Abemaciclib and Nilotinib: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 10, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Nilotinib
No brand names on recordAbemaciclib
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
You've been prescribed nilotinib and abemaciclib (Verzenio) together. Here's what's going on: your body uses an enzyme called CYP3A4 to break down abemaciclib. Nilotinib can slow that enzyme down. When that happens, abemaciclib can build up to higher levels than usual, which may bring on more of its side effects, like diarrhea, nausea, tiredness, or low blood counts.
The good news is that this is very manageable. Your care team can watch you a little more closely and, if needed, adjust your abemaciclib dose to keep you comfortable and safe. Please keep taking both exactly as prescribed, and let your pharmacist or doctor know if you notice new or worse side effects.
Effect: Nilotinib, a moderate CYP3A4 inhibitor, may reduce CYP3A4-mediated metabolism of abemaciclib (a CYP3A4 substrate), increasing plasma concentrations of abemaciclib and its active metabolites, with potential for increased toxicity.
- Direction: Increased abemaciclib exposure (AUC/Cmax).
- Onset: Unspecified.
- Evidence: Theoretical.
- Management: Monitor for adverse reactions (diarrhea, neutropenia, hepatotoxicity, fatigue). Consider dose reduction in 50-mg increments: 150 mg BID to 100 mg BID then 50 mg BID; 200 mg BID to 150, then 100, then 50 mg BID. Discontinue if 50 mg BID is not tolerated.
Neither agent's efficacy depends on CYP3A4 activation, so the interpretation is straightforward accumulation.
What happens
Increased abemaciclib plasma concentration
Interaction Deep Dive
When abemaciclib, which is a substrate of CYP3A4, is taken together with a moderate CYP3A4 inhibitor, plasma concentrations of both abemaciclib and its active metabolite may rise, potentially producing greater toxicity. Should the two be given together, watch for adverse reactions and consider lowering the abemaciclib dose in 50-mg steps. For a patient on 150 mg twice daily, reduce first to 100 mg twice daily and then to 50 mg twice daily, discontinuing the drug if 50 mg twice daily cannot be tolerated. For a patient on 200 mg twice daily, reduce first to 150 mg twice daily, next to 100 mg twice daily, and then to 50 mg twice daily, discontinuing the drug if 50 mg twice daily cannot be tolerated1.
Why it happens (mechanism)
Inhibition of CYP3A4-mediated abemaciclib metabolism
How to manage this interaction
This interaction is manageable with your care team's oversight.
- Keep taking both nilotinib and abemaciclib as prescribed unless your prescriber tells you otherwise.
- Your team may monitor you more closely for side effects such as diarrhea, nausea, unusual fatigue, signs of infection, or bruising.
- If side effects appear, the abemaciclib dose may be reduced in 50-mg steps and individualized by your care team.
- Report any new or worsening symptoms to your pharmacist or prescriber promptly.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) Drug interaction studies predict that giving abemaciclib together with verapamil and diltiazem (both moderate CYP3A inhibitors) will raise the AUC of abemaciclib along with its active metabolites (M2, M18, and M20) by roughly 1.6-fold and 2.4-fold, respectively 1.
Common questions
Can I take Abemaciclib and Nilotinib together?
Nilotinib can raise abemaciclib levels and increase its side effects, but your care team can manage this by monitoring you closely and adjusting the abemaciclib dose if needed. Keep taking both as prescribed and report new symptoms. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Abemaciclib and Nilotinib interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Abemaciclib and Nilotinib interaction managed?
This interaction is manageable with your care team's oversight. Keep taking both nilotinib and abemaciclib as prescribed unless your prescriber tells you otherwise. Your team may monitor you more closely for side effects such as diarrhea, nausea, unusual fatigue, signs of infection, or bruising. If side effects appear, the abemaciclib dose may be reduced in 50-mg steps and individualized by your c… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Abemaciclib or Nilotinib need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (1)
- Product Information: VERZENIO(TM) oral tablets, abemaciclib oral tablets. Lilly USA LLC (per FDA), Indianapolis, IN, 2018. DailyMed
Keep reading about Nilotinib
Keep reading about Abemaciclib
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
Check another combination
Our instant two-drug interaction checker is almost here.
Still have questions about this combination?
Every question gets a real answer from a licensed pharmacist — free, and usually within a day.
Ask the pharmacist