Drug interactions
Nilotinib + Nirmatrelvir
Severity: Major
Nilotinib and Nirmatrelvir: 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
Nirmatrelvir is given with ritonavir, a strong CYP3A4 inhibitor, which can significantly raise nilotinib concentrations. This increases the risk of nilotinib toxicity, including QT prolongation.
What this interaction means in plain words
Nilotinib and Nirmatrelvir 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.
Nilotinib belongs to Oncology; Nirmatrelvir belongs to Anti Virals.
Why it happens
Ritonavir-boosted CYP3A4 inhibition reduces nilotinib clearance.
What to do
Consider withholding nilotinib during the short nirmatrelvir course or use an alternative antiviral. If both are given, reduce the nilotinib dose per labeling and monitor ECG.
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 Nilotinib
- Amiodarone + Nilotinib Contraindicated
- Arsenic trioxide + Nilotinib Contraindicated
- Disopyramide + Nilotinib Contraindicated
- Dofetilide + Nilotinib Contraindicated
- Dronedarone + Nilotinib Contraindicated
- Droperidol + Nilotinib Contraindicated
Other interactions of Nirmatrelvir
- Alfuzosin + Nirmatrelvir Contraindicated
- Amiodarone + Nirmatrelvir Contraindicated
- Apalutamide + Nirmatrelvir Contraindicated
- Carbamazepine + Nirmatrelvir Contraindicated
- Colchicine + Nirmatrelvir Contraindicated
- Dronedarone + Nirmatrelvir Contraindicated
Frequently asked questions
Can I take Nilotinib with Nirmatrelvir?
MediHelp rates the interaction as major. Nilotinib and Nirmatrelvir 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. Nirmatrelvir is given with ritonavir, a strong CYP3A4 inhibitor, which can significantly raise nilotinib concentrations. This increases the risk of nilotinib toxicity, including QT prolongation.
How serious is the interaction between Nilotinib and Nirmatrelvir?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Consider withholding nilotinib during the short nirmatrelvir course or use an alternative antiviral. If both are given, reduce the nilotinib dose per labeling and monitor ECG.
What other medicines interact with Nilotinib?
MediHelp also lists interactions of Nilotinib with, for example, Amiodarone, Arsenic trioxide, Disopyramide. The full list is on the Nilotinib page.
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