Drug interactions
Ivosidenib + Olanzapine
Severity: Major
Ivosidenib and Olanzapine: 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
Ivosidenib is associated with dose-related QT prolongation, and olanzapine has a modest QT effect. Together they may increase the risk of ventricular arrhythmia.
What this interaction means in plain words
Ivosidenib and Olanzapine 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.
Ivosidenib belongs to Oncology; Olanzapine belongs to Central Nervous System.
Why it happens
Additive prolongation of the QT interval through effects on cardiac repolarization.
What to do
Avoid the combination where possible, or use an antipsychotic with lower QT liability. If unavoidable, monitor ECG and electrolytes regularly and reduce or hold ivosidenib if the QTc becomes markedly prolonged.
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
- Olanzapine 10 mg orodispersible tablets - SmPC sections 4.3/4.5 (class statement: medicinal products known to increase QTc interval; "Caution should be used if olanzapine is being administered concomitantly with medicinal products known to increase QTc interval (see section 4.4).") — electronic medicines compendium (UK SmPC)
Other interactions of Olanzapine
Other interactions of Ivosidenib
- Alfuzosin + Ivosidenib Major
- Amiodarone + Ivosidenib Major
- Amisulpride + Ivosidenib Major
- Amitriptyline + Ivosidenib Major
- Amobarbital + Ivosidenib Major
- Anagrelide + Ivosidenib Major
Frequently asked questions
Can I take Ivosidenib with Olanzapine?
MediHelp rates the interaction as major. Ivosidenib and Olanzapine 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. Ivosidenib is associated with dose-related QT prolongation, and olanzapine has a modest QT effect. Together they may increase the risk of ventricular arrhythmia.
How serious is the interaction between Ivosidenib and Olanzapine?
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 where possible, or use an antipsychotic with lower QT liability. If unavoidable, monitor ECG and electrolytes regularly and reduce or hold ivosidenib if the QTc becomes markedly prolonged.
What other medicines interact with Olanzapine?
MediHelp also lists interactions of Olanzapine with, for example, Amisulpride, Amoxapine, Apomorphine. The full list is on the Olanzapine page.
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