Drug interactions
Nevirapine + Tucatinib
Severity: Moderate
Nevirapine and Tucatinib: 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
Tucatinib is a CYP3A inhibitor and may raise exposure to CYP3A substrates, but nevirapine is a CYP3A substrate and also an inducer, with a net effect that is hard to predict. Increased nevirapine levels could raise the risk of rash and hepatotoxicity. Nevirapine could also reduce tucatinib levels, since tucatinib is metabolized by CYP2C8 and CYP3A.
What this interaction means in plain words
Nevirapine and Tucatinib 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.
Nevirapine belongs to Anti Virals; Tucatinib belongs to Oncology.
Why it happens
Tucatinib inhibits CYP3A4, reducing nevirapine clearance, while nevirapine induces CYP3A4 and may lower tucatinib exposure.
What to do
Monitor liver enzymes and skin reactions during coadministration, and watch for reduced tucatinib effectiveness. Consider an alternative antiretroviral if hepatic or cutaneous toxicity emerges.
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 Nevirapine
- Elbasvir / grazoprevir + Nevirapine Contraindicated
- Nevirapine + Ranolazine Contraindicated
- Nevirapine + St john's wort Contraindicated
- Abemaciclib + Nevirapine Major
- Acalabrutinib + Nevirapine Major
- Amobarbital + Nevirapine Major
Other interactions of Tucatinib
- Cisapride + Tucatinib Contraindicated
- Eletriptan + Tucatinib Contraindicated
- Ergotamine + Tucatinib Contraindicated
- Flibanserin + Tucatinib Contraindicated
- Ranolazine + Tucatinib Contraindicated
- Amobarbital + Tucatinib Major
Frequently asked questions
Can I take Nevirapine with Tucatinib?
MediHelp rates the interaction as moderate. Nevirapine and Tucatinib 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. Tucatinib is a CYP3A inhibitor and may raise exposure to CYP3A substrates, but nevirapine is a CYP3A substrate and also an inducer, with a net effect that is hard to predict. Increased nevirapine levels could raise the risk of rash and hepatotoxicity. Nevirapine could also reduce tucatinib levels, since tucatinib is metabolized by CYP2C8 and CYP3A.
How serious is the interaction between Nevirapine and Tucatinib?
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 liver enzymes and skin reactions during coadministration, and watch for reduced tucatinib effectiveness. Consider an alternative antiretroviral if hepatic or cutaneous toxicity emerges.
What other medicines interact with Nevirapine?
MediHelp also lists interactions of Nevirapine with, for example, Elbasvir / grazoprevir, Ranolazine, St john's wort. The full list is on the Nevirapine page.
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