Drug interactions
Aprepitant + Dexamethasone
Severity: Moderate
Aprepitant and Dexamethasone: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Aprepitant raises dexamethasone exposure through CYP3A4 inhibition, roughly doubling it in studies of the oral regimen. This is intentionally managed in antiemetic regimens by lowering the dexamethasone dose.
What this interaction means in plain words
Aprepitant and Dexamethasone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Aprepitant belongs to Gastrointestinal Tract; Dexamethasone belongs to Endocrine.
Why it happens
Aprepitant inhibits CYP3A4, which metabolizes dexamethasone.
What to do
Reduce the oral dexamethasone dose by about half when given with aprepitant for chemotherapy-induced nausea, as per labeling. When dexamethasone is used for other indications, monitor for corticosteroid adverse effects.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Aprepitant
- Aprepitant + Lomitapide Contraindicated
- Aprepitant + Pimozide Contraindicated
- Aprepitant + Avapritinib Major
- Aprepitant + Bosutinib Major
- Aprepitant + Carbamazepine Major
- Aprepitant + Cobicistat Major
Other interactions of Dexamethasone
- Bcg vaccine live + Dexamethasone Contraindicated
- Dexamethasone + Mifepristone Contraindicated
- Dexamethasone + Rilpivirine Contraindicated
- Dexamethasone + Smallpox vaccine live Contraindicated
- Dexamethasone + Varicella virus vaccine live Contraindicated
- Dexamethasone + Yellow fever vaccine Contraindicated
Frequently asked questions
Can I take Aprepitant with Dexamethasone?
MediHelp rates the interaction as moderate. Aprepitant and Dexamethasone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Aprepitant raises dexamethasone exposure through CYP3A4 inhibition, roughly doubling it in studies of the oral regimen. This is intentionally managed in antiemetic regimens by lowering the dexamethasone dose.
How serious is the interaction between Aprepitant and Dexamethasone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce the oral dexamethasone dose by about half when given with aprepitant for chemotherapy-induced nausea, as per labeling. When dexamethasone is used for other indications, monitor for corticosteroid adverse effects.
What other medicines interact with Aprepitant?
MediHelp also lists interactions of Aprepitant with, for example, Lomitapide, Pimozide, Avapritinib. The full list is on the Aprepitant page.
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