Drug interactions
Glecaprevir / pibrentasvir + Irinotecan
Severity: Moderate
Glecaprevir / pibrentasvir and Irinotecan: moderate 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
Glecaprevir and pibrentasvir inhibit P-gp, BCRP and OATP1B1/1B3, transporters involved in irinotecan and SN-38 disposition. Exposure to SN-38 may rise, increasing the risk of severe diarrhea and neutropenia. Clinical data are limited and the prediction is mechanistic.
What this interaction means in plain words
Glecaprevir / pibrentasvir and Irinotecan can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Inhibition of P-gp, BCRP and OATP1B transporters reduces efflux and hepatic uptake of irinotecan and SN-38.
What to do
Monitor for diarrhea and neutropenia during co-treatment and reduce irinotecan dose if toxicity appears; consider deferring HCV therapy if feasible.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Glecaprevir / pibrentasvir with Irinotecan?
MediHelp rates the interaction as moderate. Glecaprevir / pibrentasvir and Irinotecan can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Glecaprevir and pibrentasvir inhibit P-gp, BCRP and OATP1B1/1B3, transporters involved in irinotecan and SN-38 disposition. Exposure to SN-38 may rise, increasing the risk of severe diarrhea and neutropenia. Clinical data are limited and the prediction is mechanistic.
How serious is the interaction between Glecaprevir / pibrentasvir and Irinotecan?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for diarrhea and neutropenia during co-treatment and reduce irinotecan dose if toxicity appears; consider deferring HCV therapy if feasible.
What other medicines interact with Irinotecan?
MediHelp also lists interactions of Irinotecan with, for example, Clozapine, Sacituzumab govitecan, Adenovirus types 4 and 7 live. The full list is on the Irinotecan page.
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