Drug interactions
Crizotinib + Sirolimus
Severity: Major
Crizotinib and Sirolimus: major interaction.
Last updated Sources: US FDA label
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 inhibits CYP3A4 and possibly P-glycoprotein, which may raise sirolimus concentrations. Sirolimus has a narrow therapeutic index, and excess exposure can cause immunosuppression, hyperlipidemia and mouth ulcers.
What this interaction means in plain words
Crizotinib and Sirolimus 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; Sirolimus belongs to Miscellaneous.
Why it happens
Inhibition of CYP3A4 metabolism and P-glycoprotein efflux of sirolimus by crizotinib.
What to do
Monitor sirolimus trough concentrations frequently and reduce the sirolimus dose as needed; avoid the combination when other options exist.
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 Crizotinib
- Crizotinib + Flibanserin Contraindicated
- Crizotinib + Lomitapide Contraindicated
- Crizotinib + Lonafarnib Contraindicated
- Crizotinib + Pimozide Contraindicated
- Crizotinib + Saquinavir Contraindicated
- Crizotinib + Thioridazine Contraindicated
Other interactions of Sirolimus
- Adenovirus types 4 and 7 live + Sirolimus Contraindicated
- Bcg vaccine live + Sirolimus Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Sirolimus Contraindicated
- Ketoconazole + Sirolimus Contraindicated
- Levoketoconazole + Sirolimus Contraindicated
- Measles mumps and rubella vaccine live + Sirolimus Contraindicated
Frequently asked questions
Can I take Crizotinib with Sirolimus?
MediHelp rates the interaction as major. Crizotinib and Sirolimus 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 inhibits CYP3A4 and possibly P-glycoprotein, which may raise sirolimus concentrations. Sirolimus has a narrow therapeutic index, and excess exposure can cause immunosuppression, hyperlipidemia and mouth ulcers.
How serious is the interaction between Crizotinib and Sirolimus?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor sirolimus trough concentrations frequently and reduce the sirolimus dose as needed; avoid the combination when other options exist.
What other medicines interact with Crizotinib?
MediHelp also lists interactions of Crizotinib with, for example, Flibanserin, Lomitapide, Lonafarnib. The full list is on the Crizotinib page.
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