Drug interactions
Diltiazem + Neratinib
Severity: Major
Diltiazem and Neratinib: major interaction.
Last updated Sources: US FDA label
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
Diltiazem, a moderate CYP3A4 inhibitor, can raise neratinib exposure. Higher neratinib levels may worsen adverse effects such as severe diarrhea and hepatotoxicity.
What this interaction means in plain words
Diltiazem 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.
Diltiazem belongs to Cardiovascular; Neratinib belongs to Oncology.
Why it happens
Inhibition of CYP3A4-mediated metabolism of neratinib by diltiazem.
What to do
Avoid the combination where possible and consider an alternative antihypertensive or antianginal such as a dihydropyridine with less CYP3A4 inhibition. If it is unavoidable, monitor closely for diarrhea and liver enzyme elevations.
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 Diltiazem
- Diltiazem + Flibanserin Contraindicated
- Diltiazem + Ivabradine Contraindicated
- Diltiazem + Lomitapide Contraindicated
- Diltiazem + Lonafarnib Contraindicated
- Acebutolol + Diltiazem Major
- Alfentanil + Diltiazem Major
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 Diltiazem with Neratinib?
MediHelp rates the interaction as major. Diltiazem 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. Diltiazem, a moderate CYP3A4 inhibitor, can raise neratinib exposure. Higher neratinib levels may worsen adverse effects such as severe diarrhea and hepatotoxicity.
How serious is the interaction between Diltiazem 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 where possible and consider an alternative antihypertensive or antianginal such as a dihydropyridine with less CYP3A4 inhibition. If it is unavoidable, monitor closely for diarrhea and liver enzyme elevations.
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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