Drug interactions
Irinotecan liposomal + Regorafenib
Severity: Major
Irinotecan liposomal and Regorafenib: major interaction.
Last updated Sources: EMA 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
Regorafenib inhibits UGT1A1 and BCRP, both involved in clearance of irinotecan's active metabolite SN-38. Exposure to SN-38 may rise, increasing the risk of severe neutropenia and diarrhea.
What this interaction means in plain words
Irinotecan liposomal and Regorafenib 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.
Why it happens
Regorafenib inhibits UGT1A1-mediated glucuronidation and BCRP-mediated efflux of SN-38.
What to do
Monitor blood counts and diarrhea closely, and reduce the irinotecan dose if toxicity develops. Take particular care in patients with UGT1A1*28 genotype.
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
Other interactions of Regorafenib
Frequently asked questions
Can I take Irinotecan liposomal with Regorafenib?
MediHelp rates the interaction as major. Irinotecan liposomal and Regorafenib 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. Regorafenib inhibits UGT1A1 and BCRP, both involved in clearance of irinotecan's active metabolite SN-38. Exposure to SN-38 may rise, increasing the risk of severe neutropenia and diarrhea.
How serious is the interaction between Irinotecan liposomal and Regorafenib?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood counts and diarrhea closely, and reduce the irinotecan dose if toxicity develops. Take particular care in patients with UGT1A1*28 genotype.
What other medicines interact with Regorafenib?
MediHelp also lists interactions of Regorafenib with, for example, Apalutamide, Atazanavir, Carbamazepine. The full list is on the Regorafenib page.
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