Drug interactions
Dronedarone + Voclosporin
Severity: Major
Dronedarone and Voclosporin: 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, a moderate CYP3A4 inhibitor, can increase voclosporin exposure, raising the risk of nephrotoxicity, hypertension and hyperkalemia. Both drugs can also prolong the QT interval.
What this interaction means in plain words
Dronedarone and Voclosporin 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; Voclosporin belongs to Miscellaneous.
Why it happens
Dronedarone inhibits CYP3A4 (and P-gp), increasing voclosporin levels, with additive QTc effects.
What to do
Reduce the voclosporin dose as recommended for moderate CYP3A4 inhibitors, and monitor eGFR, blood pressure, potassium and ECG.
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 Voclosporin
- Clarithromycin + Voclosporin Contraindicated
- Cyclosporin + Voclosporin Contraindicated
- Ensitrelvir + Voclosporin Contraindicated
- Itraconazole + Voclosporin Contraindicated
- Ketoconazole + Voclosporin Contraindicated
- Posaconazole + Voclosporin Contraindicated
Frequently asked questions
Can I take Dronedarone with Voclosporin?
MediHelp rates the interaction as major. Dronedarone and Voclosporin 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, a moderate CYP3A4 inhibitor, can increase voclosporin exposure, raising the risk of nephrotoxicity, hypertension and hyperkalemia. Both drugs can also prolong the QT interval.
How serious is the interaction between Dronedarone and Voclosporin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce the voclosporin dose as recommended for moderate CYP3A4 inhibitors, and monitor eGFR, blood pressure, potassium and ECG.
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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