Drug interactions
Crizotinib + Verapamil
Severity: Major
Crizotinib 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
Crizotinib inhibits CYP3A4 and verapamil is a moderate CYP3A4 inhibitor, so each may raise the other's exposure. Increased verapamil effect may cause bradycardia, AV block and hypotension, and crizotinib toxicity and QT prolongation may also be greater.
What this interaction means in plain words
Crizotinib 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.
Crizotinib belongs to Oncology; Verapamil belongs to Cardiovascular.
Why it happens
Mutual inhibition of CYP3A4 metabolism, with additional possible P-glycoprotein effects, plus additive bradycardic effects.
What to do
Avoid the combination where possible; otherwise monitor heart rate, ECG and blood pressure, and reduce the verapamil dose if bradycardia or hypotension occurs. Consider an alternative antihypertensive or rate-control agent.
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 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 Verapamil?
MediHelp rates the interaction as major. Crizotinib 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. Crizotinib inhibits CYP3A4 and verapamil is a moderate CYP3A4 inhibitor, so each may raise the other's exposure. Increased verapamil effect may cause bradycardia, AV block and hypotension, and crizotinib toxicity and QT prolongation may also be greater.
How serious is the interaction between Crizotinib 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 the combination where possible; otherwise monitor heart rate, ECG and blood pressure, and reduce the verapamil dose if bradycardia or hypotension occurs. Consider an alternative antihypertensive or rate-control agent.
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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