Drug interactions
Erythromycin base + Nilotinib
Severity: Major
Erythromycin base and Nilotinib: 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
Erythromycin inhibits CYP3A4 and raises nilotinib levels, while both drugs prolong the QT interval. Together this markedly increases the risk of torsades de pointes and sudden death.
What this interaction means in plain words
Erythromycin base 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.
Why it happens
CYP3A4 inhibition raises nilotinib exposure, combined with additive QT prolongation.
What to do
Avoid and use a non-macrolide antibiotic such as one without CYP3A4 inhibition or QT effects. If unavoidable, reduce the nilotinib dose per labeling and monitor 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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References
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 Erythromycin base with Nilotinib?
MediHelp rates the interaction as major. Erythromycin base 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. Erythromycin inhibits CYP3A4 and raises nilotinib levels, while both drugs prolong the QT interval. Together this markedly increases the risk of torsades de pointes and sudden death.
How serious is the interaction between Erythromycin base 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 and use a non-macrolide antibiotic such as one without CYP3A4 inhibition or QT effects. If unavoidable, reduce the nilotinib dose per labeling and monitor ECG and electrolytes.
What other medicines interact with Nilotinib?
MediHelp also lists interactions of Nilotinib with, for example, Amiodarone, Arsenic trioxide, Disopyramide. The full list is on the Nilotinib page.
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