Drug interactions
Eliglustat + Pyrimethamine
Severity: Major
Eliglustat and Pyrimethamine: 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
Pyrimethamine is reported to inhibit CYP2D6, which could raise eliglustat exposure. Eliglustat can prolong PR, QTc and QRS intervals at high concentrations, so increased exposure raises arrhythmia risk.
What this interaction means in plain words
Eliglustat and Pyrimethamine 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.
Eliglustat belongs to Miscellaneous; Pyrimethamine belongs to Anti Parasitic.
Why it happens
Possible CYP2D6 inhibition by pyrimethamine reduces eliglustat clearance.
What to do
Avoid if possible; otherwise reduce the eliglustat dose per labeling for CYP2D6 inhibitors and monitor the ECG. Do not combine with any CYP3A inhibitor.
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 Pyrimethamine
- Deferiprone + Pyrimethamine Major
- Acalabrutinib + Pyrimethamine Moderate
- Brexpiprazole + Pyrimethamine Moderate
- Dapsone + Pyrimethamine Moderate
- Folic acid + Pyrimethamine Moderate
- Fosphenytoin + Pyrimethamine Moderate
Other interactions of Eliglustat
- Amiodarone + Eliglustat Contraindicated
- Clarithromycin + Eliglustat Contraindicated
- Dronedarone + Eliglustat Contraindicated
- Eliglustat + Itraconazole Contraindicated
- Eliglustat + Ketoconazole Contraindicated
- Eliglustat + Pimozide Contraindicated
Frequently asked questions
Can I take Eliglustat with Pyrimethamine?
MediHelp rates the interaction as major. Eliglustat and Pyrimethamine 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. Pyrimethamine is reported to inhibit CYP2D6, which could raise eliglustat exposure. Eliglustat can prolong PR, QTc and QRS intervals at high concentrations, so increased exposure raises arrhythmia risk.
How serious is the interaction between Eliglustat and Pyrimethamine?
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 if possible; otherwise reduce the eliglustat dose per labeling for CYP2D6 inhibitors and monitor the ECG. Do not combine with any CYP3A inhibitor.
What other medicines interact with Pyrimethamine?
MediHelp also lists interactions of Pyrimethamine with, for example, Deferiprone, Acalabrutinib, Brexpiprazole. The full list is on the Pyrimethamine page.
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