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Drug interactions

Daunorubicin + Trastuzumab deruxtecan

Severity: Major

Daunorubicin and Trastuzumab deruxtecan: major 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

Anthracyclines and HER2-directed antibodies both carry cardiotoxicity risk, and giving them together or in close sequence increases the risk of cardiomyopathy and reduced ejection fraction. Trastuzumab deruxtecan also causes interstitial lung disease and myelosuppression.

What this interaction means in plain words

Daunorubicin and Trastuzumab deruxtecan 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.

Daunorubicin belongs to Oncology; Trastuzumab deruxtecan belongs to Oncology.

Evidence level: High

Why it happens

Additive cardiotoxicity from anthracycline myocardial injury and HER2 pathway inhibition in cardiomyocytes.

What to do

Avoid concurrent use and keep the interval between anthracycline and HER2-directed therapy as long as possible. Assess left ventricular ejection fraction before and regularly during treatment.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Daunorubicin with Trastuzumab deruxtecan?

MediHelp rates the interaction as major. Daunorubicin and Trastuzumab deruxtecan 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. Anthracyclines and HER2-directed antibodies both carry cardiotoxicity risk, and giving them together or in close sequence increases the risk of cardiomyopathy and reduced ejection fraction. Trastuzumab deruxtecan also causes interstitial lung disease and myelosuppression.

How serious is the interaction between Daunorubicin and Trastuzumab deruxtecan?

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 concurrent use and keep the interval between anthracycline and HER2-directed therapy as long as possible. Assess left ventricular ejection fraction before and regularly during treatment.

What other medicines interact with Daunorubicin?

MediHelp also lists interactions of Daunorubicin with, for example, Adenovirus types 4 and 7 live, Belatacept, Cyclosporine. The full list is on the Daunorubicin page.

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