Drug interactions
Larotrectinib + Voriconazole
Severity: Major
Larotrectinib and Voriconazole: 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
Voriconazole raises larotrectinib exposure through CYP3A4 inhibition, which may increase adverse effects such as hepatotoxicity, dizziness and neurotoxicity.
What this interaction means in plain words
Larotrectinib and Voriconazole 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.
Larotrectinib belongs to Oncology; Voriconazole belongs to Anti Fungals.
Why it happens
Voriconazole inhibits CYP3A4-mediated metabolism of larotrectinib.
What to do
Avoid if possible. If unavoidable, reduce the larotrectinib dose by about half per labeling and resume the usual dose after the inhibitor has been stopped for several half-lives.
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 Voriconazole
- Avanafil + Voriconazole Contraindicated
- Butabarbital + Voriconazole Contraindicated
- Carbamazepine + Voriconazole Contraindicated
- Conivaptan + Voriconazole Contraindicated
- Dihydroergotamine intranasal + Voriconazole Contraindicated
- Dihydroergotamine + Voriconazole Contraindicated
Other interactions of Larotrectinib
Frequently asked questions
Can I take Larotrectinib with Voriconazole?
MediHelp rates the interaction as major. Larotrectinib and Voriconazole 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. Voriconazole raises larotrectinib exposure through CYP3A4 inhibition, which may increase adverse effects such as hepatotoxicity, dizziness and neurotoxicity.
How serious is the interaction between Larotrectinib and Voriconazole?
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 if possible. If unavoidable, reduce the larotrectinib dose by about half per labeling and resume the usual dose after the inhibitor has been stopped for several half-lives.
What other medicines interact with Voriconazole?
MediHelp also lists interactions of Voriconazole with, for example, Avanafil, Butabarbital, Carbamazepine. The full list is on the Voriconazole page.
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