Drug interactions
Nilotinib + Tolterodine
Severity: Major
Nilotinib and Tolterodine: 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 inhibits CYP3A4 and may raise tolterodine concentrations, mainly in CYP2D6 poor metabolizers who rely on CYP3A4. Both drugs can prolong the QT interval, so the combination adds arrhythmia risk.
What this interaction means in plain words
Nilotinib and Tolterodine 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; Tolterodine belongs to Genitourinary.
Why it happens
CYP3A4 inhibition by nilotinib reduces tolterodine clearance, with additive QT prolongation at the pharmacodynamic level.
What to do
Obtain a baseline ECG and correct potassium and magnesium before combining, and monitor the QTc during therapy. Limit tolterodine to the lower dose or choose an alternative antimuscarinic with less QT effect if the QTc rises.
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 Tolterodine
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 Tolterodine?
MediHelp rates the interaction as major. Nilotinib and Tolterodine 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 inhibits CYP3A4 and may raise tolterodine concentrations, mainly in CYP2D6 poor metabolizers who rely on CYP3A4. Both drugs can prolong the QT interval, so the combination adds arrhythmia risk.
How serious is the interaction between Nilotinib and Tolterodine?
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 combining, and monitor the QTc during therapy. Limit tolterodine to the lower dose or choose an alternative antimuscarinic with less QT effect if the QTc rises.
What other medicines interact with Tolterodine?
MediHelp also lists interactions of Tolterodine with, for example, Clarithromycin, Clozapine, Cobicistat. The full list is on the Tolterodine page.
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