Drug interactions
Imatinib + Irinotecan
Severity: Major
Imatinib and Irinotecan: 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
Imatinib inhibits CYP3A4 and may raise exposure to irinotecan and its active metabolite SN-38 through altered metabolism, increasing the risk of severe neutropenia and diarrhea. Studies suggest the combination can be poorly tolerated.
What this interaction means in plain words
Imatinib and Irinotecan 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.
Imatinib belongs to Oncology; Irinotecan belongs to Oncology.
Why it happens
Imatinib inhibits CYP3A4 and may affect UGT1A1 and transporters, altering irinotecan and SN-38 disposition.
What to do
Monitor blood counts and diarrhea closely and consider an irinotecan dose reduction. Provide prompt antidiarrheal and supportive care.
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 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 Imatinib with Irinotecan?
MediHelp rates the interaction as major. Imatinib and Irinotecan 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. Imatinib inhibits CYP3A4 and may raise exposure to irinotecan and its active metabolite SN-38 through altered metabolism, increasing the risk of severe neutropenia and diarrhea. Studies suggest the combination can be poorly tolerated.
How serious is the interaction between Imatinib and Irinotecan?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood counts and diarrhea closely and consider an irinotecan dose reduction. Provide prompt antidiarrheal and supportive care.
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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