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Drug interactions

Nilotinib + Paroxetine

Severity: Major

Nilotinib and Paroxetine: 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

Nilotinib carries a boxed warning for QT prolongation and sudden death. Paroxetine has a low QT liability, but it also inhibits CYP2D6 and may be unwise in combination because of additive risk in patients with other risk factors.

What this interaction means in plain words

Nilotinib and Paroxetine 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; Paroxetine belongs to Central Nervous System.

Evidence level: Low

Why it happens

Additive QT prolongation, with nilotinib as the dominant contributor.

What to do

Obtain a baseline ECG and correct potassium and magnesium before treatment. Repeat the ECG after starting and consider a lower-QT-risk antidepressant such as sertraline.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Nilotinib with Paroxetine?

MediHelp rates the interaction as major. Nilotinib and Paroxetine 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 carries a boxed warning for QT prolongation and sudden death. Paroxetine has a low QT liability, but it also inhibits CYP2D6 and may be unwise in combination because of additive risk in patients with other risk factors.

How serious is the interaction between Nilotinib and Paroxetine?

MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain a baseline ECG and correct potassium and magnesium before treatment. Repeat the ECG after starting and consider a lower-QT-risk antidepressant such as sertraline.

What other medicines interact with Paroxetine?

MediHelp also lists interactions of Paroxetine with, for example, Isocarboxazid, Methylene blue, Phenelzine. The full list is on the Paroxetine page.

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