Drug interactions
Dronedarone + Iloperidone
Severity: Major
Dronedarone and Iloperidone: 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
Both drugs prolong the QT interval, and dronedarone inhibits CYP2D6 and CYP3A4, the main pathways clearing iloperidone, raising its levels. Iloperidone may also inhibit CYP3A4 and increase dronedarone exposure, compounding the risk of torsades de pointes.
What this interaction means in plain words
Dronedarone and Iloperidone 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.
Dronedarone belongs to Cardiovascular; Iloperidone belongs to Central Nervous System.
Why it happens
Additive QT prolongation combined with mutual CYP3A4 inhibition and dronedarone inhibition of iloperidone CYP2D6 metabolism.
What to do
Avoid the combination when possible. If used, reduce the iloperidone dose per labeling for CYP inhibitors, monitor ECG and keep potassium and magnesium normal.
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
- Dronedarone 400 mg film-coated tablets - SmPC sections 4.3/4.5 (class statement: phenothiazines; "Medicinal products inducing torsades de pointes such as phenothiazines, cisapride, bepridil, tricyclic antidepressants, certain oral macrolides (such as erythro") — electronic medicines compendium (UK SmPC)
Other interactions of Dronedarone
- Adagrasib + Dronedarone Contraindicated
- Amiodarone + Dronedarone Contraindicated
- Arsenic trioxide + Dronedarone Contraindicated
- Artemether / lumefantrine + Dronedarone Contraindicated
- Atazanavir + Dronedarone Contraindicated
- Azithromycin + Dronedarone Contraindicated
Other interactions of Iloperidone
- Iloperidone + Thioridazine Contraindicated
- Alfuzosin + Iloperidone Major
- Amiodarone + Iloperidone Major
- Amisulpride + Iloperidone Major
- Amitriptyline + Iloperidone Major
- Anagrelide + Iloperidone Major
Frequently asked questions
Can I take Dronedarone with Iloperidone?
MediHelp rates the interaction as major. Dronedarone and Iloperidone 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. Both drugs prolong the QT interval, and dronedarone inhibits CYP2D6 and CYP3A4, the main pathways clearing iloperidone, raising its levels. Iloperidone may also inhibit CYP3A4 and increase dronedarone exposure, compounding the risk of torsades de pointes.
How serious is the interaction between Dronedarone and Iloperidone?
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 when possible. If used, reduce the iloperidone dose per labeling for CYP inhibitors, monitor ECG and keep potassium and magnesium normal.
What other medicines interact with Dronedarone?
MediHelp also lists interactions of Dronedarone with, for example, Adagrasib, Amiodarone, Arsenic trioxide. The full list is on the Dronedarone page.
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