Drug interactions
Cyclosporin + Neratinib
Severity: Major
Cyclosporin and Neratinib: major interaction.
Last updated Sources: EMA 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
Cyclosporine inhibits both CYP3A4 and P-gp and can substantially increase neratinib exposure. This heightens the risk of diarrhea, hepatotoxicity and other adverse effects.
What this interaction means in plain words
Cyclosporin and Neratinib 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.
Cyclosporin belongs to Miscellaneous; Neratinib belongs to Oncology.
Why it happens
Inhibition of CYP3A4 metabolism and P-gp efflux of neratinib by cyclosporine.
What to do
Avoid the combination and choose an alternative immunosuppressant if possible. If used together, monitor for diarrhea and liver function.
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 Cyclosporin
- Adenovirus types 4 and 7 live + Cyclosporin Contraindicated
- Aliskiren + Cyclosporin Contraindicated
- Bcg vaccine live + Cyclosporin Contraindicated
- Bosentan + Cyclosporin Contraindicated
- Cidofovir + Cyclosporin Contraindicated
- Cyclosporin + Dengue vaccine Contraindicated
Other interactions of Neratinib
- Amiodarone + Neratinib Major
- Amobarbital + Neratinib Major
- Aprepitant + Neratinib Major
- Armodafinil + Neratinib Major
- Bosentan + Neratinib Major
- Carbamazepine + Neratinib Major
Frequently asked questions
Can I take Cyclosporin with Neratinib?
MediHelp rates the interaction as major. Cyclosporin and Neratinib 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. Cyclosporine inhibits both CYP3A4 and P-gp and can substantially increase neratinib exposure. This heightens the risk of diarrhea, hepatotoxicity and other adverse effects.
How serious is the interaction between Cyclosporin and Neratinib?
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 and choose an alternative immunosuppressant if possible. If used together, monitor for diarrhea and liver function.
What other medicines interact with Cyclosporin?
MediHelp also lists interactions of Cyclosporin with, for example, Adenovirus types 4 and 7 live, Aliskiren, Bcg vaccine live. The full list is on the Cyclosporin page.
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