Drug interactions
Metronidazole + Venetoclax
Severity: Moderate
Metronidazole and Venetoclax: 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
Venetoclax is a sensitive CYP3A4 substrate, and higher exposure increases the risk of neutropenia and tumor lysis syndrome. Metronidazole is a weak inhibitor, so the effect is probably modest.
What this interaction means in plain words
Metronidazole and Venetoclax 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; Venetoclax belongs to Miscellaneous.
Why it happens
Possible weak CYP3A4 inhibition by metronidazole reducing venetoclax metabolism.
What to do
Monitor blood counts and tumor lysis parameters, especially during dose ramp-up. Reduce the venetoclax dose if toxicity appears.
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 Venetoclax
- Clarithromycin + Venetoclax Contraindicated
- Itraconazole + Venetoclax Contraindicated
- Ketoconazole + Venetoclax Contraindicated
- Posaconazole + Venetoclax Contraindicated
- Venetoclax + Voriconazole Contraindicated
- Amiodarone + Venetoclax Major
Frequently asked questions
Can I take Metronidazole with Venetoclax?
MediHelp rates the interaction as moderate. Metronidazole and Venetoclax 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. Venetoclax is a sensitive CYP3A4 substrate, and higher exposure increases the risk of neutropenia and tumor lysis syndrome. Metronidazole is a weak inhibitor, so the effect is probably modest.
How serious is the interaction between Metronidazole and Venetoclax?
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 blood counts and tumor lysis parameters, especially during dose ramp-up. Reduce the venetoclax dose if toxicity appears.
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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