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Drug interactions

Idelalisib + Quinidine

Severity: Major

Idelalisib and Quinidine: 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 CYP3A inhibitor and can substantially raise quinidine concentrations, a narrow therapeutic index drug, increasing the risk of QT prolongation and torsades de pointes. Quinidine may in turn modestly affect idelalisib exposure, though this is less important.

What this interaction means in plain words

Idelalisib and Quinidine 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; Quinidine belongs to Anti Parasitic.

Evidence level: Moderate

Why it happens

Idelalisib inhibits CYP3A4, reducing quinidine metabolism.

What to do

Avoid the combination and choose an alternative antiarrhythmic. If unavoidable, reduce the quinidine dose and monitor ECG and quinidine levels.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Idelalisib with Quinidine?

MediHelp rates the interaction as major. Idelalisib and Quinidine 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 CYP3A inhibitor and can substantially raise quinidine concentrations, a narrow therapeutic index drug, increasing the risk of QT prolongation and torsades de pointes. Quinidine may in turn modestly affect idelalisib exposure, though this is less important.

How serious is the interaction between Idelalisib and Quinidine?

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 the combination and choose an alternative antiarrhythmic. If unavoidable, reduce the quinidine dose and monitor ECG and quinidine levels.

What other medicines interact with Quinidine?

MediHelp also lists interactions of Quinidine with, for example, Adagrasib, Arsenic trioxide, Artemether / lumefantrine. The full list is on the Quinidine page.

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