Drug interactions
Ivosidenib + Ondansetron
Severity: Major
Ivosidenib and Ondansetron: 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 induces CYP3A4 and may lower ondansetron concentrations, though other enzymes also clear ondansetron. Ivosidenib itself prolongs the QT interval, so the combination also adds to QT risk.
What this interaction means in plain words
Ivosidenib and Ondansetron 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; Ondansetron belongs to Gastrointestinal Tract.
Why it happens
Additive QT prolongation, plus CYP3A4 induction by ivosidenib that may reduce ondansetron exposure.
What to do
Monitor ECG and electrolytes at baseline and periodically, and correct potassium and magnesium. Check for reduced antiemetic efficacy and change the antiemetic if needed.
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 Ondansetron
- Apomorphine + Ondansetron Contraindicated
- Ondansetron + Thioridazine Contraindicated
- Ondansetron + Vandetanib Contraindicated
- Adagrasib + Ondansetron Major
- Amiodarone + Ondansetron Major
- Amisulpride + Ondansetron Major
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 Ondansetron?
MediHelp rates the interaction as major. Ivosidenib and Ondansetron 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 induces CYP3A4 and may lower ondansetron concentrations, though other enzymes also clear ondansetron. Ivosidenib itself prolongs the QT interval, so the combination also adds to QT risk.
How serious is the interaction between Ivosidenib and Ondansetron?
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 ECG and electrolytes at baseline and periodically, and correct potassium and magnesium. Check for reduced antiemetic efficacy and change the antiemetic if needed.
What other medicines interact with Ondansetron?
MediHelp also lists interactions of Ondansetron with, for example, Apomorphine, Thioridazine, Vandetanib. The full list is on the Ondansetron page.
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