Drug interactions
Glecaprevir / pibrentasvir + Topotecan
Severity: Moderate
Glecaprevir / pibrentasvir and Topotecan: 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 intestinal P-glycoprotein and BCRP, which can raise systemic exposure to topotecan, particularly after oral dosing. Higher topotecan levels may worsen myelosuppression and gastrointestinal toxicity.
What this interaction means in plain words
Glecaprevir / pibrentasvir and Topotecan 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-glycoprotein and BCRP efflux transporters by glecaprevir and pibrentasvir reduces topotecan efflux and increases its absorption and exposure.
What to do
Monitor blood counts closely and watch for gastrointestinal toxicity during co-treatment. Consider reducing the topotecan dose if neutropenia or other adverse effects emerge, especially with oral topotecan.
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 Topotecan
- Adenovirus types 4 and 7 live + Topotecan Contraindicated
- Amiodarone + Topotecan Major
- Cisplatin + Topotecan Major
- Cobicistat + Topotecan Major
- Cyclosporine + Topotecan Major
- Cyclosporin + Topotecan Major
Frequently asked questions
Can I take Glecaprevir / pibrentasvir with Topotecan?
MediHelp rates the interaction as moderate. Glecaprevir / pibrentasvir and Topotecan 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 intestinal P-glycoprotein and BCRP, which can raise systemic exposure to topotecan, particularly after oral dosing. Higher topotecan levels may worsen myelosuppression and gastrointestinal toxicity.
How serious is the interaction between Glecaprevir / pibrentasvir and Topotecan?
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 blood counts closely and watch for gastrointestinal toxicity during co-treatment. Consider reducing the topotecan dose if neutropenia or other adverse effects emerge, especially with oral topotecan.
What other medicines interact with Topotecan?
MediHelp also lists interactions of Topotecan with, for example, Adenovirus types 4 and 7 live, Amiodarone, Cisplatin. The full list is on the Topotecan page.
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