Amiodarone and Erlotinib: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Amiodarone
Erlotinib
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
Neurotoxicity
Interaction Deep Dive
Concomitant use of amiodarone (a P-gp inhibitor) and erlotinib (a P-gp substrate) caused severe neurotoxicity in a case report of a 64-year-old man. Erlotninb was discontinued, but symptoms recurred with rechallenge. Dosage reduction of both agents resulted in no further toxicity1.
Why it happens (mechanism)
Inhibition of erlotinib P-gp efflux transport by amiodarone
Literature reports
1 report — tap to read
a) A case report described severe neurotoxicity in a 64-year-old man with lung cancer who initiated palliative systemic chemotherapy with erlotinib 150 mg/day and 6 weeks later received an amiodarone IV bolus of 300 mg for atrial fibrillation. He presented 5 hours after the amiodarone bolus with lightheadedness and weakness with loss of muscle strength and paresthesia of the left upper and lower extremities. While in the hospital, he had 2 more episodes of atrial fibrillation that required reversal with amiodarone. Four days after his initial presentation with atrial fibrillation, he had expressive aphasia, headache, and 2 generalized tonic-clonic seizures (Glasgow Coma Scale 10) that required clonazepam. Six days after the seizures, amiodarone was decreased to 200 mg/day and erlotinib was discontinued; the next day, he was discharged on erlotinib 150mg/day and amiodarone 200 mg/day. He returned to the hospital within a few hours with intermittent paralysis in both lower extremities. Erlotinib was decreased to 100 mg/day, amiodarone was continued at 200 mg/day, and no further toxicity occurred 1.
Common questions
Can I take Amiodarone and Erlotinib together?
Neurotoxicity Always confirm with your pharmacist or prescriber before making any change.
How serious is the Amiodarone and Erlotinib interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
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 Erlotinib 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)
- Lopez Brunso M, Toro Blanch C, Sais Girona E, et al: Probable drug-drug interaction between erlotinib and amiodarone causes severe neurotoxicity in a patient with advanced lung cancer. Anticancer Drugs 2018; 29(4):380-383. DOI
Keep reading about Amiodarone
Keep reading about Erlotinib
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