Drug interactions
Nintedanib + Tamoxifen
Severity: Moderate
Nintedanib and Tamoxifen: 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
Nintedanib is a P-glycoprotein substrate, and tamoxifen can inhibit this transporter, which may increase nintedanib exposure. This could worsen gastrointestinal effects and liver enzyme elevations. The clinical significance has not been well characterized.
What this interaction means in plain words
Nintedanib and Tamoxifen 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.
Nintedanib belongs to Oncology; Tamoxifen belongs to Endocrine.
Why it happens
Inhibition of P-glycoprotein efflux by tamoxifen increases nintedanib absorption and reduces its clearance.
What to do
Monitor liver enzymes and gastrointestinal tolerance during coadministration. Manage adverse effects with nintedanib dose reduction or interruption.
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 Tamoxifen
- Amiodarone + Tamoxifen Major
- Anastrozole + Tamoxifen Major
- Bupropion + Tamoxifen Major
- Carbamazepine + Tamoxifen Major
- Cinacalcet + Tamoxifen Major
- Dacomitinib + Tamoxifen Major
Other interactions of Nintedanib
- Amiodarone + Nintedanib Moderate
- Apixaban + Nintedanib Moderate
- Argatroban + Nintedanib Moderate
- Azithromycin + Nintedanib Moderate
- Carbamazepine + Nintedanib Moderate
- Carvedilol + Nintedanib Moderate
Frequently asked questions
Can I take Nintedanib with Tamoxifen?
MediHelp rates the interaction as moderate. Nintedanib and Tamoxifen 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. Nintedanib is a P-glycoprotein substrate, and tamoxifen can inhibit this transporter, which may increase nintedanib exposure. This could worsen gastrointestinal effects and liver enzyme elevations. The clinical significance has not been well characterized.
How serious is the interaction between Nintedanib and Tamoxifen?
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 gastrointestinal tolerance during coadministration. Manage adverse effects with nintedanib dose reduction or interruption.
What other medicines interact with Tamoxifen?
MediHelp also lists interactions of Tamoxifen with, for example, Amiodarone, Anastrozole, Bupropion. The full list is on the Tamoxifen page.
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