Drug interactions
Efavirenz + Nilotinib
Severity: Major
Efavirenz and Nilotinib: 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
Nilotinib carries a boxed warning for QT prolongation and sudden death, and efavirenz adds QT risk. Efavirenz also induces CYP3A4 and may lower nilotinib exposure.
What this interaction means in plain words
Efavirenz and Nilotinib 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; Nilotinib belongs to Oncology.
Why it happens
Additive QT prolongation, plus CYP3A4 induction reducing nilotinib levels.
What to do
Avoid the combination and use an antiretroviral without QT effects or CYP3A induction, such as an integrase inhibitor. If it cannot be avoided, monitor the ECG and electrolytes.
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 Nilotinib
- Amiodarone + Nilotinib Contraindicated
- Arsenic trioxide + Nilotinib Contraindicated
- Disopyramide + Nilotinib Contraindicated
- Dofetilide + Nilotinib Contraindicated
- Dronedarone + Nilotinib Contraindicated
- Droperidol + Nilotinib Contraindicated
Frequently asked questions
Can I take Efavirenz with Nilotinib?
MediHelp rates the interaction as major. Efavirenz and Nilotinib 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. Nilotinib carries a boxed warning for QT prolongation and sudden death, and efavirenz adds QT risk. Efavirenz also induces CYP3A4 and may lower nilotinib exposure.
How serious is the interaction between Efavirenz and Nilotinib?
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 and use an antiretroviral without QT effects or CYP3A induction, such as an integrase inhibitor. If it cannot be avoided, monitor the ECG and electrolytes.
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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