Drug interactions
Everolimus + Phenobarbital
Severity: Major
Everolimus and Phenobarbital: 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
Phenobarbital is a potent inducer of CYP3A4 and P-glycoprotein and can markedly lower everolimus concentrations. This risks loss of antitumor effect or graft rejection.
What this interaction means in plain words
Everolimus and Phenobarbital 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
Induction of CYP3A4 and P-glycoprotein by phenobarbital increases everolimus clearance.
What to do
Avoid if possible and use a non-inducing anticonvulsant. If it is necessary, increase the everolimus dose per labeling and monitor trough concentrations.
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 Phenobarbital?
MediHelp rates the interaction as major. Everolimus and Phenobarbital 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. Phenobarbital is a potent inducer of CYP3A4 and P-glycoprotein and can markedly lower everolimus concentrations. This risks loss of antitumor effect or graft rejection.
How serious is the interaction between Everolimus and Phenobarbital?
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 and use a non-inducing anticonvulsant. If it is necessary, increase the everolimus dose per labeling and monitor trough concentrations.
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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