Drug interactions
Dextromethorphan + Rolapitant
Severity: Moderate
Dextromethorphan and Rolapitant: moderate 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
Rolapitant is a long-acting CYP2D6 inhibitor and can markedly raise dextromethorphan exposure. This may increase dextromethorphan adverse effects such as dizziness, sedation and confusion, and the inhibition persists for days to weeks after rolapitant dosing.
What this interaction means in plain words
Dextromethorphan and Rolapitant can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Dextromethorphan belongs to Respiratory; Rolapitant belongs to Gastrointestinal Tract.
Why it happens
Rolapitant inhibits CYP2D6, reducing dextromethorphan metabolism to dextrorphan.
What to do
Avoid combining where possible, or use the lowest effective dextromethorphan dose and monitor for CNS adverse effects. Remember the inhibition persists for at least 28 days after rolapitant.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Dextromethorphan
- Dextromethorphan + Isocarboxazid Contraindicated
- Dextromethorphan + Linezolid Contraindicated
- Dextromethorphan + Phenelzine Contraindicated
- Dextromethorphan + Rasagiline Contraindicated
- Dextromethorphan + Safinamide Contraindicated
- Dextromethorphan + Selegiline Contraindicated
Other interactions of Rolapitant
- Pimozide + Rolapitant Contraindicated
- Rolapitant + Thioridazine Contraindicated
- Atomoxetine + Rolapitant Major
- Deutetrabenazine + Rolapitant Major
- Eliglustat + Rolapitant Major
- Flecainide + Rolapitant Major
Frequently asked questions
Can I take Dextromethorphan with Rolapitant?
MediHelp rates the interaction as moderate. Dextromethorphan and Rolapitant can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Rolapitant is a long-acting CYP2D6 inhibitor and can markedly raise dextromethorphan exposure. This may increase dextromethorphan adverse effects such as dizziness, sedation and confusion, and the inhibition persists for days to weeks after rolapitant dosing.
How serious is the interaction between Dextromethorphan and Rolapitant?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid combining where possible, or use the lowest effective dextromethorphan dose and monitor for CNS adverse effects. Remember the inhibition persists for at least 28 days after rolapitant.
What other medicines interact with Dextromethorphan?
MediHelp also lists interactions of Dextromethorphan with, for example, Isocarboxazid, Linezolid, Phenelzine. The full list is on the Dextromethorphan page.
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