Drug interactions
Crizotinib + Donepezil
Severity: Major
Crizotinib and Donepezil: 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
Crizotinib can prolong the QT interval and cause bradycardia, and donepezil has similar cardiac effects through cholinergic stimulation and QT prolongation. Combined use increases the risk of serious arrhythmia, including torsades de pointes, and of symptomatic bradycardia.
What this interaction means in plain words
Crizotinib and Donepezil 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.
Crizotinib belongs to Oncology; Donepezil belongs to Central Nervous System.
Why it happens
Additive QT prolongation and additive bradycardic effects.
What to do
Avoid the combination if an alternative exists; otherwise monitor ECG and heart rate and keep potassium and magnesium within normal range. Stop or reduce the dose of crizotinib if significant QTc prolongation develops.
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
- Apozyl 10 mg Orodispersible Tablets - SmPC sections 4.3/4.5 (class statement: other medicinal products known to prolong the QTc interval; "Caution is advised when donepezil is used in combination with other medicinal products known to prolong the QTc interval and clinical monitoring(ECG) may be req… — electronic medicines compendium (UK SmPC)
Other interactions of Donepezil
- Donepezil + Dronedarone Contraindicated
- Donepezil + Pimozide Contraindicated
- Donepezil + Thioridazine Contraindicated
- Donepezil + Vandetanib Contraindicated
- Amiodarone + Donepezil Major
- Amisulpride + Donepezil Major
Other interactions of Crizotinib
- Crizotinib + Flibanserin Contraindicated
- Crizotinib + Lomitapide Contraindicated
- Crizotinib + Lonafarnib Contraindicated
- Crizotinib + Pimozide Contraindicated
- Crizotinib + Saquinavir Contraindicated
- Crizotinib + Thioridazine Contraindicated
Frequently asked questions
Can I take Crizotinib with Donepezil?
MediHelp rates the interaction as major. Crizotinib and Donepezil 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. Crizotinib can prolong the QT interval and cause bradycardia, and donepezil has similar cardiac effects through cholinergic stimulation and QT prolongation. Combined use increases the risk of serious arrhythmia, including torsades de pointes, and of symptomatic bradycardia.
How serious is the interaction between Crizotinib and Donepezil?
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 if an alternative exists; otherwise monitor ECG and heart rate and keep potassium and magnesium within normal range. Stop or reduce the dose of crizotinib if significant QTc prolongation develops.
What other medicines interact with Donepezil?
MediHelp also lists interactions of Donepezil with, for example, Dronedarone, Pimozide, Thioridazine. The full list is on the Donepezil page.
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