Drug interactions
Irinotecan + Ranolazine
Severity: Moderate
Irinotecan and Ranolazine: moderate 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
Ranolazine inhibits P-glycoprotein, which may reduce efflux of irinotecan and its active metabolite SN-38. This could intensify diarrhea and neutropenia, although clinical evidence is limited.
What this interaction means in plain words
Irinotecan and Ranolazine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Irinotecan belongs to Oncology; Ranolazine belongs to Cardiovascular.
Why it happens
P-glycoprotein inhibition by ranolazine may increase exposure to irinotecan and SN-38.
What to do
Monitor for severe diarrhea and neutropenia and check blood counts regularly. Reduce the irinotecan dose or hold treatment if grade 3 toxicity develops.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Ranolazine
- Adagrasib + Ranolazine Contraindicated
- Amobarbital + Ranolazine Contraindicated
- Apalutamide + Ranolazine Contraindicated
- Butabarbital + Ranolazine Contraindicated
- Carbamazepine + Ranolazine Contraindicated
- Clarithromycin + Ranolazine Contraindicated
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 Ranolazine?
MediHelp rates the interaction as moderate. Irinotecan and Ranolazine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Ranolazine inhibits P-glycoprotein, which may reduce efflux of irinotecan and its active metabolite SN-38. This could intensify diarrhea and neutropenia, although clinical evidence is limited.
How serious is the interaction between Irinotecan and Ranolazine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for severe diarrhea and neutropenia and check blood counts regularly. Reduce the irinotecan dose or hold treatment if grade 3 toxicity develops.
What other medicines interact with Ranolazine?
MediHelp also lists interactions of Ranolazine with, for example, Adagrasib, Amobarbital, Apalutamide. The full list is on the Ranolazine page.
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