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Drug interactions

Duvelisib + Regorafenib

Severity: Major

Duvelisib and Regorafenib: 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

Duvelisib inhibits CYP3A4 and may raise regorafenib exposure, increasing hepatotoxicity, hypertension and hand-foot skin reaction. Regorafenib may in turn increase duvelisib exposure through BCRP inhibition, adding to duvelisib toxicities such as infections, diarrhea and skin reactions.

What this interaction means in plain words

Duvelisib and Regorafenib 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.

Duvelisib belongs to Oncology; Regorafenib belongs to Oncology.

Evidence level: Moderate

Why it happens

Duvelisib inhibits CYP3A4 metabolism of regorafenib, and regorafenib inhibits BCRP-mediated efflux of duvelisib.

What to do

Consider avoiding the combination or reducing the regorafenib dose, with close monitoring of liver function, blood pressure and skin toxicity. Monitor for duvelisib toxicities including infection and severe diarrhea.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Duvelisib with Regorafenib?

MediHelp rates the interaction as major. Duvelisib and Regorafenib 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. Duvelisib inhibits CYP3A4 and may raise regorafenib exposure, increasing hepatotoxicity, hypertension and hand-foot skin reaction. Regorafenib may in turn increase duvelisib exposure through BCRP inhibition, adding to duvelisib toxicities such as infections, diarrhea and skin reactions.

How serious is the interaction between Duvelisib and Regorafenib?

MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Consider avoiding the combination or reducing the regorafenib dose, with close monitoring of liver function, blood pressure and skin toxicity. Monitor for duvelisib toxicities including infection and severe diarrhea.

What other medicines interact with Regorafenib?

MediHelp also lists interactions of Regorafenib with, for example, Apalutamide, Atazanavir, Carbamazepine. The full list is on the Regorafenib page.

Full monographs, dosing and an interaction checker in the MediHelp app

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