Drug interactions
Metyrapone + Pacritinib
Severity: Major
Metyrapone and Pacritinib: 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
Metyrapone can induce CYP3A4, which may reduce pacritinib exposure and its efficacy in myelofibrosis. The loss of effect could lead to disease progression.
What this interaction means in plain words
Metyrapone and Pacritinib 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.
Metyrapone belongs to Endocrine; Pacritinib belongs to Oncology.
Why it happens
Induction of CYP3A4 by metyrapone increases the metabolic clearance of pacritinib.
What to do
Avoid concurrent use where possible and choose an alternative to metyrapone. If unavoidable, monitor spleen and symptom response to pacritinib.
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 Metyrapone
- Budesonide + Metyrapone Moderate
- Cortisone + Metyrapone Moderate
- Cyproheptadine + Metyrapone Moderate
- Deflazacort + Metyrapone Moderate
- Desogestrel-ethinyl estradiol + Metyrapone Moderate
- Dexamethasone + Metyrapone Moderate
Other interactions of Pacritinib
- Clarithromycin + Pacritinib Contraindicated
- Ketoconazole + Pacritinib Contraindicated
- Pacritinib + Posaconazole Contraindicated
- Pacritinib + Voriconazole Contraindicated
- Amiodarone + Pacritinib Major
- Carbamazepine + Pacritinib Major
Frequently asked questions
Can I take Metyrapone with Pacritinib?
MediHelp rates the interaction as major. Metyrapone and Pacritinib 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. Metyrapone can induce CYP3A4, which may reduce pacritinib exposure and its efficacy in myelofibrosis. The loss of effect could lead to disease progression.
How serious is the interaction between Metyrapone and Pacritinib?
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 concurrent use where possible and choose an alternative to metyrapone. If unavoidable, monitor spleen and symptom response to pacritinib.
What other medicines interact with Metyrapone?
MediHelp also lists interactions of Metyrapone with, for example, Budesonide, Cortisone, Cyproheptadine. The full list is on the Metyrapone page.
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