Amiodarone and Docetaxel Injection: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Amiodarone
Docetaxel Injection
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.
What happens
Increase in docetaxel exposure and risk of toxicity
Interaction Deep Dive
Concomitant use of amiodarone (a CYP3A4 and P-gp inhibitor) and docetaxel (a CYP3A4 and P-gp substrate) may increase docetaxel exposure and increase the risk of toxicity. In a case report, a patient experienced severe skin and mucosal toxicity within 3 days of docetaxel initiation with confirmed significant increase in docetaxel exposure via pharmacokinetic analysis. Amiodarone has a half-life of 20 to 100 days, so effects on docetaxel metabolism may be expected to persist well after discontinuation of amiodarone. Consider alternative chemotherapeutic agents for patients receiving or who have recently received amiodarone1.
Why it happens (mechanism)
Inhibition of CYP3A4- and P-gp-mediated docetaxel metabolism by amiodarone
Literature reports
1 report — tap to read
a) In a case report, a 77-year-old woman on stable amiodarone therapy was initiated on paclitaxel and subsequently on docetaxel and developed severe skin and mucosal toxicity with confirmed significant increase in docetaxel exposure via pharmacokinetic analysis. The patient had a history of hypertension, hyperlipidemia, and palpitations receiving long-term amiodarone and was initiated on paclitaxel 80 mg/m(2) once a week and trastuzumab for HER2-positive breast cancer. During the first 4 cycles, she developed increasing abdominal pain and facial rash that progressed to overt peeling of the palms, soles, and back of the arms and hands. Therapy was changed to docetaxel 100 or 75 mg/m(2) weekly but within 3 days she developed pain on swallowing, diarrhea, and vomiting. Upon admission, mucositis was diagnosed which required nasogastric tube insertion for enteral feeding. She was treated with predniSONE, topical ointments and cooling. Worsening of her status necessitated discontinuation of chemotherapy. A pharmacokinetic analysis revealed a 79% decrease in docetaxel clearance (9.15 vs 44.1 L/hr) and a 5-fold increase in AUC(0 to infinity; 10.9 vs 2.27 mg x L/hr). Amiodarone has a half-life of 20 to 100 days, so effects on docetaxel metabolism may be expected to persist well after discontinuation of amiodarone 1.
Common questions
Can I take Amiodarone and Docetaxel Injection together?
Increase in docetaxel exposure and risk of toxicity Always confirm with your pharmacist or prescriber before making any change.
How serious is the Amiodarone and Docetaxel Injection interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "delayed". Effects tend to build up gradually over days to weeks.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Amiodarone or Docetaxel Injection 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 a safer alternative to one of these medications for me?
References (1)
- Hammann F, Gotta V, Conen K, et al: Pharmacokinetic interaction between taxanes and amiodarone leading to severe toxicity. Br J Clin Pharmacol 2017; 83(4):927-930. PubMed
Keep reading about Amiodarone
Keep reading about Docetaxel Injection
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