Drug interactions
Indinavir + Irinotecan
Severity: Major
Indinavir 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
Indinavir inhibits CYP3A4 and may increase irinotecan and SN-38 exposure. This increases the risk of severe diarrhea and myelosuppression.
What this interaction means in plain words
Indinavir 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.
Why it happens
Indinavir inhibits CYP3A4 and possibly P-glycoprotein, decreasing irinotecan clearance.
What to do
Avoid the combination where possible, and choose an antiretroviral without CYP3A4 inhibition. If it is unavoidable, monitor blood counts and diarrhea closely.
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 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 Indinavir with Irinotecan?
MediHelp rates the interaction as major. Indinavir 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. Indinavir inhibits CYP3A4 and may increase irinotecan and SN-38 exposure. This increases the risk of severe diarrhea and myelosuppression.
How serious is the interaction between Indinavir 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: Avoid the combination where possible, and choose an antiretroviral without CYP3A4 inhibition. If it is unavoidable, monitor blood counts and diarrhea closely.
What other medicines interact with Irinotecan?
MediHelp also lists interactions of Irinotecan with, for example, Clozapine, Sacituzumab govitecan, Adenovirus types 4 and 7 live. The full list is on the Irinotecan page.
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