Drug interactions
Idelalisib + Imatinib
Severity: Major
Idelalisib and Imatinib: 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
Idelalisib is a strong CYP3A4 inhibitor and may increase imatinib exposure, while imatinib may raise idelalisib levels. The combination increases the risk of hepatotoxicity, diarrhea or colitis, pneumonitis and myelosuppression.
What this interaction means in plain words
Idelalisib and Imatinib 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.
Idelalisib belongs to Oncology; Imatinib belongs to Oncology.
Why it happens
Mutual CYP3A4 inhibition, with idelalisib acting as a strong inhibitor of imatinib metabolism.
What to do
Avoid if possible; if combined, monitor liver enzymes, blood counts and gastrointestinal and respiratory symptoms, and reduce the imatinib dose if toxicity occurs.
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 Imatinib
- Imatinib + Lomitapide Contraindicated
- Imatinib + Lonafarnib Contraindicated
- Amobarbital + Imatinib Major
- Apalutamide + Imatinib Major
- Avapritinib + Imatinib Major
- Benzhydrocodone / acetaminophen + Imatinib Major
Other interactions of Idelalisib
- Alfuzosin + Idelalisib Contraindicated
- Cisapride + Idelalisib Contraindicated
- Dihydroergotamine + Idelalisib Contraindicated
- Dronedarone + Idelalisib Contraindicated
- Eletriptan + Idelalisib Contraindicated
- Eplerenone + Idelalisib Contraindicated
Frequently asked questions
Can I take Idelalisib with Imatinib?
MediHelp rates the interaction as major. Idelalisib and Imatinib 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. Idelalisib is a strong CYP3A4 inhibitor and may increase imatinib exposure, while imatinib may raise idelalisib levels. The combination increases the risk of hepatotoxicity, diarrhea or colitis, pneumonitis and myelosuppression.
How serious is the interaction between Idelalisib and Imatinib?
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 if possible; if combined, monitor liver enzymes, blood counts and gastrointestinal and respiratory symptoms, and reduce the imatinib dose if toxicity occurs.
What other medicines interact with Imatinib?
MediHelp also lists interactions of Imatinib with, for example, Lomitapide, Lonafarnib, Amobarbital. The full list is on the Imatinib page.
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