Drug interactions
Bortezomib + Fosphenytoin
Severity: Major
Bortezomib and Fosphenytoin: major 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
Fosphenytoin is converted to phenytoin, a CYP3A4 inducer that may lower bortezomib exposure. This may reduce anti-myeloma efficacy.
What this interaction means in plain words
Bortezomib and Fosphenytoin 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.
Bortezomib belongs to Oncology; Fosphenytoin belongs to Central Nervous System.
Why it happens
Induction of CYP3A4-mediated bortezomib metabolism.
What to do
Avoid strong inducers where possible and use a non-inducing anticonvulsant. If it cannot be avoided, monitor disease response closely.
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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Other interactions of Bortezomib
- Apalutamide + Bortezomib Major
- Bortezomib + Carbamazepine Major
- Bortezomib + Etrasimod Major
- Bortezomib + Idelalisib Major
- Bortezomib + Lonafarnib Major
- Bortezomib + Mitotane Major
Other interactions of Fosphenytoin
- Dronedarone + Fosphenytoin Contraindicated
- Fosphenytoin + Ledipasvir-sofosbuvir Contraindicated
- Fosphenytoin + Lorlatinib Contraindicated
- Fosphenytoin + Lurasidone Contraindicated
- Fosphenytoin + Ranolazine Contraindicated
- Fosphenytoin + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
Frequently asked questions
Can I take Bortezomib with Fosphenytoin?
MediHelp rates the interaction as major. Bortezomib and Fosphenytoin 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. Fosphenytoin is converted to phenytoin, a CYP3A4 inducer that may lower bortezomib exposure. This may reduce anti-myeloma efficacy.
How serious is the interaction between Bortezomib and Fosphenytoin?
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 strong inducers where possible and use a non-inducing anticonvulsant. If it cannot be avoided, monitor disease response closely.
What other medicines interact with Bortezomib?
MediHelp also lists interactions of Bortezomib with, for example, Apalutamide, Carbamazepine, Etrasimod. The full list is on the Bortezomib page.
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