Drug interactions
Bosutinib + Nilotinib
Severity: Major
Bosutinib and Nilotinib: 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
Nilotinib may increase bosutinib exposure by inhibiting P-gp and CYP3A4. Both are BCR-ABL inhibitors with additive QT and myelosuppressive potential, and combining them offers no rational benefit.
What this interaction means in plain words
Bosutinib and Nilotinib 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.
Bosutinib belongs to Oncology; Nilotinib belongs to Oncology.
Why it happens
Inhibition of P-gp and CYP3A4 by nilotinib increases bosutinib exposure, with additive pharmacodynamic toxicity.
What to do
Avoid combining two BCR-ABL tyrosine kinase inhibitors. If it occurs, monitor ECG, liver tests and blood counts.
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 Nilotinib
- Amiodarone + Nilotinib Contraindicated
- Arsenic trioxide + Nilotinib Contraindicated
- Disopyramide + Nilotinib Contraindicated
- Dofetilide + Nilotinib Contraindicated
- Dronedarone + Nilotinib Contraindicated
- Droperidol + Nilotinib Contraindicated
Other interactions of Bosutinib
- Amiodarone + Bosutinib Major
- Apalutamide + Bosutinib Major
- Aprepitant + Bosutinib Major
- Bosentan + Bosutinib Major
- Bosutinib + Carbamazepine Major
- Bosutinib + Chlorpromazine Major
Frequently asked questions
Can I take Bosutinib with Nilotinib?
MediHelp rates the interaction as major. Bosutinib and Nilotinib 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. Nilotinib may increase bosutinib exposure by inhibiting P-gp and CYP3A4. Both are BCR-ABL inhibitors with additive QT and myelosuppressive potential, and combining them offers no rational benefit.
How serious is the interaction between Bosutinib and Nilotinib?
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 combining two BCR-ABL tyrosine kinase inhibitors. If it occurs, monitor ECG, liver tests and blood counts.
What other medicines interact with Nilotinib?
MediHelp also lists interactions of Nilotinib with, for example, Amiodarone, Arsenic trioxide, Disopyramide. The full list is on the Nilotinib page.
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