Drug interactions
Irinotecan + Tipranavir
Severity: Major
Irinotecan and Tipranavir: major interaction.
Last updated Sources: UK SmPC
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
Tipranavir, boosted with ritonavir, strongly inhibits CYP3A4 and may raise exposure to irinotecan and its active metabolite SN-38. This can intensify severe diarrhea and neutropenia. Tipranavir also has inducing and transporter effects that make the net result unpredictable.
What this interaction means in plain words
Irinotecan and Tipranavir 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.
Irinotecan belongs to Oncology; Tipranavir belongs to Anti Virals.
Why it happens
Inhibition of CYP3A4-mediated irinotecan metabolism (with ritonavir co-administration) alters irinotecan and SN-38 exposure.
What to do
Avoid the combination when an alternative antiretroviral is available. If it cannot be avoided, monitor closely for diarrhea and neutropenia and check blood counts frequently.
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
- CAMPTO 20 mg/ml, concentrate for solution for infusion (100mg & 300mg presentation) - SmPC sections 4.3/4.5 (class statement: protease inhibitors; "Strong CYP3A4 inhibitors: (e.g. ketoconazole, itraconazole, voriconazole, posaconazole, protease inhibitors, clarithromycine, erythromycine, telithromy… — electronic medicines compendium (UK SmPC)
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
Other interactions of Tipranavir
- Alfuzosin + Tipranavir Contraindicated
- Amiodarone + Tipranavir Contraindicated
- Atorvastatin + Tipranavir Contraindicated
- Avanafil + Tipranavir Contraindicated
- Cisapride + Tipranavir Contraindicated
- Colchicine + Tipranavir Contraindicated
Frequently asked questions
Can I take Irinotecan with Tipranavir?
MediHelp rates the interaction as major. Irinotecan and Tipranavir 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. Tipranavir, boosted with ritonavir, strongly inhibits CYP3A4 and may raise exposure to irinotecan and its active metabolite SN-38. This can intensify severe diarrhea and neutropenia. Tipranavir also has inducing and transporter effects that make the net result unpredictable.
How serious is the interaction between Irinotecan and Tipranavir?
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 when an alternative antiretroviral is available. If it cannot be avoided, monitor closely for diarrhea and neutropenia and check blood counts frequently.
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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