Drug interactions
Naloxegol + Quinidine
Severity: Major
Naloxegol and Quinidine: 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
Naloxegol is a CYP3A4 and P-gp substrate, and quinidine inhibits P-gp and, to a degree, CYP3A4. Higher naloxegol exposure may lead to opioid withdrawal symptoms such as abdominal pain and diarrhea.
What this interaction means in plain words
Naloxegol and Quinidine 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.
Naloxegol belongs to Gastrointestinal Tract; Quinidine belongs to Anti Parasitic.
Why it happens
Inhibition of P-gp and CYP3A4 reduces naloxegol clearance and efflux, increasing exposure.
What to do
Avoid if possible; if used, reduce naloxegol to 12.5 mg daily and watch for withdrawal symptoms.
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 Quinidine
- Adagrasib + Quinidine Contraindicated
- Arsenic trioxide + Quinidine Contraindicated
- Artemether / lumefantrine + Quinidine Contraindicated
- Chloroquine + Quinidine Contraindicated
- Dofetilide + Quinidine Contraindicated
- Dronedarone + Quinidine Contraindicated
Other interactions of Naloxegol
- Clarithromycin + Naloxegol Contraindicated
- Itraconazole + Naloxegol Contraindicated
- Ketoconazole + Naloxegol Contraindicated
- Naloxegol + Posaconazole Contraindicated
- Naloxegol + Voriconazole Contraindicated
- Bupropion-naltrexone + Naloxegol Major
Frequently asked questions
Can I take Naloxegol with Quinidine?
MediHelp rates the interaction as major. Naloxegol and Quinidine 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. Naloxegol is a CYP3A4 and P-gp substrate, and quinidine inhibits P-gp and, to a degree, CYP3A4. Higher naloxegol exposure may lead to opioid withdrawal symptoms such as abdominal pain and diarrhea.
How serious is the interaction between Naloxegol and Quinidine?
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 used, reduce naloxegol to 12.5 mg daily and watch for withdrawal symptoms.
What other medicines interact with Quinidine?
MediHelp also lists interactions of Quinidine with, for example, Adagrasib, Arsenic trioxide, Artemether / lumefantrine. The full list is on the Quinidine page.
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