Deferasirox and Paclitaxel: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Deferasirox
Paclitaxel
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
Increased PACLitaxel exposure
Interaction Deep Dive
Exercise caution when administering PACLitaxel concomitantly with CYP2C8 inhibitors as this may result in increased PACLitaxel exposure. PACLitaxel is a CYP2C8 substrate with a narrow therapeutic index (NTI). In vitro studies showed that PACLitaxel was metabolized primarily to 6-alpha-hydroxyPACLitaxel by CYP2C8. The pharmacokinetics of PACLitaxel may be altered as a result of interactions in vivo with compounds that are inhibitors of CYP2C812.
Why it happens (mechanism)
Inhibition of CYP2C8-mediated metabolism of PACLitaxel
Literature reports
3 reports — tap to read
a) Concomitant use of PACLitaxel and clopidogrel did not result in significantly increased risk of grade 2 or greater peripheral neuropathy compared with concomitant PACLitaxel and low-dose aspirin in the overall group in a case-control study (N=136; event rate, 42% vs 31%), but high-dose PACLitaxel (135 mg/m(2) or more) was significantly associated with a 2.3-fold increased risk (95% CI, 1.1- to 4.5 fold; event rate, 47% vs 32%) during concomitant use with clopidogrel versus low-dose aspirin 3.
b) In a retrospective review of patients administered a combination of PACLitaxel (60 to 132.8 mg/week) and clopidogrel (N=8; 75 mg/day), Grade 3 or higher neutropenia occurred in 100%, Grade 4 neutropenia in 88%, febrile neutropenia in 50%, and adverse effects causing discontinuation in 50%. In one patient treated with 2 separate courses of PACLitaxel for 6 cycles, once with and once without concomitant clopidogrel, mean neutrophil count on day 8 was significantly reduced with clopidogrel (370 vs 1240 cells/mm(3); neutrophil reduction rate, 82.6% vs 54.1%) 4.
c) In vitro studies showed that PACLitaxel was metabolized primarily to 6-alpha-hydroxyPACLitaxel by the cytochrome P450 isozyme CYP2C8. The pharmacokinetics of PACLitaxel may also be altered as a result of interactions in vivo with compounds that are inhibitors of CYP2C8 12.
Common questions
Can I take Deferasirox and Paclitaxel together?
Increased PACLitaxel exposure Always confirm with your pharmacist or prescriber before making any change.
How serious is the Deferasirox and Paclitaxel 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.
Questions for your pharmacist
- Does my dose of Deferasirox or Paclitaxel 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 (4)
- Product Information: PACLITAXEL intravenous injection, paclitaxel intravenous injection. Fresenius Kabi (per Dailymed), Lake Zurich, IL, 2024. DailyMed
- Product Information: PACLITAXEL PROTEIN-BOUND PARTICLES (ALBUMIN-BOUND) intravenous injection lyophilized powder for suspension, paclitaxel protein-bound particles (albumin-bound) intravenous injection lyophilized powder for suspension. Sandoz Inc (per Dailymed), Princeton, NJ, 2024. DailyMed
- Agergaard K, Mau-Sorensen M, Stage TB, et al: Clopidogrel-paclitaxel drug-drug interaction: a pharmacoepidemiologic study. Clin Pharmacol Ther 2017; 102(3):547-553. PubMed
- Shinoda Y, Kimura M, Usami E, et al: Potential drug interaction between paclitaxel and clopidogrel. Biomed Rep 2016; 5(1):141-145. DOI
Keep reading about Deferasirox
Keep reading about Paclitaxel
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.
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