Drug interactions
Selpercatinib + Voriconazole
Severity: Major
Selpercatinib and Voriconazole: 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
Voriconazole inhibits CYP3A4 and can increase selpercatinib exposure, while both drugs can prolong the QT interval. The combination raises the risk of QT prolongation and arrhythmia as well as selpercatinib toxicity.
What this interaction means in plain words
Selpercatinib and Voriconazole 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.
Selpercatinib belongs to Oncology; Voriconazole belongs to Anti Fungals.
Why it happens
CYP3A4 inhibition by voriconazole raises selpercatinib levels, and both drugs have additive QTc-prolonging effects.
What to do
Avoid the combination if possible; if needed, reduce the selpercatinib dose per labeling for strong CYP3A4 inhibitors. Monitor ECG and electrolytes (potassium, magnesium).
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 Voriconazole
- Avanafil + Voriconazole Contraindicated
- Butabarbital + Voriconazole Contraindicated
- Carbamazepine + Voriconazole Contraindicated
- Conivaptan + Voriconazole Contraindicated
- Dihydroergotamine intranasal + Voriconazole Contraindicated
- Dihydroergotamine + Voriconazole Contraindicated
Other interactions of Selpercatinib
Frequently asked questions
Can I take Selpercatinib with Voriconazole?
MediHelp rates the interaction as major. Selpercatinib and Voriconazole 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. Voriconazole inhibits CYP3A4 and can increase selpercatinib exposure, while both drugs can prolong the QT interval. The combination raises the risk of QT prolongation and arrhythmia as well as selpercatinib toxicity.
How serious is the interaction between Selpercatinib and Voriconazole?
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 if possible; if needed, reduce the selpercatinib dose per labeling for strong CYP3A4 inhibitors. Monitor ECG and electrolytes (potassium, magnesium).
What other medicines interact with Voriconazole?
MediHelp also lists interactions of Voriconazole with, for example, Avanafil, Butabarbital, Carbamazepine. The full list is on the Voriconazole page.
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