Drug interactions
Irinotecan + Trastuzumab deruxtecan
Severity: Major
Irinotecan and Trastuzumab deruxtecan: 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
Trastuzumab deruxtecan carries a topoisomerase I inhibitor payload and causes neutropenia, while irinotecan is also myelosuppressive. Combined use may add hematologic toxicity, diarrhea and infection risk.
What this interaction means in plain words
Irinotecan and Trastuzumab deruxtecan 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; Trastuzumab deruxtecan belongs to Oncology.
Why it happens
Additive myelosuppression and gastrointestinal toxicity from two topoisomerase I inhibitor exposures.
What to do
Avoid routine concurrent use; if combined, monitor complete blood counts frequently and reduce doses or delay treatment for neutropenia.
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
Other interactions of Trastuzumab deruxtecan
Frequently asked questions
Can I take Irinotecan with Trastuzumab deruxtecan?
MediHelp rates the interaction as major. Irinotecan and Trastuzumab deruxtecan 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. Trastuzumab deruxtecan carries a topoisomerase I inhibitor payload and causes neutropenia, while irinotecan is also myelosuppressive. Combined use may add hematologic toxicity, diarrhea and infection risk.
How serious is the interaction between Irinotecan and Trastuzumab deruxtecan?
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 routine concurrent use; if combined, monitor complete blood counts frequently and reduce doses or delay treatment for neutropenia.
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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