Drug interactions
Flecainide + Nilotinib
Severity: Major
Flecainide 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 prolongs the QT interval, which carries a boxed warning, and may inhibit CYP2D6 to raise flecainide levels. Together they increase the risk of torsades de pointes and sudden death.
What this interaction means in plain words
Flecainide 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.
Flecainide belongs to Cardiovascular; Nilotinib belongs to Oncology.
Why it happens
Additive QT and conduction effects plus possible CYP2D6 inhibition by nilotinib reducing flecainide clearance.
What to do
Avoid the combination if possible and choose a non-QT-prolonging alternative. If unavoidable, monitor ECG closely, keep potassium and magnesium normal and consider flecainide level monitoring.
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 Flecainide
- Flecainide + Nirmatrelvir Contraindicated
- Flecainide + Nirmatrelvir / ritonavir Contraindicated
- Flecainide + Pimozide Contraindicated
- Flecainide + Ritonavir Contraindicated
- Flecainide + Thioridazine Contraindicated
- Flecainide + Tipranavir 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 Flecainide with Nilotinib?
MediHelp rates the interaction as major. Flecainide 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 prolongs the QT interval, which carries a boxed warning, and may inhibit CYP2D6 to raise flecainide levels. Together they increase the risk of torsades de pointes and sudden death.
How serious is the interaction between Flecainide 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 if possible and choose a non-QT-prolonging alternative. If unavoidable, monitor ECG closely, keep potassium and magnesium normal and consider flecainide level monitoring.
What other medicines interact with Flecainide?
MediHelp also lists interactions of Flecainide with, for example, Nirmatrelvir, Nirmatrelvir / ritonavir, Pimozide. The full list is on the Flecainide page.
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