Drug interactions
Irinotecan + Sorafenib
Severity: Moderate
Irinotecan and Sorafenib: 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
Sorafenib inhibits UGT1A1, which inactivates SN-38, the active metabolite of irinotecan. Exposure to SN-38 can rise, increasing the risk of diarrhea and neutropenia.
What this interaction means in plain words
Irinotecan and Sorafenib 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; Sorafenib belongs to Oncology.
Why it happens
Sorafenib inhibits UGT1A1-mediated glucuronidation of SN-38, raising its levels.
What to do
Monitor closely for severe diarrhea and neutropenia and check blood counts regularly. Reduce the irinotecan dose if toxicity occurs, particularly in patients with UGT1A1*28 genotype.
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 Sorafenib
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 Sorafenib?
MediHelp rates the interaction as moderate. Irinotecan and Sorafenib 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. Sorafenib inhibits UGT1A1, which inactivates SN-38, the active metabolite of irinotecan. Exposure to SN-38 can rise, increasing the risk of diarrhea and neutropenia.
How serious is the interaction between Irinotecan and Sorafenib?
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 closely for severe diarrhea and neutropenia and check blood counts regularly. Reduce the irinotecan dose if toxicity occurs, particularly in patients with UGT1A1*28 genotype.
What other medicines interact with Sorafenib?
MediHelp also lists interactions of Sorafenib with, for example, Adagrasib, Amiodarone, Amisulpride. The full list is on the Sorafenib page.
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