Drug interactions
Topotecan + Verapamil
Severity: Moderate
Topotecan and Verapamil: 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
Verapamil inhibits P-gp and BCRP-related efflux and may increase topotecan absorption and exposure, particularly with oral topotecan. This could worsen myelosuppression.
What this interaction means in plain words
Topotecan and Verapamil 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.
Topotecan belongs to Oncology; Verapamil belongs to Cardiovascular.
Why it happens
Inhibition of P-gp efflux of topotecan, increasing oral bioavailability and reducing clearance.
What to do
Avoid verapamil with oral topotecan where possible. With IV topotecan, monitor blood counts closely.
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 Verapamil
- Dofetilide + Verapamil Contraindicated
- Flibanserin + Verapamil Contraindicated
- Lomitapide + Verapamil Contraindicated
- Lonafarnib + Verapamil Contraindicated
- Pimozide + Verapamil Contraindicated
- Acebutolol + Verapamil Major
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 Topotecan with Verapamil?
MediHelp rates the interaction as moderate. Topotecan and Verapamil 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. Verapamil inhibits P-gp and BCRP-related efflux and may increase topotecan absorption and exposure, particularly with oral topotecan. This could worsen myelosuppression.
How serious is the interaction between Topotecan and Verapamil?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid verapamil with oral topotecan where possible. With IV topotecan, monitor blood counts closely.
What other medicines interact with Verapamil?
MediHelp also lists interactions of Verapamil with, for example, Dofetilide, Flibanserin, Lomitapide. The full list is on the Verapamil page.
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