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Drug interactions

Imatinib + Neratinib

Severity: Major

Imatinib and Neratinib: 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 may increase neratinib exposure, raising the risk of severe diarrhea and hepatotoxicity. Neratinib labeling advises avoiding moderate and strong CYP3A4 inhibitors.

What this interaction means in plain words

Imatinib and Neratinib 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; Neratinib belongs to Oncology.

Evidence level: Moderate

Why it happens

Imatinib inhibits CYP3A4, which metabolizes neratinib.

What to do

Avoid the combination if possible. If used, monitor for diarrhea with antidiarrheal prophylaxis and check liver tests.

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 Imatinib with Neratinib?

MediHelp rates the interaction as major. Imatinib and Neratinib 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 may increase neratinib exposure, raising the risk of severe diarrhea and hepatotoxicity. Neratinib labeling advises avoiding moderate and strong CYP3A4 inhibitors.

How serious is the interaction between Imatinib and Neratinib?

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 if possible. If used, monitor for diarrhea with antidiarrheal prophylaxis and check liver tests.

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.

Full monographs, dosing and an interaction checker in the MediHelp app

Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.

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