Drug interactions
Bosutinib + Verapamil
Severity: Major
Bosutinib and Verapamil: 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
Verapamil inhibits both CYP3A4 and P-glycoprotein, and bosutinib is a substrate of both. Bosutinib exposure may rise, increasing gastrointestinal toxicity, hepatotoxicity and myelosuppression.
What this interaction means in plain words
Bosutinib and Verapamil 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; Verapamil belongs to Cardiovascular.
Why it happens
Verapamil inhibits CYP3A4 and P-gp, decreasing bosutinib metabolism and efflux.
What to do
Avoid moderate CYP3A or P-gp inhibitors with bosutinib where possible; choose an alternative antihypertensive or antiarrhythmic, otherwise monitor liver enzymes and GI toxicity.
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 Verapamil
- Dofetilide + Verapamil Contraindicated
- Flibanserin + Verapamil Contraindicated
- Lomitapide + Verapamil Contraindicated
- Lonafarnib + Verapamil Contraindicated
- Pimozide + Verapamil Contraindicated
- Acebutolol + Verapamil Major
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 Verapamil?
MediHelp rates the interaction as major. Bosutinib and Verapamil 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. Verapamil inhibits both CYP3A4 and P-glycoprotein, and bosutinib is a substrate of both. Bosutinib exposure may rise, increasing gastrointestinal toxicity, hepatotoxicity and myelosuppression.
How serious is the interaction between Bosutinib and Verapamil?
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 moderate CYP3A or P-gp inhibitors with bosutinib where possible; choose an alternative antihypertensive or antiarrhythmic, otherwise monitor liver enzymes and GI toxicity.
What other medicines interact with Verapamil?
MediHelp also lists interactions of Verapamil with, for example, Dofetilide, Flibanserin, Lomitapide. The full list is on the Verapamil page.
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