Drug interactions
Gemfibrozil + Irinotecan
Severity: Major
Gemfibrozil and Irinotecan: 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
Gemfibrozil and its glucuronide inhibit UGT1A1, which inactivates SN-38, the active metabolite of irinotecan. Higher SN-38 exposure could increase the risk of severe diarrhea and neutropenia.
What this interaction means in plain words
Gemfibrozil and Irinotecan 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.
Gemfibrozil belongs to Cardiovascular; Irinotecan belongs to Oncology.
Why it happens
Inhibition of UGT1A1-mediated glucuronidation of SN-38 by gemfibrozil raises SN-38 exposure.
What to do
Avoid gemfibrozil during irinotecan therapy where possible and use an alternative lipid-lowering agent. If unavoidable, monitor closely for diarrhea and neutropenia.
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 Gemfibrozil
- Daprodustat + Gemfibrozil Contraindicated
- Elagolix + Gemfibrozil Contraindicated
- Gemfibrozil + Mavacamten Contraindicated
- Gemfibrozil + Metformin-repaglinide Contraindicated
- Gemfibrozil + Ombitasvir / paritaprevir / ritonavir and dasabuvir Contraindicated
- Gemfibrozil + Repaglinide Contraindicated
Other interactions of Irinotecan
- Clozapine + Irinotecan Contraindicated
- Irinotecan + Sacituzumab govitecan Contraindicated
- Adenovirus types 4 and 7 live + Irinotecan Major
- Apalutamide + Irinotecan Major
- Atazanavir + Irinotecan Major
- Carbamazepine + Irinotecan Major
Frequently asked questions
Can I take Gemfibrozil with Irinotecan?
MediHelp rates the interaction as major. Gemfibrozil and Irinotecan 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. Gemfibrozil and its glucuronide inhibit UGT1A1, which inactivates SN-38, the active metabolite of irinotecan. Higher SN-38 exposure could increase the risk of severe diarrhea and neutropenia.
How serious is the interaction between Gemfibrozil and Irinotecan?
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 gemfibrozil during irinotecan therapy where possible and use an alternative lipid-lowering agent. If unavoidable, monitor closely for diarrhea and neutropenia.
What other medicines interact with Gemfibrozil?
MediHelp also lists interactions of Gemfibrozil with, for example, Daprodustat, Elagolix, Mavacamten. The full list is on the Gemfibrozil page.
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