Drug interactions
Doxorubicin + Verapamil
Severity: Major
Doxorubicin and Verapamil: major interaction.
Last updated Sources: UK SmPC
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
Verapamil inhibits P-glycoprotein and CYP3A4 and can increase doxorubicin plasma and tissue exposure. This may increase myelosuppression and the risk of cardiotoxicity. Both drugs also affect cardiac function.
What this interaction means in plain words
Doxorubicin and Verapamil 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; Verapamil belongs to Cardiovascular.
Why it happens
Verapamil inhibits P-glycoprotein-mediated efflux and CYP3A4 metabolism of doxorubicin, raising its exposure.
What to do
Avoid the combination where an alternative antihypertensive or antiarrhythmic is feasible. If used together, monitor LVEF, blood counts and 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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References
Other interactions of Verapamil
- Dofetilide + Verapamil Contraindicated
- Flibanserin + Verapamil Contraindicated
- Lomitapide + Verapamil Contraindicated
- Lonafarnib + Verapamil Contraindicated
- Pimozide + Verapamil Contraindicated
- Acebutolol + Verapamil Major
Other interactions of Doxorubicin
Frequently asked questions
Can I take Doxorubicin with Verapamil?
MediHelp rates the interaction as major. Doxorubicin and Verapamil 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. Verapamil inhibits P-glycoprotein and CYP3A4 and can increase doxorubicin plasma and tissue exposure. This may increase myelosuppression and the risk of cardiotoxicity. Both drugs also affect cardiac function.
How serious is the interaction between Doxorubicin and Verapamil?
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 an alternative antihypertensive or antiarrhythmic is feasible. If used together, monitor LVEF, blood counts and for heart failure symptoms.
What other medicines interact with Verapamil?
MediHelp also lists interactions of Verapamil with, for example, Dofetilide, Flibanserin, Lomitapide. The full list is on the Verapamil page.
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