Drug interactions
Aprepitant + Eliglustat
Severity: Major
Aprepitant and Eliglustat: major interaction.
Last updated Sources: UK SmPC
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 inhibits CYP3A4 and can increase eliglustat exposure. Raised eliglustat levels may prolong PR, QTc and QRS intervals and provoke arrhythmias, especially in CYP2D6 poor or intermediate metabolizers.
What this interaction means in plain words
Aprepitant and Eliglustat can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Aprepitant belongs to Gastrointestinal Tract; Eliglustat belongs to Miscellaneous.
Why it happens
Aprepitant inhibits CYP3A4, a secondary clearance pathway for eliglustat that becomes important in reduced CYP2D6 function.
What to do
Avoid in CYP2D6 poor or intermediate metabolizers. In extensive metabolizers reduce eliglustat to 84 mg once daily and monitor ECG.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
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 Eliglustat
- Amiodarone + Eliglustat Contraindicated
- Clarithromycin + Eliglustat Contraindicated
- Dronedarone + Eliglustat Contraindicated
- Eliglustat + Itraconazole Contraindicated
- Eliglustat + Ketoconazole Contraindicated
- Eliglustat + Pimozide Contraindicated
Frequently asked questions
Can I take Aprepitant with Eliglustat?
MediHelp rates the interaction as major. Aprepitant and Eliglustat can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Aprepitant inhibits CYP3A4 and can increase eliglustat exposure. Raised eliglustat levels may prolong PR, QTc and QRS intervals and provoke arrhythmias, especially in CYP2D6 poor or intermediate metabolizers.
How serious is the interaction between Aprepitant and Eliglustat?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid in CYP2D6 poor or intermediate metabolizers. In extensive metabolizers reduce eliglustat to 84 mg once daily and monitor ECG.
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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