Drug interactions
Bosutinib + Phenytoin
Severity: Major
Bosutinib and Phenytoin: 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
Phenytoin is a strong inducer of CYP3A4 and markedly lowers bosutinib exposure. This can lead to loss of antileukemic efficacy and risk of disease progression or resistance.
What this interaction means in plain words
Bosutinib and Phenytoin 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; Phenytoin belongs to Central Nervous System.
Why it happens
Induction of CYP3A4 by phenytoin increases the metabolic clearance of bosutinib.
What to do
Avoid the combination and switch to a non-enzyme-inducing anticonvulsant such as levetiracetam. If it cannot be avoided, monitor hematologic and molecular 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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References
Other interactions of Phenytoin
- Artemether / lumefantrine + Phenytoin Contraindicated
- Bictegravir + Phenytoin Contraindicated
- Cabotegravir + Phenytoin Contraindicated
- Doravirine + Phenytoin Contraindicated
- Elbasvir / grazoprevir + Phenytoin Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Phenytoin 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 Phenytoin?
MediHelp rates the interaction as major. Bosutinib and Phenytoin 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. Phenytoin is a strong inducer of CYP3A4 and markedly lowers bosutinib exposure. This can lead to loss of antileukemic efficacy and risk of disease progression or resistance.
How serious is the interaction between Bosutinib and Phenytoin?
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 the combination and switch to a non-enzyme-inducing anticonvulsant such as levetiracetam. If it cannot be avoided, monitor hematologic and molecular response closely.
What other medicines interact with Phenytoin?
MediHelp also lists interactions of Phenytoin with, for example, Artemether / lumefantrine, Bictegravir, Cabotegravir. The full list is on the Phenytoin page.
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