Drug interactions
Diltiazem + Trabectedin
Severity: Major
Diltiazem and Trabectedin: 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
Diltiazem is a moderate CYP3A4 inhibitor and can increase trabectedin exposure. This may increase toxicities such as hepatotoxicity, myelosuppression and rhabdomyolysis.
What this interaction means in plain words
Diltiazem and Trabectedin 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; Trabectedin belongs to Oncology.
Why it happens
Inhibition of CYP3A4-mediated trabectedin metabolism by diltiazem.
What to do
Avoid the combination where possible and use an alternative antihypertensive or rate-control agent. If it cannot be avoided, monitor liver enzymes, CPK and blood counts closely.
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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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 Trabectedin
Frequently asked questions
Can I take Diltiazem with Trabectedin?
MediHelp rates the interaction as major. Diltiazem and Trabectedin 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 is a moderate CYP3A4 inhibitor and can increase trabectedin exposure. This may increase toxicities such as hepatotoxicity, myelosuppression and rhabdomyolysis.
How serious is the interaction between Diltiazem and Trabectedin?
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 use an alternative antihypertensive or rate-control agent. If it cannot be avoided, monitor liver enzymes, CPK and blood counts closely.
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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