Drug interactions
Irinotecan + Nefazodone
Severity: Major
Irinotecan and Nefazodone: major interaction.
Last updated Sources: US FDA label
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
Nefazodone is a CYP3A4 inhibitor and may increase irinotecan and SN-38 exposure. This can worsen diarrhea and neutropenia.
What this interaction means in plain words
Irinotecan and Nefazodone 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
Nefazodone inhibits CYP3A4, reducing irinotecan oxidative metabolism.
What to do
Avoid the combination and choose an antidepressant that does not inhibit CYP3A4, such as sertraline. If unavoidable, monitor for diarrhea and myelosuppression.
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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References
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 Irinotecan with Nefazodone?
MediHelp rates the interaction as major. Irinotecan and Nefazodone 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. Nefazodone is a CYP3A4 inhibitor and may increase irinotecan and SN-38 exposure. This can worsen diarrhea and neutropenia.
How serious is the interaction between Irinotecan and Nefazodone?
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 antidepressant that does not inhibit CYP3A4, such as sertraline. If unavoidable, monitor for diarrhea and myelosuppression.
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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