Drug interactions
Dronedarone + Trabectedin
Severity: Major
Dronedarone and Trabectedin: 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
Dronedarone may raise trabectedin exposure by inhibiting its CYP3A4 metabolism, increasing the risk of hepatotoxicity, myelosuppression and rhabdomyolysis. Labeling advises avoiding strong CYP3A4 inhibitors, and moderate inhibitors warrant caution.
What this interaction means in plain words
Dronedarone 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.
Dronedarone belongs to Cardiovascular; Trabectedin belongs to Oncology.
Why it happens
Dronedarone inhibits CYP3A4, reducing trabectedin clearance.
What to do
Avoid the combination if possible; if used, monitor liver enzymes, CPK and blood counts closely and adjust trabectedin per labeling.
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: substrates of P-glycoproteins, CYP 3A4 or CYP 2D6; "Dronedarone has therefore, the potential to interact on medicinal products substrates of P-glycoproteins, CYP 3A4 or CYP 2D6.") — 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 Trabectedin
Frequently asked questions
Can I take Dronedarone with Trabectedin?
MediHelp rates the interaction as major. Dronedarone 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. Dronedarone may raise trabectedin exposure by inhibiting its CYP3A4 metabolism, increasing the risk of hepatotoxicity, myelosuppression and rhabdomyolysis. Labeling advises avoiding strong CYP3A4 inhibitors, and moderate inhibitors warrant caution.
How serious is the interaction between Dronedarone 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 if possible; if used, monitor liver enzymes, CPK and blood counts closely and adjust trabectedin per labeling.
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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