Drug interactions
Metronidazole + Neratinib
Severity: Moderate
Metronidazole and Neratinib: moderate 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
Neratinib is metabolized mainly by CYP3A4, and its exposure rises with strong inhibitors, which increases the risk of diarrhea and liver toxicity. Metronidazole is only a weak inhibitor, so a clinically important rise is not established.
What this interaction means in plain words
Metronidazole and Neratinib can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Metronidazole belongs to Anti Parasitic; Neratinib belongs to Oncology.
Why it happens
Possible weak CYP3A4 inhibition by metronidazole reducing neratinib metabolism.
What to do
Monitor for diarrhea and liver enzyme elevation, and use antidiarrheal prophylaxis as per neratinib labeling. Choose another antimicrobial if possible.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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
Other interactions of Neratinib
- Amiodarone + Neratinib Major
- Amobarbital + Neratinib Major
- Aprepitant + Neratinib Major
- Armodafinil + Neratinib Major
- Bosentan + Neratinib Major
- Carbamazepine + Neratinib Major
Frequently asked questions
Can I take Metronidazole with Neratinib?
MediHelp rates the interaction as moderate. Metronidazole and Neratinib can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Neratinib is metabolized mainly by CYP3A4, and its exposure rises with strong inhibitors, which increases the risk of diarrhea and liver toxicity. Metronidazole is only a weak inhibitor, so a clinically important rise is not established.
How serious is the interaction between Metronidazole and Neratinib?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for diarrhea and liver enzyme elevation, and use antidiarrheal prophylaxis as per neratinib labeling. Choose another antimicrobial if possible.
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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