Drug interactions
Everolimus + Indinavir
Severity: Major
Everolimus and Indinavir: major interaction.
Last updated Sources: US FDA label
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
Indinavir inhibits CYP3A4 and P-glycoprotein and can raise everolimus exposure substantially. This increases the risk of everolimus toxicity such as mucositis, infections, hyperglycemia, hyperlipidemia, pneumonitis and renal impairment. Everolimus labeling advises avoiding strong CYP3A4/P-gp inhibitors.
What this interaction means in plain words
Everolimus and Indinavir 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
Inhibition of CYP3A4 metabolism and P-glycoprotein efflux of everolimus by indinavir.
What to do
Avoid the combination and choose an antiretroviral without strong CYP3A4 inhibition. If it cannot be avoided, reduce the everolimus dose per labeling and monitor everolimus trough levels and toxicity.
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 Everolimus
- Bcg vaccine live + Everolimus Contraindicated
- Everolimus + Influenza virus vaccine quadrivalent intranasal Contraindicated
- Everolimus + Levoketoconazole Contraindicated
- Everolimus + Measles mumps and rubella vaccine live Contraindicated
- Everolimus + Measles mumps rubella and varicella vaccine live Contraindicated
- Everolimus + Measles vaccine Contraindicated
Frequently asked questions
Can I take Everolimus with Indinavir?
MediHelp rates the interaction as major. Everolimus and Indinavir 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. Indinavir inhibits CYP3A4 and P-glycoprotein and can raise everolimus exposure substantially. This increases the risk of everolimus toxicity such as mucositis, infections, hyperglycemia, hyperlipidemia, pneumonitis and renal impairment. Everolimus labeling advises avoiding strong CYP3A4/P-gp inhibitors.
How serious is the interaction between Everolimus and Indinavir?
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 choose an antiretroviral without strong CYP3A4 inhibition. If it cannot be avoided, reduce the everolimus dose per labeling and monitor everolimus trough levels and toxicity.
What other medicines interact with Everolimus?
MediHelp also lists interactions of Everolimus with, for example, Bcg vaccine live, Influenza virus vaccine quadrivalent intranasal, Levoketoconazole. The full list is on the Everolimus page.
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