Drug interactions
Irinotecan liposomal + Metronidazole
Severity: Minor
Irinotecan liposomal and Metronidazole: minor 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
Irinotecan is activated by carboxylesterases and inactivated partly by CYP3A4, so strong CYP3A4 inhibitors raise exposure to its toxic metabolite. Metronidazole is a weak inhibitor at most, so any effect is likely small. Higher exposure would increase the risk of neutropenia and severe diarrhea.
What this interaction means in plain words
Irinotecan liposomal and Metronidazole have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Why it happens
Possible weak inhibition of CYP3A4-mediated irinotecan metabolism.
What to do
No dose change is needed; monitor blood counts and diarrhea during chemotherapy.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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Other interactions of Metronidazole
- Ethanol + Metronidazole Contraindicated
- Metronidazole + Pimozide Contraindicated
- Amiodarone + Metronidazole Major
- Disulfiram + Metronidazole Major
- Ergotamine + Metronidazole Major
- Lomitapide + Metronidazole Major
Frequently asked questions
Can I take Irinotecan liposomal with Metronidazole?
MediHelp rates the interaction as minor. Irinotecan liposomal and Metronidazole have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Irinotecan is activated by carboxylesterases and inactivated partly by CYP3A4, so strong CYP3A4 inhibitors raise exposure to its toxic metabolite. Metronidazole is a weak inhibitor at most, so any effect is likely small. Higher exposure would increase the risk of neutropenia and severe diarrhea.
How serious is the interaction between Irinotecan liposomal and Metronidazole?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: No dose change is needed; monitor blood counts and diarrhea during chemotherapy.
What other medicines interact with Metronidazole?
MediHelp also lists interactions of Metronidazole with, for example, Ethanol, Pimozide, Amiodarone. The full list is on the Metronidazole page.
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