Ponatinib can be decreased when combined with Acebutolol.
Acenocoumarol	The risk or severity of bleeding can be increased when Acenocoumarol is combined with Ponatinib.
Acetaminophen	The metabolism of Ponatinib can be increased when combined with Acetaminophen.
Acetazolamide	The metabolism of Ponatinib can be decreased when combined with Acetazolamide.
Acetylsalicylic acid	The risk or severity of bleeding can be increased when Acetylsalicylic acid is combined with Ponatinib.
Adalimumab	The metabolism of Ponatinib can be increased when combined with Adalimumab.
Adenovirus	The risk or severity of infection can be increased when Adenovirus type 7 vaccine live is combined with Ponatinib.
Afatinib	The serum concentration of Afatinib can be increased when it is combined with Ponatinib.
Albendazole	The metabolism of Ponatinib can be decreased when combined with Albendazole.
Aldesleukin	The metabolism of Ponatinib can be decreased when combined with Aldesleukin.
Alectinib	Alectinib may decrease the excretion rate of Ponatinib which could result in a higher serum level.
Alefacept	The risk or severity of adverse effects can be increased when Alefacept is combined with Ponatinib.
Alemtuzumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Ponatinib.
Alfentanil	The metabolism of Ponatinib can be decreased when combined with Alfentanil.
Allogeneic	The therapeutic efficacy of Allogeneic processed thymus tissue can be decreased when used in combination with Ponatinib.
Allopurinol	The risk or severity of adverse effects can be increased when Allopurinol is combined with Ponatinib.
Almotriptan	The metabolism of Ponatinib can be decreased when combined with Almotriptan.
Alogliptin	The metabolism of Ponatinib can be decreased when combined with Alogliptin.
Alpelisib	The serum concentration of Alpelisib can be increased when it is combined with Ponatinib.
Alprazolam	The metabolism of Ponatinib can be decreased when combined with Alprazolam.
Alteplase	The risk or severity of bleeding can be increased when Alteplase is combined with Ponatinib.
Altretamine	The risk or severity of adverse effects can be increased when Altretamine is combined with Ponatinib.
Ambrisentan	The metabolism of Ponatinib can be decreased when combined with Ambrisentan.
Aminoglutethimide	The metabolism of Ponatinib can be increased when combined with Aminoglutethimide.
Aminophenazone	The metabolism of Ponatinib can be decreased when combined with Aminophenazone.
Amiodarone	The metabolism of Ponatinib can be decreased when combined with Amiodarone.
Amitriptyline	The metabolism of Ponatinib can be decreased when combined with Amitriptyline.
Amobarbital	The metabolism of Ponatinib can be increased when combined with Amobarbital.
Amodiaquine	The metabolism of Ponatinib can be decreased when combined with Amodiaquine.
Amoxapine	The metabolism of Ponatinib can be decreased when combined with Amoxapine.
Amphetamine	The metabolism of Ponatinib can be decreased when combined with Amphetamine.
Amprenavir	The metabolism of Ponatinib can be decreased when combined with Amprenavir.
Amsacrine	The risk or severity of adverse effects can be increased when Amsacrine is combined with Ponatinib.
Anagrelide	The risk or severity of bleeding can be increased when Anagrelide is combined with Ponatinib.
Anakinra	The metabolism of Ponatinib can be increased when combined with Anakinra.
Anastrozole	The metabolism of Ponatinib can be decreased when combined with Anastrozole.
Ancrod	The risk or severity of bleeding can be increased when Ancrod is combined with Ponatinib.
Anifrolumab	The risk or severity of adverse effects can be increased when Ponatinib is combined with Anifrolumab.
Anistreplase	The risk or severity of bleeding can be increased when Anistreplase is combined with Ponatinib.
Anthrax immune	The therapeutic efficacy of Anthrax immune globulin human can be decreased when used in combination with Ponatinib.
Anthrax vaccine	The risk or severity of infection can be increased when Anthrax vaccine is combined with Ponatinib.
Antilymphocyte	The risk or severity of adverse effects can be increased when Ponatinib is combined with Antilymphocyte immunoglobulin (horse).
Antipyrine	The metabolism of Ponatinib can be decreased when combined with Antipyrine.
Antithrombin Alfa	The risk or severity of bleeding can be increased when Antithrombin Alfa is combined with Ponatinib.
Antithrombin III	The risk or severity of bleeding can be increased when Antithrombin III human is combined with Ponatinib.
Antithymocyte	The risk or severity of adverse effects can be increased when Antithymocyte immunoglobulin (rabbit) is combined with Ponatinib.
Apalutamide	The metabolism of Ponatinib can be increased when combined with Apalutamide.
Apixaban	The metabolism of Ponatinib can be decreased when combined with Apixaban.
Apomorphine	The metabolism of Ponatinib can be decreased when combined with Apomorphine.
Apremilast	The metabolism of Ponatinib can be increased when combined with Apremilast.
Aprepitant	The metabolism of Ponatinib can be decreased when combined with Aprepitant.
Ardeparin	The risk or severity of bleeding can be increased when Ardeparin is combined with Ponatinib.
Arformoterol	The metabolism of Ponatinib can be decreased when combined with Arformoterol.
Argatroban	The risk or severity of bleeding can be increased when Argatroban is combined with Ponatinib.
Aripiprazole	The metabolism of Ponatinib can be decreased when combined with Aripiprazole.
Aripiprazole	The metabolism of Ponatinib can be decreased when combined with Aripiprazole lauroxil.
Armodafinil	The metabolism of Ponatinib can be increased when combined with Armodafinil.
Arsenic trioxide	The risk or severity of adverse effects can be increased when Arsenic trioxide is combined with Ponatinib.
Artemether	The metabolism of Ponatinib can be decreased when combined with Artemether.
Artenimol	The metabolism of Ponatinib can be decreased when combined with Artenimol.
Articaine	The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Articaine.
Asciminib	The serum concentration of Ponatinib can be increased when it is combined with Asciminib.
Astemizole	The metabolism of Ponatinib can be decreased when combined with Astemizole.
ACOVID-19 Vacci	The therapeutic efficacy of AstraZeneca COVID-19 Vaccine can be decreased when used in combination with Ponatinib.
Asunaprevir	The metabolism of Ponatinib can be decreased when combined with Asunaprevir.
Atazanavir	The metabolism of Ponatinib can be decreased when combined with Atazanavir.
Atenolol	The metabolism of Ponatinib can be decreased when combined with Atenolol.
Atomoxetine	The metabolism of Ponatinib can be decreased when combined with Atomoxetine.
Atorvastatin	The metabolism of Ponatinib can be decreased when combined with Atorvastatin.
Avacopan	The metabolism of Ponatinib can be decreased when combined with Avacopan.
Avanafil	The serum concentration of Avanafil can be increased when it is combined with Ponatinib.
Avatrombopag	The metabolism of Ponatinib can be increased when combined with Avatrombopag.
Axitinib	The serum concentration of Axitinib can be increased when it is combined with Ponatinib.
Azacitidine	The risk or severity of adverse effects can be increased when Azacitidine is combined with Ponatinib.
Azathioprine	The risk or severity of adverse effects can be increased when Azathioprine is combined with Ponatinib.
Azelastine	The metabolism of Ponatinib can be decreased when combined with Azelastine.
Azithromycin	The metabolism of Ponatinib can be decreased when combined with Azithromycin.
Bacillus antigen	The risk or severity of infection can be increased when Bacillus calmette-guerin substrain connaught live antigen is combined with Ponatinib.
Bacillus	The therapeutic efficacy of Bacillus calmette-guerin substrain russian BCG-I live antigen can be decreased when used in combination with Ponatinib.
Bacillus calmette	The risk or severity of infection can be increased when Bacillus calmette-guerin substrain tice live antigen is combined with Ponatinib.
Baricitinib	The risk or severity of adverse effects can be increased when Ponatinib is combined with Baricitinib.
Basiliximab	The risk or severity of adverse effects can be increased when Basiliximab is combined with Ponatinib.
BCG vaccine	The risk or severity of infection can be increased when BCG vaccine is combined with Ponatinib.
Beclomethasone	The metabolism of Ponatinib can be increased when combined with Beclomethasone dipropionate.
Belantamab	The serum concentration of Belantamab mafodotin can be increased when it is combined with Ponatinib.
Belatacept	The risk or severity of adverse effects can be increased when Belatacept is combined with Ponatinib.
Belimumab	The risk or severity of adverse effects can be increased when Belimumab is combined with Ponatinib.
Belinostat	The risk or severity of adverse effects can be increased when Belinostat is combined with Ponatinib.
Belumosudil	The risk or severity of adverse effects can be increased when Ponatinib is combined with Belumosudil.
Belzutifan	The serum concentration of Ponatinib can be decreased when it is combined with Belzutifan.
Bemiparin	The risk or severity of bleeding can be increased when Bemiparin is combined with Ponatinib.
Bendamustine	The serum concentration of Bendamustine can be increased when it is combined with Ponatinib.
Bendroflumethia	The risk or severity of neutropenia and thrombocytopenia can be increased when Bendroflumethiazide is combined with Ponatinib.

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Benzatropine	The metabolism of Ponatinib can be decreased when combined with Benzatropine.
Benzocaine	The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Benzocaine.
Benzthiazide	The risk or severity of neutropenia and thrombocytopenia can be increased when Benzthiazide is combined with Ponatinib.
Benzyl alcohol	The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Benzyl alcohol.
Bepridil	The metabolism of Ponatinib can be decreased when combined with Bepridil.
Berotralstat	The serum concentration of Berotralstat can be increased when it is combined with Ponatinib.
Betamethasone	The metabolism of Ponatinib can be increased when combined with Betamethasone.
Betamethasone	The metabolism of Ponatinib can be increased when combined with Betamethasone phosphate.
Betaxolol	The metabolism of Ponatinib can be decreased when combined with Betaxolol.
Betrixaban	The serum concentration of Betrixaban can be increased when it is combined with Ponatinib.
Bexarotene	The metabolism of Ponatinib can be increased when combined with Bexarotene.
Bezafibrate	The metabolism of Ponatinib can be decreased when combined with Bezafibrate.
Bicalutamide	The metabolism of Ponatinib can be decreased when combined with Bicalutamide.
Bifonazole	The metabolism of Ponatinib can be decreased when combined with Bifonazole.
Bimekizumab	The metabolism of Ponatinib can be increased when combined with Bimekizumab.
Binimetinib	The serum concentration of Binimetinib can be increased when it is combined with Ponatinib.
Biperiden	The metabolism of Ponatinib can be decreased when combined with Biperiden.
Bisoprolol	The serum concentration of Bisoprolol can be increased when it is combined with Ponatinib.
Bivalirudin	The risk or severity of bleeding can be increased when Bivalirudin is combined with Ponatinib.
Bleomycin	The risk or severity of adverse effects can be increased when Bleomycin is combined with Ponatinib.
Blinatumomab	The risk or severity of adverse effects can be increased when Ponatinib is combined with Blinatumomab.
Boceprevir	The metabolism of Ponatinib can be decreased when combined with Boceprevir.
Bordetella	The therapeutic efficacy of Bordetella pertussis toxoid antigen (formaldehyde, glutaraldehyde inactivated) can be decreased when used in combination with Ponatinib.
Bortezomib	The serum concentration of Bortezomib can be increased when it is combined with Ponatinib.
Bosentan	The metabolism of Ponatinib can be increased when combined with Bosentan.
Bosutinib	The serum concentration of Bosutinib can be increased when it is combined with Ponatinib.
Brentuximab	The serum concentration of Brentuximab vedotin can be increased when it is combined with Ponatinib.
Brexpiprazole	The metabolism of Ponatinib can be decreased when combined with Brexpiprazole.
Brigatinib	The metabolism of Brigatinib can be decreased when combined with Ponatinib.
Brodalumab	The risk or severity of adverse effects can be increased when Ponatinib is combined with Brodalumab.
Budesonide	The metabolism of Ponatinib can be increased when combined with Budesonide.
Bupivacaine	The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Bupivacaine.
Buprenorphine	The metabolism of Ponatinib can be decreased when combined with Buprenorphine.
Bupropion	The metabolism of Ponatinib can be decreased when combined with Bupropion.
Buspirone	The metabolism of Ponatinib can be decreased when combined with Buspirone.
Busulfan	The risk or severity of adverse effects can be increased when Busulfan is combined with Ponatinib.
Butacaine	The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Butacaine.
Butalbital	The metabolism of Ponatinib can be increased when combined with Butalbital.
Butamben	The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Butamben.
Cabazitaxel	The serum concentration of Cabazitaxel can be increased when it is combined with Ponatinib.
Cabergoline	The serum concentration of Cabergoline can be increased when it is combined with Ponatinib.
Cabozantinib	The metabolism of Ponatinib can be decreased when combined with Cabozantinib.
Caffeine	Caffeine may decrease the excretion rate of Ponatinib which could result in a higher serum level.
Calcitriol	The metabolism of Ponatinib can be increased when combined with Calcitriol.
Canagliflozin	The serum concentration of Canagliflozin can be increased when it is combined with Ponatinib.
Canakinumab	The metabolism of Ponatinib can be increased when combined with Canakinumab.
Candesartan	The metabolism of Ponatinib can be decreased when combined with Candesartan cilexetil.
Candicidin	The metabolism of Ponatinib can be decreased when combined with Candicidin.
Cangrelor	The risk or severity of bleeding can be increased when Cangrelor is combined with Ponatinib.
Cannabidiol	The metabolism of Ponatinib can be decreased when combined with Cannabidiol.
Capecitabine	The risk or severity of adverse effects can be increased when Capecitabine is combined with Ponatinib.
Caplacizumab	The risk or severity of bleeding can be increased when Caplacizumab is combined with Ponatinib.
Capmatinib	The serum concentration of Ponatinib can be increased when it is combined with Capmatinib.
Capsaicin	The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Capsaicin.
Carbamazepine	The metabolism of Ponatinib can be increased when combined with Carbamazepine.
Carbimazole	The therapeutic efficacy of Carbimazole can be decreased when used in combination with Ponatinib.
Carboplatin	The risk or severity of adverse effects can be increased when Carboplatin is combined with Ponatinib.
Carfilzomib	The serum concentration of Carfilzomib can be increased when it is combined with Ponatinib.
Carmustine	The risk or severity of adverse effects can be increased when Carmustine is combined with Ponatinib.
Carvedilol	The metabolism of Ponatinib can be decreased when combined with Carvedilol.
Cefradine	The metabolism of Ponatinib can be increased when combined with Cefradine.
Celecoxib	The metabolism of Ponatinib can be decreased when combined with Celecoxib.
Celiprolol	The metabolism of Ponatinib can be decreased when combined with Celiprolol.
Cenobamate	The serum concentration of Ponatinib can be decreased when it is combined with Cenobamate.
Cephalexin	The metabolism of Ponatinib can be decreased when combined with Cephalexin.
Ceritinib	The serum concentration of Ceritinib can be increased when it is combined with Ponatinib.
Cerivastatin	The metabolism of Ponatinib can be increased when combined with Cerivastatin.
Certolizumab	The metabolism of Ponatinib can be increased when combined with Certolizumab pegol.
Cevimeline	The metabolism of Ponatinib can be decreased when combined with Cevimeline.
Chlorambucil	The risk or severity of adverse effects can be increased when Chlorambucil is combined with Ponatinib.
Chloramphenicol	The metabolism of Ponatinib can be decreased when combined with Chloramphenicol.
Chloroprocaine	The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Chloroprocaine.
Chloroquine	The metabolism of Ponatinib can be decreased when combined with Chloroquine.
Chlorothiazide	The risk or severity of neutropenia and thrombocytopenia can be increased when Chlorothiazide is combined with Ponatinib.
Chlorpheniramine	The metabolism of Ponatinib can be decreased when combined with Chlorpheniramine.
Chlorpromazine	The metabolism of Ponatinib can be decreased when combined with Chlorpromazine.
Chlorzoxazone	The metabolism of Ponatinib can be decreased when combined with Chlorzoxazone.
Cholecalciferol	The metabolism of Ponatinib can be decreased when combined with Cholecalciferol.
Cholesterol	Cholesterol may increase the excretion rate of Ponatinib which could result in a lower serum level and potentially a reduction in efficacy.
Ciclesonide	The metabolism of Ponatinib can be decreased when combined with Ciclesonide.
Cilostazol	The metabolism of Ponatinib can be decreased when combined with Cilostazol.
Cimetidine	The metabolism of Ponatinib can be decreased when combined with Cimetidine.
Cinacalcet	The metabolism of Ponatinib can be decreased when combined with Cinacalcet.
Cinchocaine	The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Cinchocaine.
Cinnarizine	The metabolism of Ponatinib can be decreased when combined with Cinnarizine.
Ciprofloxacin	The metabolism of Ponatinib can be decreased when combined with Ciprofloxacin.
Cisapride	The metabolism of Ponatinib can be decreased when combined with Cisapride.
Cisplatin	The risk or severity of adverse effects can be increased when Cisplatin is combined with Ponatinib.
Citalopram	The metabolism of Ponatinib can be decreased when combined with Citalopram.
Cladribine	The risk or severity of adverse effects can be increased when Cladribine is combined with Ponatinib.
Clarithromycin	The metabolism of Ponatinib can be decreased when combined with Clarithromycin.
Clemastine	The metabolism of Ponatinib can be decreased when combined with Clemastine.
Clevidipine	The metabolism of Ponatinib can be increased when combined with Clevidipine.
Clindamycin	The metabolism of Ponatinib can be decreased when combined with Clindamycin.
Clobazam	The metabolism of Ponatinib can be decreased when combined with Clobazam.
Clobetasol	The metabolism of Ponatinib can be increased when combined with Clobetasol propionate.
Clofarabine	The risk or severity of adverse effects can be increased when Clofarabine is combined with Ponatinib.
Clofazimine	The metabolism of Ponatinib can be decreased when combined with Clofazimine.
Clofibrate	The metabolism of Ponatinib can be increased when combined with Clofibrate.
Clomifene	The serum concentration of Clomifene can be increased when it is combined with Ponatinib.

Clomipramine	The metabolism of Ponatinib can be decreased when combined with Clomipramine.
Clonidine	The metabolism of Ponatinib can be decreased when combined with Clonidine.
Clopidogrel	The metabolism of Ponatinib can be decreased when combined with Clopidogrel.
Clostridium	The therapeutic efficacy of Clostridium tetani toxoid antigen (formaldehyde inactivated) can be decreased when used in combination with Ponatinib.
Clozapine	The risk or severity of neutropenia can be increased when Ponatinib is combined with Clozapine.
Cobicistat	The metabolism of Ponatinib can be decreased when combined with Cobicistat.
Cobimetinib	The serum concentration of Cobimetinib can be increased when it is combined with Ponatinib.
Cocaine	The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Cocaine.
Codeine	The metabolism of Ponatinib can be decreased when combined with Codeine.
Colchicine	The serum concentration of Colchicine can be increased when it is combined with Ponatinib.
Conivaptan	The metabolism of Ponatinib can be decreased when combined with Conivaptan.
Conestrogens	Ponatinib may decrease the excretion rate of Conjugated estrogens which could result in a higher serum level.
Copanlisib	The serum concentration of Copanlisib can be increased when it is combined with Ponatinib.
Corticotropin	The metabolism of Ponatinib can be increased when combined with Corticotropin.
Cortisone acetate	The metabolism of Ponatinib can be increased when combined with Cortisone acetate.
Corynebacterium	The therapeutic efficacy of Corynebacterium diphtheriae toxoid antigen (formaldehyde inactivated) can be decreased when used in combination with Ponatinib.
Crizotinib	The metabolism of Ponatinib can be decreased when combined with Crizotinib.
Curcumin	The metabolism of Ponatinib can be decreased when combined with Curcumin.
Cyanocobalamin	The therapeutic efficacy of Cyanocobalamin can be decreased when used in combination with Ponatinib.
Cyclopenthiazide	The risk or severity of neutropenia and thrombocytopenia can be increased when Cyclopenthiazide is combined with Ponatinib.
Cyclophosphamide	The metabolism of Ponatinib can be increased when combined with Cyclophosphamide.
Cyclosporine	Ponatinib may increase the immunosuppressive activities of Cyclosporine.
Cyclothiazide	The risk or severity of neutropenia and thrombocytopenia can be increased when Cyclothiazide is combined with Ponatinib.
Cyproterone	The metabolism of Ponatinib can be decreased when combined with Cyproterone acetate.
Cytarabine	The risk or severity of adverse effects can be increased when Cytarabine is combined with Ponatinib.
Dabigatran	The risk or severity of bleeding can be increased when Dabigatran is combined with Ponatinib.
Dabigatran	The serum concentration of Dabigatran etexilate can be increased when it is combined with Ponatinib.
Dabrafenib	The serum concentration of Ponatinib can be decreased when it is combined with Dabrafenib.
Dacarbazine	The risk or severity of adverse effects can be increased when Dacarbazine is combined with Ponatinib.
Daclatasvir	The metabolism of Ponatinib can be decreased when combined with Daclatasvir.
Dacomitinib	The serum concentration of Dacomitinib can be increased when it is combined with Ponatinib.
Dactinomycin	The serum concentration of Dactinomycin can be increased when it is combined with Ponatinib.
Dalfopristin	The metabolism of Ponatinib can be decreased when combined with Dalfopristin.
Dalteparin	The risk or severity of bleeding can be increased when Dalteparin is combined with Ponatinib.
Danaparoid	The risk or severity of bleeding can be increased when Danaparoid is combined with Ponatinib.
Danazol	The metabolism of Ponatinib can be decreased when combined with Danazol.
Dapagliflozin	The metabolism of Ponatinib can be decreased when combined with Dapagliflozin.
Dapsone	The metabolism of Ponatinib can be decreased when combined with Dapsone.
Daptomycin	The serum concentration of Daptomycin can be increased when it is combined with Ponatinib.
Darbepoetin alfa	The risk or severity of Thrombosis can be increased when Darbepoetin alfa is combined with Ponatinib.
Darifenacin	The metabolism of Ponatinib can be decreased when combined with Darifenacin.
Darolutamide	The serum concentration of Ponatinib can be increased when it is combined with Darolutamide.
Darunavir	The serum concentration of Ponatinib can be increased when it is combined with Darunavir.
Dasabuvir	The metabolism of Ponatinib can be decreased when combined with Dasabuvir.
Dasatinib	The serum concentration of Dasatinib can be increased when it is combined with Ponatinib.
Daunorubicin	The metabolism of Ponatinib can be decreased when combined with Daunorubicin.
Debrisoquine	The metabolism of Ponatinib can be decreased when combined with Debrisoquine.
Decitabine	The risk or severity of adverse effects can be increased when Decitabine is combined with Ponatinib.
Deferasirox	The metabolism of Ponatinib can be increased when combined with Deferasirox.
Defibrotide	The risk or severity of bleeding can be increased when Defibrotide is combined with Ponatinib.
Deflazacort	The metabolism of Ponatinib can be increased when combined with Deflazacort.
Delafloxacin	Ponatinib may decrease the excretion rate of Delafloxacin which could result in a higher serum level.
Delavirdine	The metabolism of Ponatinib can be decreased when combined with Delavirdine.
Denosumab	The risk or severity of adverse effects can be increased when Denosumab is combined with Ponatinib.
Desipramine	The metabolism of Ponatinib can be decreased when combined with Desipramine.
Desirudin	The risk or severity of bleeding can be increased when Desirudin is combined with Ponatinib.
Desoximetasone	The risk or severity of adverse effects can be increased when Desoximetasone is combined with Ponatinib.
Desvenlafaxine	The metabolism of Ponatinib can be decreased when combined with Desvenlafaxine.
Deucravacitinib	The risk or severity of adverse effects can be increased when Ponatinib is combined with Deucravacitinib.
Deutetrabenazine	The metabolism of Ponatinib can be decreased when combined with Deutetrabenazine.
Dexamethasone	The metabolism of Ponatinib can be increased when combined with Dexamethasone.
Dexamethasone	The metabolism of Ponatinib can be increased when combined with Dexamethasone acetate.
Dexchlorphenira	The metabolism of Ponatinib can be decreased when combined with Dexchlorpheniramine maleate.
Dexfenfluramine	The metabolism of Ponatinib can be decreased when combined with Dexfenfluramine.
Dexibuprofen	The metabolism of Ponatinib can be decreased when combined with Dexibuprofen.
Dexmedetomidine	The metabolism of Ponatinib can be decreased when combined with Dexmedetomidine.
Dexrazoxane	The risk or severity of adverse effects can be increased when Dexrazoxane is combined with Ponatinib.
Dextran	The risk or severity of bleeding can be increased when Dextran is combined with Ponatinib.
Dextroampheta	The metabolism of Ponatinib can be decreased when combined with Dextroamphetamine.
Dextromethorphan	The metabolism of Ponatinib can be decreased when combined with Dextromethorphan.
Dextropropox	The metabolism of Ponatinib can be decreased when combined with Dextropropoxyphene.
Diacerein	The metabolism of Ponatinib can be decreased when combined with Diacerein.
Diazepam	The metabolism of Ponatinib can be decreased when combined with Diazepam.
Diclofenac	The metabolism of Ponatinib can be decreased when combined with Diclofenac.
Dicloxacillin	The metabolism of Ponatinib can be increased when combined with Dicloxacillin.
Dicoumarol	The risk or severity of bleeding can be increased when Dicoumarol is combined with Ponatinib.
Diethylstilbestrol	The metabolism of Ponatinib can be decreased when combined with Diethylstilbestrol.
Difluocortolone	The metabolism of Ponatinib can be increased when combined with Difluocortolone.
Digitoxin	The serum concentration of Digitoxin can be increased when it is combined with Ponatinib.
Digoxin	Ponatinib may decrease the excretion rate of Digoxin which could result in a higher serum level.
Dihydrocodeine	The metabolism of Ponatinib can be decreased when combined with Dihydrocodeine.
Dihydroergocornine	The metabolism of Ponatinib can be decreased when combined with Dihydroergocornine.
Dihydroergocristine	The metabolism of Ponatinib can be decreased when combined with Dihydroergocristine.
Dihydroergotamine	The metabolism of Ponatinib can be decreased when combined with Dihydroergotamine.
Diltiazem	The metabolism of Ponatinib can be decreased when combined with Diltiazem.
Dimethyl fumarate	The risk or severity of adverse effects can be increased when Ponatinib is combined with Dimethyl fumarate.
Dimethyl sulfoxide	The metabolism of Ponatinib can be decreased when combined with Dimethyl sulfoxide.
Dinutuximab	The risk or severity of adverse effects can be increased when Ponatinib is combined with Dinutuximab.
Diosmin	The metabolism of Ponatinib can be decreased when combined with Diosmin.
Diphenhydramine	The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Diphenhydramine.
Dipyridamole	The risk or severity of bleeding can be increased when Dipyridamole is combined with Ponatinib.
Diroximel fumarate	The risk or severity of adverse effects can be increased when Ponatinib is combined with Diroximel fumarate.
Disulfiram	The metabolism of Ponatinib can be decreased when combined with Disulfiram.
Docetaxel	The metabolism of Ponatinib can be decreased when combined with Docetaxel.
Dolasetron	The metabolism of Ponatinib can be decreased when combined with Dolasetron.
Dolutegravir	Ponatinib may decrease the excretion rate of Dolutegravir which could result in a higher serum level.
Domperidone	The metabolism of Ponatinib can be decreased when combined with Domperidone.
Donepezil	The metabolism of Ponatinib can be decreased when combined with Donepezil.
Doravirine	The metabolism of Ponatinib can be decreased when combined with Doravirine.
Dosulepin	The metabolism of Ponatinib can be decreased when combined with Dosulepin.

Doxazosin	The metabolism of Ponatinib can be decreased when combined with Doxazosin.
Doxepin	The metabolism of Ponatinib can be decreased when combined with Doxepin.
Doxorubicin	The serum concentration of Doxorubicin can be increased when it is combined with Ponatinib.
Dronabinol	The metabolism of Ponatinib can be decreased when combined with Dronabinol.
Dronedarone	The serum concentration of Ponatinib can be increased when it is combined with Dronedarone.
Drospirenone	The metabolism of Ponatinib can be decreased when combined with Drospirenone.
Drotrecogin alfa	The risk or severity of bleeding can be increased when Drotrecogin alfa is combined with Ponatinib.
Duloxetine	The metabolism of Ponatinib can be decreased when combined with Duloxetine.
Dutasteride	The metabolism of Ponatinib can be decreased when combined with Dutasteride.
Duvelisib	The metabolism of Ponatinib can be decreased when combined with Duvelisib.
Dyclonine	The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Dyclonine.
Ebastine	The metabolism of Ponatinib can be decreased when combined with Ebastine.
Ebola Zaire)	The therapeutic efficacy of Ebola Zaire vaccine (live, attenuated) can be decreased when used in combination with Ponatinib.
Echinacea	The metabolism of Ponatinib can be increased when combined with Echinacea.
Eculizumab	The risk or severity of adverse effects can be increased when Eculizumab is combined with Ponatinib.
Edetic acid	The risk or severity of bleeding can be increased when Edetic acid is combined with Ponatinib.
Edoxaban	The serum concentration of Edoxaban can be increased when it is combined with Ponatinib.
Efalizumab	The risk or severity of adverse effects can be increased when Efalizumab is combined with Ponatinib.
Efavirenz	The metabolism of Ponatinib can be decreased when combined with Efavirenz.
Elagolix	The metabolism of Ponatinib can be decreased when combined with Elagolix.
Elbasvir	The metabolism of Ponatinib can be decreased when combined with Elbasvir.
Eletriptan	The metabolism of Ponatinib can be decreased when combined with Eletriptan.
Elexacaftor	The metabolism of Ponatinib can be decreased when combined with Elexacaftor.
Eliglustat	The metabolism of Ponatinib can be decreased when combined with Eliglustat.
Eltrombopag	The metabolism of Ponatinib can be decreased when combined with Eltrombopag.
Elvitegravir	The metabolism of Ponatinib can be decreased when combined with Elvitegravir.
Emapalumab	The metabolism of Ponatinib can be increased when combined with Emapalumab.
Enasidenib	The metabolism of Ponatinib can be increased when combined with Enasidenib.
Encainide	The metabolism of Ponatinib can be decreased when combined with Encainide.
Encorafenib	The metabolism of Ponatinib can be decreased when combined with Encorafenib.
Enfortumab	The serum concentration of Enfortumab vedotin can be increased when it is combined with Ponatinib.
Enoxaparin	The risk or severity of bleeding can be increased when Enoxaparin is combined with Ponatinib.
Entacapone	The metabolism of Ponatinib can be decreased when combined with Entacapone.
Enzalutamide	The serum concentration of Ponatinib can be decreased when it is combined with Enzalutamide.
Epinastine	The metabolism of Ponatinib can be decreased when combined with Epinastine.
Epinephrine	The metabolism of Ponatinib can be decreased when combined with Epinephrine.
Epirubicin	The risk or severity of adverse effects can be increased when Epirubicin is combined with Ponatinib.
Eplerenone	The metabolism of Ponatinib can be decreased when combined with Eplerenone.
Epoprostenol	The risk or severity of bleeding can be increased when Epoprostenol is combined with Ponatinib.
Eptifibatide	The risk or severity of bleeding can be increased when Eptifibatide is combined with Ponatinib.
Ergotamine	The metabolism of Ponatinib can be decreased when combined with Ergotamine.
Eribulin	The risk or severity of adverse effects can be increased when Eribulin is combined with Ponatinib.
Erlotinib	The metabolism of Ponatinib can be decreased when combined with Erlotinib.
Ertugliflozin	Ponatinib may decrease the excretion rate of Ertugliflozin which could result in a higher serum level.
Erythromycin	The metabolism of Ponatinib can be decreased when combined with Erythromycin.
Erythropoietin	The risk or severity of Thrombosis can be increased when Erythropoietin is combined with Ponatinib.
Escitalopram	The serum concentration of Ponatinib can be increased when it is combined with Escitalopram.
Esketamine	The metabolism of Ponatinib can be increased when combined with Esketamine.
Eslicarbazepine	The metabolism of Ponatinib can be increased when combined with Eslicarbazepine.
Eslicarbazepine	The metabolism of Ponatinib can be increased when combined with Eslicarbazepine acetate.
Esmolol	The metabolism of Ponatinib can be decreased when combined with Esmolol.
Estetrol	The metabolism of Ponatinib can be decreased when combined with Estetrol.
Estradiol	The metabolism of Ponatinib can be decreased when combined with Estradiol.
Estradiol acetate	The metabolism of Ponatinib can be increased when combined with Estradiol acetate.
Estradiol benzoate	The metabolism of Ponatinib can be increased when combined with Estradiol benzoate.
Estradiol cypionate	The metabolism of Ponatinib can be increased when combined with Estradiol cypionate.
Estradiol dienant	The metabolism of Ponatinib can be increased when combined with Estradiol dienanthate.
Estradiol valerate	The metabolism of Ponatinib can be increased when combined with Estradiol valerate.
Estramustine	The risk or severity of adverse effects can be increased when Estramustine is combined with Ponatinib.
Eszopiclone	The metabolism of Ponatinib can be decreased when combined with Eszopiclone.
Etanercept	The metabolism of Ponatinib can be increased when combined with Etanercept.
Ethambutol	The metabolism of Ponatinib can be decreased when combined with Ethambutol.
Ethanol	The metabolism of Ponatinib can be increased when combined with Ethanol.
Ethinylestradiol	The metabolism of Ponatinib can be decreased when combined with Ethinylestradiol.
Ethyl chloride	The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Ethyl chloride.
Etidocaine	The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Etidocaine.
Etoposide	The serum concentration of Etoposide can be increased when it is combined with Ponatinib.
Etoricoxib	The metabolism of Ponatinib can be decreased when combined with Etoricoxib.
Etravirine	The metabolism of Ponatinib can be increased when combined with Etravirine.
Everolimus	The serum concentration of Everolimus can be increased when it is combined with Ponatinib.
Ezetimibe	Ponatinib may decrease the excretion rate of Ezetimibe which could result in a higher serum level.
Famtozinameran	The therapeutic efficacy of Famtozinameran can be decreased when used in combination with Ponatinib.
Favipiravir	The metabolism of Ponatinib can be decreased when combined with Favipiravir.
Febuxostat	The excretion of Ponatinib can be decreased when combined with Febuxostat.
Fedratinib	The metabolism of Ponatinib can be decreased when combined with Fedratinib.
Felbamate	The metabolism of Ponatinib can be increased when combined with Felbamate.
Felodipine	The metabolism of Ponatinib can be decreased when combined with Felodipine.
Fenfluramine	The metabolism of Ponatinib can be decreased when combined with Fenfluramine.
Fenofibrate	The metabolism of Ponatinib can be decreased when combined with Fenofibrate.
Fesoterodine	The metabolism of Ponatinib can be decreased when combined with Fesoterodine.
Fexinidazole	The metabolism of Ponatinib can be decreased when combined with Fexinidazole.
Fexofenadine	The serum concentration of Fexofenadine can be increased when it is combined with Ponatinib.
Filgotinib	The risk or severity of adverse effects can be increased when Ponatinib is combined with Filgotinib.
Finasteride	The metabolism of Ponatinib can be decreased when combined with Finasteride.
Finerenone	The metabolism of Ponatinib can be decreased when combined with Finerenone.
Fingolimod	Ponatinib may increase the immunosuppressive activities of Fingolimod.
Flecainide	The metabolism of Ponatinib can be decreased when combined with Flecainide.
Floxuridine	The risk or severity of adverse effects can be increased when Floxuridine is combined with Ponatinib.
Flucloxacillin	The metabolism of Ponatinib can be increased when combined with Flucloxacillin.
Fluconazole	The metabolism of Ponatinib can be decreased when combined with Fluconazole.
Flucytosine	The risk or severity of adverse effects can be increased when Flucytosine is combined with Ponatinib.
Fludarabine	The risk or severity of adverse effects can be increased when Fludarabine is combined with Ponatinib.
Fludrocortisone	The risk or severity of adverse effects can be increased when Fludrocortisone is combined with Ponatinib.
Fluindione	The risk or severity of bleeding can be increased when Fluindione is combined with Ponatinib.
Flunarizine	The metabolism of Ponatinib can be decreased when combined with Flunarizine.
Flunisolide	The metabolism of Ponatinib can be increased when combined with Flunisolide.
Fluocinolone	The metabolism of Ponatinib can be increased when combined with Fluocinolone acetonide.
Fluocinonide	The metabolism of Ponatinib can be increased when combined with Fluocinonide.
Fluocortolone	The metabolism of Ponatinib can be increased when combined with Fluocortolone.
Fluorometholone	The risk or severity of adverse effects can be increased when Fluorometholone is combined with Ponatinib.

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Irinotecan	The metabolism of Ponatinib can be decreased when combined with Irinotecan.
Isavuconazole	The metabolism of Ponatinib can be increased when combined with Isavuconazole.
Isavuconazonium	The metabolism of Ponatinib can be increased when combined with Isavuconazonium.
Isoniazid	The metabolism of Ponatinib can be decreased when combined with Isoniazid.
Isradipine	The metabolism of Ponatinib can be decreased when combined with Isradipine.
Istradefylline	The metabolism of Ponatinib can be decreased when combined with Istradefylline.
Itraconazole	The metabolism of Ponatinib can be decreased when combined with Itraconazole.
Ivacaftor	The metabolism of Ponatinib can be decreased when combined with Ivacaftor.
Ivermectin	Ponatinib may decrease the excretion rate of Ivermectin which could result in a higher serum level.
Ivosidenib	The metabolism of Ponatinib can be increased when combined with Ivosidenib.
Ixabepilone	The risk or severity of adverse effects can be increased when Ixabepilone is combined with Ponatinib.
Ixekizumab	The risk or severity of adverse effects can be increased when Ponatinib is combined with Ixekizumab.
Janssen COVID	The therapeutic efficacy of Janssen COVID-19 Vaccine can be decreased when used in combination with Ponatinib.
Ja encephalits	The therapeutic efficacy of Japanese encephalitis virus strain sa 14-14-2 antigen (formaldehyde inactivated) can be decreased when used in combination with Ponatinib.
Ketamine	The metabolism of Ponatinib can be decreased when combined with Ketamine.
Ketazolam	The metabolism of Ponatinib can be decreased when combined with Ketazolam.
Ketoconazole	The metabolism of Ponatinib can be decreased when combined with Ketoconazole.
Ketoprofen	The metabolism of Ponatinib can be decreased when combined with Ketoprofen.
Ketorolac	The metabolism of Ponatinib can be decreased when combined with Ketorolac.
Labetalol	The metabolism of Ponatinib can be decreased when combined with Labetalol.
Lacosamide	The metabolism of Ponatinib can be decreased when combined with Lacosamide.
Lamivudine	Ponatinib may decrease the excretion rate of Lamivudine which could result in a higher serum level.
Lanreotide	The metabolism of Ponatinib can be decreased when combined with Lanreotide.
Lansoprazole	The metabolism of Ponatinib can be decreased when combined with Lansoprazole.
Lapatinib	The metabolism of Ponatinib can be decreased when combined with Lapatinib.
Larotrectinib	The serum concentration of Larotrectinib can be increased when it is combined with Ponatinib.
Lasmiditan	The serum concentration of Ponatinib can be increased when it is combined with Lasmiditan.
Ledipasvir	The serum concentration of Ledipasvir can be increased when it is combined with Ponatinib.
Lefamulin	Ponatinib may decrease the excretion rate of Lefamulin which could result in a higher serum level.
Leflunomide	The risk or severity of adverse effects can be increased when Ponatinib is combined with Leflunomide.
Lemborexant	The metabolism of Ponatinib can be decreased when combined with Lemborexant.
Lenalidomide	The risk or severity of adverse effects can be increased when Lenalidomide is combined with Ponatinib.
Lenvatinib	Ponatinib may decrease the excretion rate of Lenvatinib which could result in a higher serum level.
Lepirudin	The risk or severity of bleeding can be increased when Lepirudin is combined with Ponatinib.
Lercanidipine	The metabolism of Ponatinib can be decreased when combined with Lercanidipine.
Lesinurad	The metabolism of Ponatinib can be increased when combined with Lesinurad.
Letermovir	The metabolism of Ponatinib can be decreased when combined with Letermovir.
Levamlodipine	The metabolism of Ponatinib can be decreased when combined with Levamlodipine.
Levobetaxolol	The metabolism of Ponatinib can be decreased when combined with Levobetaxolol.
Levobupivacaine	The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Levobupivacaine.
Levoketoconazole	The metabolism of Ponatinib can be decreased when combined with Levoketoconazole.
Levomilnacipran	The metabolism of Ponatinib can be decreased when combined with Levomilnacipran.
Levonorgestrel	The metabolism of Ponatinib can be decreased when combined with Levonorgestrel.
Levothyroxine	The therapeutic efficacy of Levothyroxine can be decreased when used in combination with Ponatinib.
Lidocaine	The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Lidocaine.
Linagliptin	The metabolism of Ponatinib can be decreased when combined with Linagliptin.
Linezolid	The risk or severity of adverse effects can be increased when Linezolid is combined with Ponatinib.
Linzagolix	The serum concentration of Ponatinib can be increased when it is combined with Linzagolix.
Liothyronine	The therapeutic efficacy of Liothyronine can be decreased when used in combination with Ponatinib.
Liotrix	The therapeutic efficacy of Liotrix can be decreased when used in combination with Ponatinib.
Lipegfilgrastim	Ponatinib may increase the myelosuppressive activities of Lipegfilgrastim.
Lisdexamfeta	The metabolism of Ponatinib can be decreased when combined with Lisdexamfetamine.
Lisuride	The metabolism of Ponatinib can be decreased when combined with Lisuride.
Lofexidine	The metabolism of Ponatinib can be decreased when combined with Lofexidine.
Lomitapide	The metabolism of Ponatinib can be decreased when combined with Lomitapide.
Lomustine	The risk or severity of adverse effects can be increased when Lomustine is combined with Ponatinib.
Lonafarnib	The metabolism of Ponatinib can be decreased when combined with Lonafarnib.
Loncastuximab	The serum concentration of Loncastuximab tesirine can be increased when it is combined with Ponatinib.
Loperamide	The excretion of Loperamide can be decreased when combined with Ponatinib.
Lopinavir	The metabolism of Ponatinib can be decreased when combined with Lopinavir.
Loratadine	The metabolism of Ponatinib can be decreased when combined with Loratadine.
Lorcaserin	The metabolism of Ponatinib can be decreased when combined with Lorcaserin.
Lorlatinib	The metabolism of Ponatinib can be increased when combined with Lorlatinib.
Lorpiprazole	The metabolism of Ponatinib can be decreased when combined with Lorpiprazole.
Losartan	The metabolism of Ponatinib can be decreased when combined with Losartan.
Lovastatin	The metabolism of Ponatinib can be decreased when combined with Lovastatin.
Lumacaftor	The metabolism of Ponatinib can be increased when combined with Lumacaftor.
Lumefantrine	The metabolism of Ponatinib can be decreased when combined with Lumefantrine.
Lusutrombopag	Ponatinib may decrease the excretion rate of Lusutrombopag which could result in a higher serum level.
Magnesium	The serum concentration of Magnesium can be decreased when it is combined with Ponatinib.
Manidipine	The metabolism of Ponatinib can be decreased when combined with Manidipine.
Mannitol	The serum concentration of Mannitol can be increased when it is combined with Ponatinib.
Maprotiline	The metabolism of Ponatinib can be decreased when combined with Maprotiline.
Maribavir	Maribavir may decrease the excretion rate of Ponatinib which could result in a higher serum level.
Mavacamten	The serum concentration of Ponatinib can be decreased when it is combined with Mavacamten.
Measles virus	The therapeutic efficacy of Measles virus vaccine live attenuated can be decreased when used in combination with Ponatinib.
Mechlorethamine	The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Ponatinib.
Meclizine	The metabolism of Ponatinib can be decreased when combined with Meclizine.
Medroxypro	The metabolism of Ponatinib can be increased when combined with Medroxyprogesterone acetate.
Mefloquine	The serum concentration of Mefloquine can be increased when it is combined with Ponatinib.
Meloxicam	The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Meloxicam.
Melphalan	The risk or severity of adverse effects can be increased when Melphalan is combined with Ponatinib.
Meningococcal	The therapeutic efficacy of Meningococcal (groups A, C, Y and W-135) oligosaccharide diphtheria CRM197 conjugate vaccine can be decreased when used in combination with Ponatinib.
Meperidine	The metabolism of Ponatinib can be decreased when combined with Meperidine.
Mephenytoin	The metabolism of Ponatinib can be decreased when combined with Mephenytoin.
Mepivacaine	The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Mepivacaine.
Mepolizumab	The risk or severity of adverse effects can be increased when Mepolizumab is combined with Ponatinib.
Meprednisone	The metabolism of Ponatinib can be increased when combined with Meprednisone.
Mepyramine	The metabolism of Ponatinib can be decreased when combined with Mepyramine.
Mercaptopurine	The risk or severity of adverse effects can be increased when Mercaptopurine is combined with Ponatinib.
Mesoridazine	The metabolism of Ponatinib can be decreased when combined with Mesoridazine.
Mestranol	The metabolism of Ponatinib can be decreased when combined with Mestranol.
Metamfetamine	The metabolism of Ponatinib can be decreased when combined with Metamfetamine.
Metamizole	The risk or severity of myelosuppression can be increased when Metamizole is combined with Ponatinib.
Methadone	The metabolism of Ponatinib can be decreased when combined with Methadone.
Methimazole	The metabolism of Ponatinib can be decreased when combined with Methimazole.

Methotrexate	The risk or severity of adverse effects can be increased when Methotrexate is combined with Ponatinib.
Methotrimeprazine	The metabolism of Ponatinib can be decreased when combined with Methotrimeprazine.
Methoxy	The risk or severity of Thrombosis can be increased when Methoxy polyethylene glycol-epoetin beta is combined with Ponatinib.
Methoxyflurane	The metabolism of Ponatinib can be decreased when combined with Methoxyflurane.
Methylene blue	The metabolism of Ponatinib can be decreased when combined with Methylene blue.
Methylergometrine	The metabolism of Ponatinib can be decreased when combined with Methylergometrine.
Methylphenobarb	The metabolism of Ponatinib can be increased when combined with Methylphenobarbital.
Methylprednisolo	The metabolism of Ponatinib can be increased when combined with Methylprednisolone.
Methylprednisone	The metabolism of Ponatinib can be decreased when combined with Methylprednisone.
Methysergide	The metabolism of Ponatinib can be decreased when combined with Methysergide.
Metoclopramide	The metabolism of Ponatinib can be decreased when combined with Metoclopramide.
Metoprolol	The metabolism of Ponatinib can be decreased when combined with Metoprolol.
Metreleptin	The metabolism of Ponatinib can be increased when combined with Metreleptin.
Metronidazole	The metabolism of Ponatinib can be decreased when combined with Metronidazole.
Metyrapone	The metabolism of Ponatinib can be increased when combined with Metyrapone.
Mexiletine	The metabolism of Ponatinib can be decreased when combined with Mexiletine.
Mianserin	The metabolism of Ponatinib can be decreased when combined with Mianserin.
Miconazole	The metabolism of Ponatinib can be decreased when combined with Miconazole.
Midazolam	The metabolism of Ponatinib can be decreased when combined with Midazolam.
Midostaurin	The metabolism of Ponatinib can be decreased when combined with Midostaurin.
Mifepristone	The serum concentration of Ponatinib can be increased when it is combined with Mifepristone.
Milnacipran	The metabolism of Ponatinib can be decreased when combined with Milnacipran.
Minaprine	The metabolism of Ponatinib can be decreased when combined with Minaprine.
Miocamycin	The metabolism of Ponatinib can be decreased when combined with Miocamycin.
Mirabegron	The serum concentration of Ponatinib can be increased when it is combined with Mirabegron.
Mirtazapine	The metabolism of Ponatinib can be decreased when combined with Mirtazapine.
Mitapivat	The metabolism of Ponatinib can be increased when combined with Mitapivat.
Mitomycin	The risk or severity of adverse effects can be increased when Mitomycin is combined with Ponatinib.
Mitotane	The metabolism of Ponatinib can be increased when combined with Mitotane.
Mitoxantrone	The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Ponatinib.
Mobocertinib	The serum concentration of Ponatinib can be decreased when it is combined with Mobocertinib.
Moclobemide	The metabolism of Ponatinib can be decreased when combined with Moclobemide.
Modafinil	The metabolism of Ponatinib can be increased when combined with Modafinil.
MCOVID-19 Vac	The therapeutic efficacy of Moderna COVID-19 Vaccine can be decreased when used in combination with Ponatinib.
Modified vaccinia	The therapeutic efficacy of Modified vaccinia ankara can be decreased when used in combination with Ponatinib.
Mometasone fur	The metabolism of Ponatinib can be increased when combined with Mometasone furoate.
Monomethyl fum	The risk or severity of adverse effects can be increased when Ponatinib is combined with Monomethyl fumarate.
Montelukast	The metabolism of Ponatinib can be decreased when combined with Montelukast.
Morphine	The metabolism of Ponatinib can be decreased when combined with Morphine.
Mosunetuzumab	The metabolism of Ponatinib can be decreased when combined with Mosunetuzumab.
Mumps virus	The therapeutic efficacy of Mumps virus strain B level jeryl lynn live antigen can be decreased when used in combination with Ponatinib.
Muromonab	The risk or severity of adverse effects can be increased when Muromonab is combined with Ponatinib.
Mycophenolate	The metabolism of Ponatinib can be decreased when combined with Mycophenolate mofetil.
Mycophenolic	The risk or severity of adverse effects can be increased when Mycophenolic acid is combined with Ponatinib.
Nadolol	The metabolism of Ponatinib can be decreased when combined with Nadolol.
Nadroparin	The risk or severity of bleeding can be increased when Nadroparin is combined with Ponatinib.
Nafcillin	The metabolism of Ponatinib can be increased when combined with Nafcillin.
Naloxegol	The serum concentration of Naloxegol can be increased when it is combined with Ponatinib.
Naloxone	The metabolism of Ponatinib can be decreased when combined with Naloxone.
Naproxen	The metabolism of Ponatinib can be decreased when combined with Naproxen.
Natalizumab	The risk or severity of adverse effects can be increased when Ponatinib is combined with Natalizumab.
Nateglinide	The metabolism of Ponatinib can be decreased when combined with Nateglinide.
Nebivolol	The metabolism of Ponatinib can be decreased when combined with Nebivolol.
Nefazodone	The metabolism of Ponatinib can be decreased when combined with Nefazodone.
Nelarabine	The risk or severity of adverse effects can be increased when Nelarabine is combined with Ponatinib.
Nelfinavir	The metabolism of Ponatinib can be decreased when combined with Nelfinavir.
Netupitant	The metabolism of Ponatinib can be decreased when combined with Netupitant.
Nevirapine	The metabolism of Ponatinib can be decreased when combined with Nevirapine.
Niacin	The metabolism of Ponatinib can be decreased when combined with Niacin.
Nicardipine	The metabolism of Ponatinib can be decreased when combined with Nicardipine.
Nicergoline	The metabolism of Ponatinib can be decreased when combined with Nicergoline.
Nifedipine	The metabolism of Ponatinib can be decreased when combined with Nifedipine.
Nilotinib	The metabolism of Ponatinib can be decreased when combined with Nilotinib.
Nilutamide	The metabolism of Ponatinib can be decreased when combined with Nilutamide.
Nilvadipine	The metabolism of Ponatinib can be decreased when combined with Nilvadipine.
Nimesulide	The risk or severity of bleeding can be increased when Nimesulide is combined with Ponatinib.
Nintedanib	The metabolism of Ponatinib can be decreased when combined with Nintedanib.
Nisoldipine	The metabolism of Ponatinib can be decreased when combined with Nisoldipine.
Nitrendipine	The metabolism of Ponatinib can be decreased when combined with Nitrendipine.
Nitrofurantoin	Ponatinib may decrease the excretion rate of Nitrofurantoin which could result in a higher serum level.
Norethisterone	The metabolism of Ponatinib can be decreased when combined with Norethisterone.
Norgestimate	The metabolism of Ponatinib can be increased when combined with Norgestimate.
Nortriptyline	The serum concentration of Nortriptyline can be increased when it is combined with Ponatinib.
Noscapine	The metabolism of Ponatinib can be decreased when combined with Noscapine.
Novobiocin	Novobiocin may decrease the excretion rate of Ponatinib which could result in a higher serum level.
Nuvaxovid	The therapeutic efficacy of Nuvaxovid can be decreased when used in combination with Ponatinib.
Obinutuzumab	The risk or severity of adverse effects can be increased when Ponatinib is combined with Obinutuzumab.
Ocrelizumab	The risk or severity of adverse effects can be increased when Ponatinib is combined with Ocrelizumab.
Octreotide	The serum concentration of Ponatinib can be increased when it is combined with Octreotide.
Ofatumumab	The risk or severity of adverse effects can be increased when Ofatumumab is combined with Ponatinib.
Olanzapine	The metabolism of Ponatinib can be decreased when combined with Olanzapine.
Olaparib	The metabolism of Ponatinib can be decreased when combined with Olaparib.
Oliceridine	The metabolism of Ponatinib can be decreased when combined with Oliceridine.
Olodaterol	The metabolism of Ponatinib can be decreased when combined with Olodaterol.
Omadacycline	The serum concentration of Omadacycline can be increased when it is combined with Ponatinib.
Ombitasvir	The metabolism of Ponatinib can be decreased when combined with Ombitasvir.
Omeprazole	The metabolism of Ponatinib can be increased when combined with Omeprazole.
Ondansetron	The metabolism of Ponatinib can be decreased when combined with Ondansetron.
Opium	The metabolism of Ponatinib can be decreased when combined with Opium.
Oritavancin	The metabolism of Ponatinib can be increased when combined with Oritavancin.
Orphenadrine	The metabolism of Ponatinib can be decreased when combined with Orphenadrine.
Osilodrostat	The metabolism of Ponatinib can be decreased when combined with Osilodrostat.
Osimertinib	The serum concentration of Osimertinib can be increased when it is combined with Ponatinib.
Ospemifene	The metabolism of Ponatinib can be decreased when combined with Ospemifene.
Oteseconazole	The serum concentration of Ponatinib can be increased when it is combined with Oteseconazole.
Oxaliplatin	The risk or severity of adverse effects can be increased when Oxaliplatin is combined with Ponatinib.
Oxamniquine	The metabolism of Ponatinib can be decreased when combined with Oxamniquine.
Oxcarbazepine	The metabolism of Ponatinib can be increased when combined with Oxcarbazepine.
Oxetacaine	The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Oxetacaine.
Oxprenolol	The metabolism of Ponatinib can be decreased when combined with Oxprenolol.

Oxybuprocaine	The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Oxybuprocaine.
Oxybutynin	The metabolism of Ponatinib can be decreased when combined with Oxybutynin.
Oxycodone	The metabolism of Ponatinib can be decreased when combined with Oxycodone.
Oxymorphone	The metabolism of Ponatinib can be decreased when combined with Oxymorphone.
Ozanimod	Ponatinib may decrease the excretion rate of Ozanimod which could result in a higher serum level.
Paclitaxel	The metabolism of Ponatinib can be increased when combined with Paclitaxel.
Pacritinib	The serum concentration of Ponatinib can be increased when it is combined with Pacritinib.
Palbociclib	The metabolism of Ponatinib can be decreased when combined with Palbociclib.
Palifermin	The therapeutic efficacy of Palifermin can be decreased when used in combination with Ponatinib.
Paliperidone	The metabolism of Ponatinib can be decreased when combined with Paliperidone.
Palonosetron	The metabolism of Ponatinib can be decreased when combined with Palonosetron.
Panobinostat	The metabolism of Ponatinib can be decreased when combined with Panobinostat.
Pantoprazole	Pantoprazole may decrease the excretion rate of Ponatinib which could result in a higher serum level.
Paramethadione	The metabolism of Ponatinib can be decreased when combined with Paramethadione.
Parathyroid	The therapeutic efficacy of Parathyroid hormone can be decreased when used in combination with Ponatinib.
Paritaprevir	The metabolism of Ponatinib can be decreased when combined with Paritaprevir.
Parnaparin	The risk or severity of bleeding can be increased when Parnaparin is combined with Ponatinib.
Paroxetine	The metabolism of Ponatinib can be decreased when combined with Paroxetine.
Pasireotide	The metabolism of Ponatinib can be decreased when combined with Pasireotide.
Pazopanib	The serum concentration of Pazopanib can be increased when it is combined with Ponatinib.
Pegaspargase	The risk or severity of adverse effects can be increased when Pegaspargase is combined with Ponatinib.
Pegcetacoplan	The risk or severity of adverse effects can be increased when Ponatinib is combined with Pegcetacoplan.
Peginesatide	The risk or severity of Thrombosis can be increased when Peginesatide is combined with Ponatinib.
Peginterferon	The risk or severity of adverse effects can be increased when Peginterferon alfa-2a is combined with Ponatinib.
Peginterferon	The metabolism of Ponatinib can be decreased when combined with Peginterferon alfa-2b.
Peginterferon	The risk or severity of adverse effects can be increased when Ponatinib is combined with Peginterferon beta-1a.
Pemetrexed	The risk or severity of adverse effects can be increased when Pemetrexed is combined with Ponatinib.
Penbutolol	The metabolism of Ponatinib can be decreased when combined with Penbutolol.
Penicillamine	The risk or severity of adverse effects can be increased when Penicillamine is combined with Ponatinib.
Pentamidine	The metabolism of Ponatinib can be decreased when combined with Pentamidine.
Pentobarbital	The metabolism of Ponatinib can be increased when combined with Pentobarbital.
Pentosan polys	The risk or severity of bleeding can be increased when Pentosan polysulfate is combined with Ponatinib.
Pentostatin	The risk or severity of adverse effects can be increased when Pentostatin is combined with Ponatinib.
Pentoxifylline	The risk or severity of bleeding can be increased when Pentoxifylline is combined with Ponatinib.
Perampanel	The metabolism of Ponatinib can be increased when combined with Perampanel.
Perhexiline	The metabolism of Ponatinib can be decreased when combined with Perhexiline.
Perphenazine	The metabolism of Ponatinib can be decreased when combined with Perphenazine.
Pertussis vaccine	The therapeutic efficacy of Pertussis vaccine can be decreased when used in combination with Ponatinib.
Pexidartinib	Ponatinib may increase the hepatotoxic activities of Pexidartinib.
Phenformin	The metabolism of Ponatinib can be decreased when combined with Phenformin.
Phenindione	The risk or severity of bleeding can be increased when Phenindione is combined with Ponatinib.
Phenobarbital	The metabolism of Ponatinib can be increased when combined with Phenobarbital.
Phenol	The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Phenol.
Phenprocoumon	The metabolism of Ponatinib can be decreased when combined with Phenprocoumon.
Phenylalanine	The risk or severity of adverse effects can be increased when Phenylalanine is combined with Ponatinib.
Phenylbutazone	The metabolism of Ponatinib can be increased when combined with Phenylbutazone.
Phenylbutyric acid	The metabolism of Ponatinib can be decreased when combined with Phenylbutyric acid.
Phenytoin	The metabolism of Ponatinib can be increased when combined with Phenytoin.
Pibrentasvir	Ponatinib may decrease the excretion rate of Pibrentasvir which could result in a higher serum level.
Pimavanserin	The metabolism of Ponatinib can be decreased when combined with Pimavanserin.
Pimecrolimus	The risk or severity of adverse effects can be increased when Pimecrolimus is combined with Ponatinib.
Pimozide	The metabolism of Ponatinib can be decreased when combined with Pimozide.
Pindolol	The metabolism of Ponatinib can be decreased when combined with Pindolol.
Pioglitazone	The metabolism of Ponatinib can be decreased when combined with Pioglitazone.
Piperaquine	The metabolism of Ponatinib can be decreased when combined with Piperaquine.
Piperazine	The metabolism of Ponatinib can be decreased when combined with Piperazine.
Pipotiazine	The metabolism of Ponatinib can be decreased when combined with Pipotiazine.
Pirfenidone	The metabolism of Ponatinib can be decreased when combined with Pirfenidone.
Piroxicam	The metabolism of Ponatinib can be decreased when combined with Piroxicam.
Pitavastatin	The metabolism of Ponatinib can be decreased when combined with Pitavastatin.
Pitolisant	The serum concentration of Ponatinib can be decreased when it is combined with Pitolisant.
Polythiazide	The risk or severity of neutropenia and thrombocytopenia can be increased when Polythiazide is combined with Ponatinib.
Pomalidomide	The serum concentration of Pomalidomide can be increased when it is combined with Ponatinib.
Ponesimod	The metabolism of Ponatinib can be decreased when combined with Ponesimod.
Posaconazole	The metabolism of Ponatinib can be decreased when combined with Posaconazole.
Potassium Iodide	The therapeutic efficacy of Potassium Iodide can be decreased when used in combination with Ponatinib.
Potassium	The therapeutic efficacy of Potassium perchlorate can be decreased when used in combination with Ponatinib.
Practolol	The metabolism of Ponatinib can be decreased when combined with Practolol.
Pralatrexate	The risk or severity of adverse effects can be increased when Pralatrexate is combined with Ponatinib.
Pralsetinib	The serum concentration of Pralsetinib can be increased when it is combined with Ponatinib.
Pramocaine	The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Pramocaine.
Prasugrel	The risk or severity of bleeding can be increased when Prasugrel is combined with Ponatinib.
Pravastatin	Pravastatin may decrease the excretion rate of Ponatinib which could result in a higher serum level.
Praziquantel	The metabolism of Ponatinib can be decreased when combined with Praziquantel.
Prazosin	Ponatinib may decrease the excretion rate of Prazosin which could result in a higher serum level.
Prednisolone	The metabolism of Ponatinib can be increased when combined with Prednisolone.
Prednisolone	The metabolism of Ponatinib can be increased when combined with Prednisolone acetate.
Prednisolone	The metabolism of Ponatinib can be increased when combined with Prednisolone phosphate.
Prednisone	The risk or severity of adverse effects can be increased when Prednisone is combined with Ponatinib.
Prednisone	The metabolism of Ponatinib can be increased when combined with Prednisone acetate.
Pretomanid	The metabolism of Ponatinib can be decreased when combined with Pretomanid.
Prilocaine	The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Prilocaine.
Primaquine	The metabolism of Ponatinib can be decreased when combined with Primaquine.
Primidone	The metabolism of Ponatinib can be increased when combined with Primidone.
Probenecid	The metabolism of Ponatinib can be increased when combined with Probenecid.
Procainamide	The metabolism of Ponatinib can be decreased when combined with Procainamide.
Procaine	The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Procaine.
Procarbazine	The risk or severity of adverse effects can be increased when Procarbazine is combined with Ponatinib.
Prochlorperazine	The metabolism of Ponatinib can be decreased when combined with Prochlorperazine.
Progesterone	The metabolism of Ponatinib can be decreased when combined with Progesterone.
Proguanil	The metabolism of Ponatinib can be decreased when combined with Proguanil.
Promazine	The metabolism of Ponatinib can be decreased when combined with Promazine.
Promethazine	The metabolism of Ponatinib can be decreased when combined with Promethazine.
Propafenone	The metabolism of Ponatinib can be decreased when combined with Propafenone.
Proparacaine	The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Proparacaine.
Propofol	The metabolism of Ponatinib can be decreased when combined with Propofol.
Propoxycaine	The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Propoxycaine.
Propranolol	The metabolism of Ponatinib can be decreased when combined with Propranolol.
Propylthiouracil	The therapeutic efficacy of Propylthiouracil can be decreased when used in combination with Ponatinib.
Protein C	The risk or severity of bleeding can be increased when Protein C is combined with Ponatinib.

Protein S	The risk or severity of bleeding can be increased when Protein S human is combined with Ponatinib.
Protirelin	The therapeutic efficacy of Protirelin can be decreased when used in combination with Ponatinib.
Prucalopride	The serum concentration of Prucalopride can be increased when it is combined with Ponatinib.
Pyrimethamine	The metabolism of Ponatinib can be decreased when combined with Pyrimethamine.
Quetiapine	The metabolism of Ponatinib can be decreased when combined with Quetiapine.
Quinidine	The serum concentration of Quinidine can be increased when it is combined with Ponatinib.
Quinine	The metabolism of Ponatinib can be decreased when combined with Quinine.
Quinupristin	The metabolism of Ponatinib can be decreased when combined with Quinupristin.
Rabeprazole	Rabeprazole may decrease the excretion rate of Ponatinib which could result in a higher serum level.
Rabies immun	The therapeutic efficacy of Rabies immune globulin, human can be decreased when used in combination with Ponatinib.
Rabies A	The therapeutic efficacy of Rabies virus inactivated antigen, A can be decreased when used in combination with Ponatinib.
Rabies B	The therapeutic efficacy of Rabies virus inactivated antigen, B can be decreased when used in combination with Ponatinib.
Raloxifene	The metabolism of Ponatinib can be decreased when combined with Raloxifene.
Raltitrexed	The risk or severity of adverse effects can be increased when Raltitrexed is combined with Ponatinib.
Ranitidine	The metabolism of Ponatinib can be decreased when combined with Ranitidine.
Ranolazine	The serum concentration of Ranolazine can be increased when it is combined with Ponatinib.
Ravulizumab	The risk or severity of adverse effects can be increased when Ponatinib is combined with Ravulizumab.
Reboxetine	The metabolism of Ponatinib can be decreased when combined with Reboxetine.
Regorafenib	The serum concentration of Regorafenib can be increased when it is combined with Ponatinib.
Relugolix	The serum concentration of Relugolix can be increased when it is combined with Ponatinib.
Remdesivir	The metabolism of Ponatinib can be decreased when combined with Remdesivir.
Remoxipride	The metabolism of Ponatinib can be decreased when combined with Remoxipride.
Repaglinide	The metabolism of Ponatinib can be decreased when combined with Repaglinide.
Reserpine	The metabolism of Ponatinib can be increased when combined with Reserpine.
Reteplase	The risk or severity of bleeding can be increased when Reteplase is combined with Ponatinib.
Revefenacin	The metabolism of Ponatinib can be decreased when combined with Revefenacin.
Reviparin	The risk or severity of bleeding can be increased when Reviparin is combined with Ponatinib.
Ribociclib	The metabolism of Ponatinib can be decreased when combined with Ribociclib.
Rifabutin	The metabolism of Ponatinib can be increased when combined with Rifabutin.
Rifampicin	The metabolism of Ponatinib can be increased when combined with Rifampicin.
Rifamycin	The metabolism of Ponatinib can be increased when combined with Rifamycin.
Rifapentine	The metabolism of Ponatinib can be increased when combined with Rifapentine.
Rifaximin	The serum concentration of Rifaximin can be increased when it is combined with Ponatinib.
Rilonacept	The metabolism of Ponatinib can be increased when combined with Rilonacept.
Rilpivirine	The metabolism of Ponatinib can be decreased when combined with Rilpivirine.
Riluzole	Ponatinib may decrease the excretion rate of Riluzole which could result in a higher serum level.
Rimegepant	The serum concentration of Rimegepant can be increased when it is combined with Ponatinib.
Riociguat	The metabolism of Ponatinib can be decreased when combined with Riociguat.
Ripretinib	Ponatinib may decrease the excretion rate of Ripretinib which could result in a higher serum level.
Risankizumab	The risk or severity of adverse effects can be increased when Ponatinib is combined with Risankizumab.
Risperidone	The metabolism of Ponatinib can be decreased when combined with Risperidone.
Ritonavir	The metabolism of Ponatinib can be decreased when combined with Ritonavir.
Rituximab	The risk or severity of adverse effects can be increased when Rituximab is combined with Ponatinib.
Rivaroxaban	The metabolism of Ponatinib can be decreased when combined with Rivaroxaban.
Rofecoxib	The metabolism of Ponatinib can be increased when combined with Rofecoxib.
Roflumilast	Roflumilast may increase the immunosuppressive activities of Ponatinib.
Rolapitant	The metabolism of Ponatinib can be decreased when combined with Rolapitant.
Romidepsin	The serum concentration of Romidepsin can be increased when it is combined with Ponatinib.
Ropeginterfer	The metabolism of Ponatinib can be decreased when combined with Ropeginterferon alfa-2b.
Ropivacaine	The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Ropivacaine.
Rosiglitazone	The metabolism of Ponatinib can be decreased when combined with Rosiglitazone.
Rosuvastatin	The metabolism of Ponatinib can be decreased when combined with Rosuvastatin.
Rotavirus vaccine	The therapeutic efficacy of Rotavirus vaccine can be decreased when used in combination with Ponatinib.
Rotigotine	The metabolism of Ponatinib can be decreased when combined with Rotigotine.
Roxadustat	The serum concentration of Ponatinib can be increased when it is combined with Roxadustat.
Roxithromycin	The metabolism of Ponatinib can be decreased when combined with Roxithromycin.
Rubella virus	The risk or severity of infection can be increased when Rubella virus vaccine is combined with Ponatinib.
Rucaparib	The metabolism of Ponatinib can be decreased when combined with Rucaparib.
Rufinamide	The metabolism of Ponatinib can be increased when combined with Rufinamide.
Rupatadine	The metabolism of Ponatinib can be decreased when combined with Rupatadine.
Ruxolitinib	The risk or severity of adverse effects can be increased when Ruxolitinib is combined with Ponatinib.
Safinamide	Safinamide may decrease the excretion rate of Ponatinib which could result in a higher serum level.
Salmeterol	The metabolism of Ponatinib can be decreased when combined with Salmeterol.
Salmon calcito	The therapeutic efficacy of Salmon calcitonin can be decreased when used in combination with Ponatinib.
Saquinavir	The metabolism of Ponatinib can be decreased when combined with Saquinavir.
Sarilumab	The metabolism of Ponatinib can be increased when combined with Sarilumab.
Satralizumab	The serum concentration of Ponatinib can be decreased when it is combined with Satralizumab.
Saxagliptin	The metabolism of Ponatinib can be decreased when combined with Saxagliptin.
Secobarbital	The metabolism of Ponatinib can be increased when combined with Secobarbital.
Secukinumab	The metabolism of Ponatinib can be increased when combined with Secukinumab.
Selegiline	The metabolism of Ponatinib can be decreased when combined with Selegiline.
Selexipag	The metabolism of Ponatinib can be decreased when combined with Selexipag.
Selpercatinib	The serum concentration of Ponatinib can be increased when it is combined with Selpercatinib.
Selumetinib	The metabolism of Ponatinib can be decreased when combined with Selumetinib.
Sertindole	The metabolism of Ponatinib can be decreased when combined with Sertindole.
Sertraline	The metabolism of Ponatinib can be decreased when combined with Sertraline.
Sildenafil	The metabolism of Ponatinib can be decreased when combined with Sildenafil.
Silodosin	The excretion of Silodosin can be decreased when combined with Ponatinib.
Siltuximab	The metabolism of Ponatinib can be increased when combined with Siltuximab.
Simeprevir	The metabolism of Ponatinib can be decreased when combined with Simeprevir.
Simvastatin	The metabolism of Ponatinib can be decreased when combined with Simvastatin.
Siponimod	The risk or severity of adverse effects can be increased when Ponatinib is combined with Siponimod.
Sipuleucel-T	The therapeutic efficacy of Sipuleucel-T can be decreased when used in combination with Ponatinib.
Sirolimus	The serum concentration of Sirolimus can be increased when it is combined with Ponatinib.
Sitagliptin	The metabolism of Ponatinib can be decreased when combined with Sitagliptin.
Sitaxentan	The metabolism of Ponatinib can be decreased when combined with Sitaxentan.
Smallpox	The therapeutic efficacy of Smallpox (Vaccinia) Vaccine, Live can be decreased when used in combination with Ponatinib.
Sodium citrate	The risk or severity of bleeding can be increased when Sodium citrate is combined with Ponatinib.
Sofosbuvir	Ponatinib may decrease the excretion rate of Sofosbuvir which could result in a higher serum level.
Solifenacin	The metabolism of Ponatinib can be decreased when combined with Solifenacin.
Somatostatin	The metabolism of Ponatinib can be decreased when combined with Somatostatin.
Somatrogon	The metabolism of Ponatinib can be increased when combined with Somatrogon.
Sorafenib	The metabolism of Ponatinib can be decreased when combined with Sorafenib.
Sotagliflozin	Sotagliflozin may decrease the excretion rate of Ponatinib which could result in a higher serum level.
Sotalol	The metabolism of Ponatinib can be decreased when combined with Sotalol.
Sotorasib	The serum concentration of Ponatinib can be decreased when it is combined with Sotorasib.
Spesolimab	The risk or severity of adverse effects can be increased when Ponatinib is combined with Spesolimab.
Spironolactone	The metabolism of Ponatinib can be decreased when combined with Spironolactone.
St. John’s Wort	The metabolism of Ponatinib can be increased when combined with St. John’s Wort.
Stiripentol	The metabolism of Ponatinib can be decreased when combined with Stiripentol.

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Streptokinase	The risk or severity of bleeding can be increased when Streptokinase is combined with Ponatinib.
Streptozocin	The risk or severity of adverse effects can be increased when Streptozocin is combined with Ponatinib.
Sulfadiazine	The metabolism of Ponatinib can be decreased when combined with Sulfadiazine.
Sulfamethoxazole	The risk or severity of myelosuppression can be increased when Sulfamethoxazole is combined with Ponatinib.
Sulfaphenazole	The metabolism of Ponatinib can be decreased when combined with Sulfaphenazole.
Sulfasalazine	The risk or severity of adverse effects can be increased when Sulfasalazine is combined with Ponatinib.
Sulfinpyrazone	The metabolism of Ponatinib can be increased when combined with Sulfinpyrazone.
Sulodexide	The risk or severity of bleeding can be increased when Sulodexide is combined with Ponatinib.
Sumatriptan	Ponatinib may decrease the excretion rate of Sumatriptan which could result in a higher serum level.
Sunitinib	The metabolism of Ponatinib can be decreased when combined with Sunitinib.
Suvorexant	The metabolism of Ponatinib can be decreased when combined with Suvorexant.
Tacrolimus	Tacrolimus may increase the immunosuppressive activities of Ponatinib.
Tadalafil	The metabolism of Ponatinib can be decreased when combined with Tadalafil.
Tafamidis	The serum concentration of Ponatinib can be increased when it is combined with Tafamidis.
Tafenoquine	The metabolism of Ponatinib can be decreased when combined with Tafenoquine.
Talazoparib	The serum concentration of Talazoparib can be increased when it is combined with Ponatinib.
Tamoxifen	The metabolism of Ponatinib can be increased when combined with Tamoxifen.
Tamsulosin	The metabolism of Ponatinib can be decreased when combined with Tamsulosin.
Tasimelteon	The metabolism of Ponatinib can be decreased when combined with Tasimelteon.
Taurocholic acid	Taurocholic acid may decrease the excretion rate of Ponatinib which could result in a higher serum level.
Tazarotene	The metabolism of Ponatinib can be decreased when combined with Tazarotene.
Tazemetostat	The metabolism of Ponatinib can be decreased when combined with Tazemetostat.
Technetium	The serum concentration of Technetium Tc-99m sestamibi can be increased when it is combined with Ponatinib.
Tecovirimat	The metabolism of Ponatinib can be increased when combined with Tecovirimat.
Tedizolid	The risk or severity of myelosuppression can be increased when Ponatinib is combined with Tedizolid phosphate.
Tegafur	The metabolism of Tegafur can be decreased when combined with Ponatinib.
Tegaserod	The metabolism of Ponatinib can be decreased when combined with Tegaserod.
Telaprevir	The metabolism of Ponatinib can be decreased when combined with Telaprevir.
Telithromycin	The metabolism of Ponatinib can be decreased when combined with Telithromycin.
Telmisartan	Telmisartan may decrease the excretion rate of Ponatinib which could result in a higher serum level.
Telotristat ethyl	The serum concentration of Ponatinib can be decreased when it is combined with Telotristat ethyl.
Temozolomide	The risk or severity of adverse effects can be increased when Temozolomide is combined with Ponatinib.
Temsirolimus	The serum concentration of Temsirolimus can be increased when it is combined with Ponatinib.
Tenecteplase	The risk or severity of bleeding can be increased when Tenecteplase is combined with Ponatinib.
Teniposide	The metabolism of Ponatinib can be decreased when combined with Teniposide.
Tenofovir alafe	The serum concentration of Tenofovir alafenamide can be increased when it is combined with Ponatinib.
Tenofovir	The serum concentration of Tenofovir disoproxil can be increased when it is combined with Ponatinib.
Tepotinib	The serum concentration of Tepotinib can be increased when it is combined with Ponatinib.
Teprotumumab	The risk or severity of adverse effects can be increased when Teprotumumab is combined with Ponatinib.
Terbinafine	The metabolism of Ponatinib can be decreased when combined with Terbinafine.
Terfenadine	The metabolism of Ponatinib can be decreased when combined with Terfenadine.
Teriflunomide	The metabolism of Ponatinib can be decreased when combined with Teriflunomide.
Teriparatide	The therapeutic efficacy of Teriparatide can be decreased when used in combination with Ponatinib.
Testosterone	The metabolism of Ponatinib can be increased when combined with Testosterone.
Testosterone	The metabolism of Ponatinib can be decreased when combined with Testosterone cypionate.
Testosterone	The metabolism of Ponatinib can be decreased when combined with Testosterone enanthate.
Tetrabenazine	The metabolism of Ponatinib can be decreased when combined with Tetrabenazine.
Tetracaine	The risk or severity of methemoglobinemia can be increased when Ponatinib is combined with Tetracaine.
Tetracycline	The metabolism of Ponatinib can be decreased when combined with Tetracycline.
Tezacaftor	The metabolism of Ponatinib can be decreased when combined with Tezacaftor.
Thalidomide	The risk or severity of adverse effects can be increased when Thalidomide is combined with Ponatinib.
Theophylline	The metabolism of Ponatinib can be decreased when combined with Theophylline.
Thiamylal	The metabolism of Ponatinib can be increased when combined with Thiamylal.
Thioridazine	The metabolism of Ponatinib can be decreased when combined with Thioridazine.
Thiotepa	The risk or severity of adverse effects can be increased when Thiotepa is combined with Ponatinib.
Thyroid, porcine	The therapeutic efficacy of Thyroid, porcine can be decreased when used in combination with Ponatinib.
Thyrotropin alfa	The therapeutic efficacy of Thyrotropin alfa can be decreased when used in combination with Ponatinib.
Ticagrelor	The metabolism of Ponatinib can be decreased when combined with Ticagrelor.
Tic encephalitis	The therapeutic efficacy of Tick-borne encephalitis vaccine (whole virus, inactivated) can be decreased when used in combination with Ponatinib.
Ticlopidine	The metabolism of Ponatinib can be decreased when combined with Ticlopidine.
Timolol	The metabolism of Ponatinib can be decreased when combined with Timolol.
Tinzaparin	The risk or severity of bleeding can be increased when Tinzaparin is combined with Ponatinib.
Tioguanine	The risk or severity of adverse effects can be increased when Tioguanine is combined with Ponatinib.
Tiotropium	The metabolism of Ponatinib can be decreased when combined with Tiotropium.
Tipranavir	The metabolism of Ponatinib can be decreased when combined with Tipranavir.
Tirofiban	The risk or severity of bleeding can be increased when Tirofiban is combined with Ponatinib.
Tivozanib	Tivozanib may decrease the excretion rate of Ponatinib which could result in a higher serum level.
Tixocortol	The risk or severity of adverse effects can be increased when Ponatinib is combined with Tixocortol.
Tocilizumab	The metabolism of Ponatinib can be increased when combined with Tocilizumab.
Tofacitinib	Ponatinib may increase the immunosuppressive activities of Tofacitinib.
Tolbutamide	The metabolism of Ponatinib can be decreased when combined with Tolbutamide.
Tolterodine	The metabolism of Ponatinib can be decreased when combined with Tolterodine.
Tolvaptan	The serum concentration of Tolvaptan can be increased when it is combined with Ponatinib.
Topiramate	The metabolism of Ponatinib can be increased when combined with Topiramate.
Topotecan	The serum concentration of Topotecan can be increased when it is combined with Ponatinib.
Torasemide	The metabolism of Ponatinib can be decreased when combined with Torasemide.
Toremifene	The serum concentration of Toremifene can be increased when it is combined with Ponatinib.
Tositumomab	The risk or severity of adverse effects can be increased when Tositumomab is combined with Ponatinib.
Trabectedin	The metabolism of Ponatinib can be decreased when combined with Trabectedin.
Tramadol	The metabolism of Ponatinib can be decreased when combined with Tramadol.
Trametinib	The metabolism of Ponatinib can be decreased when combined with Trametinib.
Tranylcypromine	The metabolism of Ponatinib can be decreased when combined with Tranylcypromine.
Trastuzumab	Trastuzumab may increase the neutropenic activities of Ponatinib.
Trastuzumab	The serum concentration of Trastuzumab emtansine can be increased when it is combined with Ponatinib.
Trazodone	The metabolism of Ponatinib can be decreased when combined with Trazodone.
Treprostinil	The metabolism of Ponatinib can be decreased when combined with Treprostinil.
Tretinoin	The metabolism of Ponatinib can be decreased when combined with Tretinoin.
Triamcinolone	The metabolism of Ponatinib can be increased when combined with Triamcinolone.
Triazolam	The metabolism of Ponatinib can be decreased when combined with Triazolam.
Trichlormethiazide	The risk or severity of neutropenia and thrombocytopenia can be increased when Trichlormethiazide is combined with Ponatinib.
Triclabendazole	The metabolism of Ponatinib can be decreased when combined with Triclabendazole.
Trifluridine	The risk or severity of adverse effects can be increased when Trifluridine is combined with Ponatinib.
Triflusal	The risk or severity of bleeding can be increased when Triflusal is combined with Ponatinib.
Trilaciclib	Ponatinib may decrease the excretion rate of Trilaciclib which could result in a higher serum level.
Trilostane	The risk or severity of adverse effects can be increased when Trilostane is combined with Ponatinib.
Trimethadione	The metabolism of Ponatinib can be decreased when combined with Trimethadione.
Trimethoprim	The metabolism of Ponatinib can be decreased when combined with Trimethoprim.
Trimipramine	The serum concentration of Trimipramine can be increased when it is combined with Ponatinib.
Tripelennamine	The metabolism of Ponatinib can be decreased when combined with Tripelennamine.
Troglitazone	The metabolism of Ponatinib can be increased when combined with Troglitazone.

Troleandomycin	The metabolism of Ponatinib can be decreased when combined with Troleandomycin.
Trospium	The metabolism of Ponatinib can be decreased when combined with Trospium.
Tucatinib	The metabolism of Tucatinib can be decreased when combined with Ponatinib.
Typhoid vaccine	The therapeutic efficacy of Typhoid vaccine can be decreased when used in combination with Ponatinib.
Typhoid Vaccine	The risk or severity of infection can be increased when Typhoid Vaccine Live is combined with Ponatinib.
Typhoid Vi po	The therapeutic efficacy of Typhoid Vi polysaccharide vaccine can be decreased when used in combination with Ponatinib.
Ubrogepant	The serum concentration of Ubrogepant can be increased when it is combined with Ponatinib.
Udenafil	The metabolism of Ponatinib can be decreased when combined with Udenafil.
Umeclidinium	The metabolism of Ponatinib can be decreased when combined with Umeclidinium.
Upadacitinib	The risk or severity of adverse effects can be increased when Ponatinib is combined with Upadacitinib.
Urokinase	The risk or severity of bleeding can be increased when Urokinase is combined with Ponatinib.
Valbenazine	The metabolism of Ponatinib can be decreased when combined with Valbenazine.
Valoctocogene	The therapeutic efficacy of Valoctocogene roxaparvovec can be decreased when used in combination with Ponatinib.
Valproic acid	The metabolism of Ponatinib can be decreased when combined with Valproic acid.
Vandetanib	Vandetanib may decrease the excretion rate of Ponatinib which could result in a higher serum level.
Vardenafil	The metabolism of Ponatinib can be decreased when combined with Vardenafil.
Varicella zoster	The risk or severity of infection can be increased when Varicella zoster vaccine (live/attenuated) is combined with Ponatinib.
Varicella zoster	The therapeutic efficacy of Varicella zoster vaccine (recombinant) can be decreased when used in combination with Ponatinib.
Vedolizumab	The risk or severity of adverse effects can be increased when Ponatinib is combined with Vedolizumab.
Velpatasvir	The metabolism of Ponatinib can be decreased when combined with Velpatasvir.
Vemurafenib	The serum concentration of Vemurafenib can be increased when it is combined with Ponatinib.
Venetoclax	The serum concentration of Venetoclax can be increased when it is combined with Ponatinib.
Venlafaxine	The metabolism of Ponatinib can be decreased when combined with Venlafaxine.
Verapamil	The metabolism of Ponatinib can be decreased when combined with Verapamil.
Vernakalant	The metabolism of Ponatinib can be decreased when combined with Vernakalant.
Vibrio cholerae	The therapeutic efficacy of Vibrio cholerae CVD 103-HgR strain live antigen can be decreased when used in combination with Ponatinib.
Vilanterol	The risk or severity of adverse effects can be increased when Ponatinib is combined with Vilanterol.
Vilazodone	The metabolism of Ponatinib can be decreased when combined with Vilazodone.
Viloxazine	The metabolism of Ponatinib can be decreased when combined with Viloxazine.
Vinblastine	The serum concentration of Vinblastine can be increased when it is combined with Ponatinib.
Vincristine	The excretion of Vincristine can be decreased when combined with Ponatinib.
Vindesine	The risk or severity of adverse effects can be increased when Vindesine is combined with Ponatinib.
Vinflunine	The serum concentration of Vinflunine can be increased when it is combined with Ponatinib.
Vinorelbine	The metabolism of Ponatinib can be decreased when combined with Vinorelbine.
Vismodegib	Vismodegib may decrease the excretion rate of Ponatinib which could result in a higher serum level.
Vitamin E	The metabolism of Ponatinib can be increased when combined with Vitamin E.
Voclosporin	The risk or severity of adverse effects can be increased when Ponatinib is combined with Voclosporin.
Vonoprazan	The metabolism of Ponatinib can be decreased when combined with Vonoprazan.
Vorapaxar	The metabolism of Ponatinib can be decreased when combined with Vorapaxar.
Voriconazole	The metabolism of Ponatinib can be decreased when combined with Voriconazole.
Vorinostat	The risk or severity of adverse effects can be increased when Vorinostat is combined with Ponatinib.
Vortioxetine	The metabolism of Ponatinib can be decreased when combined with Vortioxetine.
Voxelotor	The serum concentration of Ponatinib can be increased when it is combined with Voxelotor.
Voxilaprevir	The metabolism of Ponatinib can be decreased when combined with Voxilaprevir.
Warfarin	The metabolism of Ponatinib can be increased when combined with Warfarin.
Ximelagatran	The risk or severity of bleeding can be increased when Ximelagatran is combined with Ponatinib.
Yellow fever vaccine	The risk or severity of infection can be increased when Yellow fever vaccine is combined with Ponatinib.
Yohimbine	The metabolism of Ponatinib can be decreased when combined with Yohimbine.
Zafirlukast	The metabolism of Ponatinib can be decreased when combined with Zafirlukast.
Zaleplon	The metabolism of Ponatinib can be decreased when combined with Zaleplon.
Zidovudine	The metabolism of Ponatinib can be decreased when combined with Zidovudine.
Zimelidine	The metabolism of Ponatinib can be decreased when combined with Zimelidine.
Ziprasidone	The metabolism of Ponatinib can be decreased when combined with Ziprasidone.
Zolpidem	The metabolism of Ponatinib can be decreased when combined with Zolpidem.
Zonisamide	The metabolism of Ponatinib can be decreased when combined with Zonisamide.
Zopiclone	The metabolism of Ponatinib can be decreased when combined with Zopiclone.
Zuclopenthixol	The metabolism of Ponatinib can be decreased when combined with Zuclopenthixol

Pregnancy and Lactation

AU TGA pregnancy category D

Pregnancy

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

Lactation

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

How should this medicine be used?

Ponatinib comes as a tablet to take by mouth. It is usually taken once a day with or without food. Take ponatinib at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take ponatinib exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

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

What special precautions should I follow?

Before taking ponatinib,

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

References

Ponatinib – Uses, Dosage, Side Effects, Interaction

Mechanism of Action

Indications

Contraindications