Drug interactions
Cenobamate + Irinotecan
Severity: Moderate
Cenobamate and Irinotecan: moderate 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
Cenobamate induces CYP3A4 and CYP2B6, which could reduce irinotecan and SN-38 exposure and potentially lower efficacy. Strong enzyme-inducing antiepileptics have been shown to reduce SN-38 exposure.
What this interaction means in plain words
Cenobamate and Irinotecan can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Cenobamate belongs to Central Nervous System; Irinotecan belongs to Oncology.
Why it happens
Induction of CYP3A4 by cenobamate increases irinotecan metabolism to inactive metabolites, lowering SN-38 exposure.
What to do
Monitor clinical response to irinotecan and consider an alternative antiseizure drug without enzyme induction where feasible.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Irinotecan
- Clozapine + Irinotecan Contraindicated
- Irinotecan + Sacituzumab govitecan Contraindicated
- Adenovirus types 4 and 7 live + Irinotecan Major
- Apalutamide + Irinotecan Major
- Atazanavir + Irinotecan Major
- Carbamazepine + Irinotecan Major
Other interactions of Cenobamate
Frequently asked questions
Can I take Cenobamate with Irinotecan?
MediHelp rates the interaction as moderate. Cenobamate and Irinotecan can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Cenobamate induces CYP3A4 and CYP2B6, which could reduce irinotecan and SN-38 exposure and potentially lower efficacy. Strong enzyme-inducing antiepileptics have been shown to reduce SN-38 exposure.
How serious is the interaction between Cenobamate and Irinotecan?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor clinical response to irinotecan and consider an alternative antiseizure drug without enzyme induction where feasible.
What other medicines interact with Irinotecan?
MediHelp also lists interactions of Irinotecan with, for example, Clozapine, Sacituzumab govitecan, Adenovirus types 4 and 7 live. The full list is on the Irinotecan page.
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