Drug interactions
Doxorubicin + Trastuzumab deruxtecan
Severity: Major
Doxorubicin 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
Trastuzumab-based therapies can cause left ventricular dysfunction, and the risk is greatest when they are given with or soon after anthracyclines such as doxorubicin. Both agents have cardiotoxic potential, so the combined risk of cardiomyopathy and heart failure is increased.
What this interaction means in plain words
Doxorubicin 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.
Doxorubicin belongs to Oncology; Trastuzumab deruxtecan belongs to Oncology.
Why it happens
Additive cardiotoxicity through anthracycline-induced myocardial injury and HER2 pathway inhibition impairing cardiomyocyte repair.
What to do
Avoid concurrent anthracycline use where possible and consider the cumulative anthracycline dose and washout interval. If combined, assess LVEF before and regularly during treatment and monitor for heart failure symptoms.
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 Doxorubicin
Other interactions of Trastuzumab deruxtecan
Frequently asked questions
Can I take Doxorubicin with Trastuzumab deruxtecan?
MediHelp rates the interaction as major. Doxorubicin 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. Trastuzumab-based therapies can cause left ventricular dysfunction, and the risk is greatest when they are given with or soon after anthracyclines such as doxorubicin. Both agents have cardiotoxic potential, so the combined risk of cardiomyopathy and heart failure is increased.
How serious is the interaction between Doxorubicin 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 anthracycline use where possible and consider the cumulative anthracycline dose and washout interval. If combined, assess LVEF before and regularly during treatment and monitor for heart failure symptoms.
What other medicines interact with Doxorubicin?
MediHelp also lists interactions of Doxorubicin with, for example, Adenovirus types 4 and 7 live, Belatacept, Cobicistat. The full list is on the Doxorubicin page.
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