Drug interactions
Ibrutinib + Verapamil
Severity: Major
Ibrutinib and Verapamil: 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
Verapamil, a moderate CYP3A4 inhibitor, increases ibrutinib exposure several-fold. This raises the risk of ibrutinib toxicity, including bleeding, arrhythmias such as atrial fibrillation, and cytopenias.
What this interaction means in plain words
Ibrutinib and Verapamil 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.
Ibrutinib belongs to Oncology; Verapamil belongs to Cardiovascular.
Why it happens
Inhibition of CYP3A4-mediated first-pass and systemic metabolism of ibrutinib.
What to do
Reduce the ibrutinib dose according to labeling for moderate CYP3A4 inhibitors. Monitor for bleeding, heart rhythm changes and other adverse effects, or choose a non-interacting antihypertensive or rate-control agent.
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 Verapamil
- Dofetilide + Verapamil Contraindicated
- Flibanserin + Verapamil Contraindicated
- Lomitapide + Verapamil Contraindicated
- Lonafarnib + Verapamil Contraindicated
- Pimozide + Verapamil Contraindicated
- Acebutolol + Verapamil Major
Other interactions of Ibrutinib
- Abciximab + Ibrutinib Major
- Acetylsalicylic acid + Ibrutinib Major
- Alteplase + Ibrutinib Major
- Amobarbital + Ibrutinib Major
- Apalutamide + Ibrutinib Major
- Apixaban + Ibrutinib Major
Frequently asked questions
Can I take Ibrutinib with Verapamil?
MediHelp rates the interaction as major. Ibrutinib and Verapamil 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. Verapamil, a moderate CYP3A4 inhibitor, increases ibrutinib exposure several-fold. This raises the risk of ibrutinib toxicity, including bleeding, arrhythmias such as atrial fibrillation, and cytopenias.
How serious is the interaction between Ibrutinib and Verapamil?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce the ibrutinib dose according to labeling for moderate CYP3A4 inhibitors. Monitor for bleeding, heart rhythm changes and other adverse effects, or choose a non-interacting antihypertensive or rate-control agent.
What other medicines interact with Verapamil?
MediHelp also lists interactions of Verapamil with, for example, Dofetilide, Flibanserin, Lomitapide. The full list is on the Verapamil page.
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