Drug interactions
Ranolazine + Topotecan
Severity: Major
Ranolazine and Topotecan: 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
Ranolazine inhibits P-glycoprotein and may increase topotecan exposure, especially oral topotecan. This could worsen myelosuppression and gastrointestinal toxicity.
What this interaction means in plain words
Ranolazine and Topotecan 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.
Ranolazine belongs to Cardiovascular; Topotecan belongs to Oncology.
Why it happens
P-gp inhibition by ranolazine increases topotecan absorption and reduces efflux clearance.
What to do
Avoid ranolazine with oral topotecan. With IV topotecan, monitor blood counts closely and consider an alternative antianginal.
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 Ranolazine
- Adagrasib + Ranolazine Contraindicated
- Amobarbital + Ranolazine Contraindicated
- Apalutamide + Ranolazine Contraindicated
- Butabarbital + Ranolazine Contraindicated
- Carbamazepine + Ranolazine Contraindicated
- Clarithromycin + Ranolazine Contraindicated
Other interactions of Topotecan
- Adenovirus types 4 and 7 live + Topotecan Contraindicated
- Amiodarone + Topotecan Major
- Cisplatin + Topotecan Major
- Cobicistat + Topotecan Major
- Cyclosporine + Topotecan Major
- Cyclosporin + Topotecan Major
Frequently asked questions
Can I take Ranolazine with Topotecan?
MediHelp rates the interaction as major. Ranolazine and Topotecan 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. Ranolazine inhibits P-glycoprotein and may increase topotecan exposure, especially oral topotecan. This could worsen myelosuppression and gastrointestinal toxicity.
How serious is the interaction between Ranolazine and Topotecan?
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 ranolazine with oral topotecan. With IV topotecan, monitor blood counts closely and consider an alternative antianginal.
What other medicines interact with Ranolazine?
MediHelp also lists interactions of Ranolazine with, for example, Adagrasib, Amobarbital, Apalutamide. The full list is on the Ranolazine page.
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