Drug interactions
Efavirenz + Ivosidenib
Severity: Major
Efavirenz and Ivosidenib: 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
Efavirenz may reduce ivosidenib exposure and compromise its antileukemic activity. Both drugs are also associated with QT prolongation, which adds arrhythmia risk.
What this interaction means in plain words
Efavirenz and Ivosidenib 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.
Efavirenz belongs to Anti Virals; Ivosidenib belongs to Oncology.
Why it happens
CYP3A4 induction by efavirenz increases ivosidenib clearance, and both drugs have additive QTc-prolonging effects.
What to do
Avoid strong CYP3A4 inducers with ivosidenib and choose an alternative antiretroviral if possible. If unavoidable, monitor ECG and electrolytes and watch for loss of response.
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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Other interactions of Efavirenz
- Cobimetinib + Efavirenz Contraindicated
- Dienogest / estradiol valerate + Efavirenz Contraindicated
- Dihydroergotamine intranasal + Efavirenz Contraindicated
- Dihydroergotamine + Efavirenz Contraindicated
- Doravirine + Efavirenz Contraindicated
- Efavirenz + Elbasvir / grazoprevir Contraindicated
Other interactions of Ivosidenib
- Alfuzosin + Ivosidenib Major
- Amiodarone + Ivosidenib Major
- Amisulpride + Ivosidenib Major
- Amitriptyline + Ivosidenib Major
- Amobarbital + Ivosidenib Major
- Anagrelide + Ivosidenib Major
Frequently asked questions
Can I take Efavirenz with Ivosidenib?
MediHelp rates the interaction as major. Efavirenz and Ivosidenib 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. Efavirenz may reduce ivosidenib exposure and compromise its antileukemic activity. Both drugs are also associated with QT prolongation, which adds arrhythmia risk.
How serious is the interaction between Efavirenz and Ivosidenib?
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 strong CYP3A4 inducers with ivosidenib and choose an alternative antiretroviral if possible. If unavoidable, monitor ECG and electrolytes and watch for loss of response.
What other medicines interact with Efavirenz?
MediHelp also lists interactions of Efavirenz with, for example, Cobimetinib, Dienogest / estradiol valerate, Dihydroergotamine intranasal. The full list is on the Efavirenz page.
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