Drug interactions
Nilotinib + Phenytoin
Severity: Major
Nilotinib and Phenytoin: 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
Phenytoin markedly lowers nilotinib exposure and may compromise leukemia control. Nilotinib also prolongs the QT interval and can raise phenytoin levels.
What this interaction means in plain words
Nilotinib and Phenytoin 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; Phenytoin belongs to Central Nervous System.
Why it happens
Phenytoin induces CYP3A4 and P-glycoprotein, increasing nilotinib clearance, while nilotinib inhibits CYP2C9.
What to do
Avoid the combination and choose a non-inducing antiseizure drug. If unavoidable, monitor response, QT and phenytoin levels.
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 Phenytoin
- Artemether / lumefantrine + Phenytoin Contraindicated
- Bictegravir + Phenytoin Contraindicated
- Cabotegravir + Phenytoin Contraindicated
- Doravirine + Phenytoin Contraindicated
- Elbasvir / grazoprevir + Phenytoin Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Phenytoin Contraindicated
Other interactions of Nilotinib
- Amiodarone + Nilotinib Contraindicated
- Arsenic trioxide + Nilotinib Contraindicated
- Disopyramide + Nilotinib Contraindicated
- Dofetilide + Nilotinib Contraindicated
- Dronedarone + Nilotinib Contraindicated
- Droperidol + Nilotinib Contraindicated
Frequently asked questions
Can I take Nilotinib with Phenytoin?
MediHelp rates the interaction as major. Nilotinib and Phenytoin 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. Phenytoin markedly lowers nilotinib exposure and may compromise leukemia control. Nilotinib also prolongs the QT interval and can raise phenytoin levels.
How serious is the interaction between Nilotinib and Phenytoin?
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 the combination and choose a non-inducing antiseizure drug. If unavoidable, monitor response, QT and phenytoin levels.
What other medicines interact with Phenytoin?
MediHelp also lists interactions of Phenytoin with, for example, Artemether / lumefantrine, Bictegravir, Cabotegravir. The full list is on the Phenytoin page.
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