Drug interactions
Nefazodone + Paclitaxel
Severity: Major
Nefazodone and Paclitaxel: 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
Nefazodone is a potent CYP3A4 inhibitor and may raise paclitaxel concentrations. This can increase myelosuppression and neurotoxicity from paclitaxel.
What this interaction means in plain words
Nefazodone and Paclitaxel 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.
Why it happens
Nefazodone inhibits CYP3A4-mediated metabolism of paclitaxel.
What to do
Choose an antidepressant with little CYP3A4 inhibition, such as sertraline or escitalopram. If nefazodone must continue, monitor blood counts and neuropathy and reduce the paclitaxel dose as needed.
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 Paclitaxel
Frequently asked questions
Can I take Nefazodone with Paclitaxel?
MediHelp rates the interaction as major. Nefazodone and Paclitaxel 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. Nefazodone is a potent CYP3A4 inhibitor and may raise paclitaxel concentrations. This can increase myelosuppression and neurotoxicity from paclitaxel.
How serious is the interaction between Nefazodone and Paclitaxel?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Choose an antidepressant with little CYP3A4 inhibition, such as sertraline or escitalopram. If nefazodone must continue, monitor blood counts and neuropathy and reduce the paclitaxel dose as needed.
What other medicines interact with Paclitaxel?
MediHelp also lists interactions of Paclitaxel with, for example, Adenovirus types 4 and 7 live, Cobicistat, Cyclosporine. The full list is on the Paclitaxel page.
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