Gepotidacin and Neratinib: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Neratinib
Gepotidacin
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 CYP3A4 substrate with NTI exposure
Interaction Deep Dive
Avoid concomitant use of gepotidacin with CYP3A4 substrates having narrow therapeutic index as it may increase CYP3A4 substrate with NTI exposure. Concomitant administration of midazolam (CYP3A4 substrate) (2 mg single dose) with gepotidacin (2 doses of 3,000 mg, given 12 hours apart; not an approved dosage of gepotidacin) resulted in a 1.9-fold increase in midazolam AUC(0 to inf)1.
Why it happens (mechanism)
Inhibition of CYP3A4-substrate metabolism by gepotidacin
Literature reports
1 report — tap to read
a) Concomitant administration of midazolam (CYP3A4 substrate) (2 mg single dose) with gepotidacin (2 doses of 3,000 mg, given 12 hours apart; not an approved dosage of gepotidacin) resulted in a 1.9-fold increase in midazolam AUC(0 to inf) 1.
Common questions
Can I take Gepotidacin and Neratinib together?
Increased CYP3A4 substrate with NTI exposure Always confirm with your pharmacist or prescriber before making any change.
How serious is the Gepotidacin and Neratinib 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 Gepotidacin or Neratinib 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)
- Product Information: BLUJEPA oral tablets, gepotidacin oral tablets. GlaxoSmithKline (per FDA), Durham, NC, 2025. DailyMed
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