Drug General Information (ID: DDIPV5LO26)
Drug Name			Cabozantinib		Drug Info		Avapritinib		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Vegf/Vegfr Inhibitors				Multikinase Inhibitors
Structure

Mechanism of Cabozantinib-Avapritinib Interaction (Severity Level: Major)
Increased risk of bleeding Click to Show/Hide Mechanism Graph
Drug Name		Cabozantinib				Avapritinib
Mechanism		Risk of bleeding Antiplatelet/anticoagulant effects				Risk of bleeding Antiplatelet/anticoagulant effects
Key Mechanism Factor 1
		Factor Name		Bleeding
		Factor Description		Patients may be at risk for bleeding when the outcome of a disease or disease treatment confounds the standard mechanisms for maintaining hemostasis. Signs or symptoms of abnormal bleeding include: bleeding that takes a long time to stop (including nosebleeds, bleeding gums, bleeding from cuts and abrasions, and menstrual bleeding); severe unexplained bruising, or bruising that becomes larger; blood in the urine or stool, etc.
Mechanism Description		Increased risk of bleeding by the combination of Cabozantinib and Avapritinib

Recommended Action
Management		Concomitant use of avapritinib with other drugs that increase the risk of bleeding should be approached with caution. Close clinical and laboratory monitoring for bleeding complications is recommended during therapy. Patients should be advised to promptly report any signs and symptoms of bleeding to their physician. Patients should also seek immediate medical attention if they experience neurological signs and symptoms that may be associated with intracranial hemorrhage such as severe headache, vision problems, somnolence, or focal weakness. Brain imaging by magnetic resonance imaging (MRI) or computed tomography (CT) may be performed at the discretion of the physician based on severity and clinical presentation.

References
1	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
2	Product Information. Ayvakit (avapritinib). Blueprint Medicines Corporation, Cambridge, MA.