Drug interactions
Diltiazem + Irinotecan liposomal
Severity: Moderate
Diltiazem and Irinotecan liposomal: 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
Irinotecan is converted to its active metabolite SN-38 and is also cleared by CYP3A4 into inactive products. A CYP3A4 inhibitor such as diltiazem may increase exposure to irinotecan and SN-38, raising the risk of neutropenia and diarrhea. Evidence for moderate inhibitors is limited.
What this interaction means in plain words
Diltiazem and Irinotecan liposomal 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.
Why it happens
Diltiazem inhibits CYP3A4 metabolism of irinotecan and SN-38 precursors.
What to do
Monitor blood counts and for severe diarrhea, or consider an alternative antihypertensive that does not inhibit CYP3A4.
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 Diltiazem
- Diltiazem + Flibanserin Contraindicated
- Diltiazem + Ivabradine Contraindicated
- Diltiazem + Lomitapide Contraindicated
- Diltiazem + Lonafarnib Contraindicated
- Acebutolol + Diltiazem Major
- Alfentanil + Diltiazem Major
Frequently asked questions
Can I take Diltiazem with Irinotecan liposomal?
MediHelp rates the interaction as moderate. Diltiazem and Irinotecan liposomal 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. Irinotecan is converted to its active metabolite SN-38 and is also cleared by CYP3A4 into inactive products. A CYP3A4 inhibitor such as diltiazem may increase exposure to irinotecan and SN-38, raising the risk of neutropenia and diarrhea. Evidence for moderate inhibitors is limited.
How serious is the interaction between Diltiazem and Irinotecan liposomal?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood counts and for severe diarrhea, or consider an alternative antihypertensive that does not inhibit CYP3A4.
What other medicines interact with Diltiazem?
MediHelp also lists interactions of Diltiazem with, for example, Flibanserin, Ivabradine, Lomitapide. The full list is on the Diltiazem page.
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