Drug Interaction Report

Irinotecan Injection and Eltrombopag: Interaction Details

A pharmacist-reviewed analysis of the Irinotecan Injection and Eltrombopag interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Irinotecan Injection

Camptosar Camptosar® Onivyde
+

Eltrombopag

Alvaiz Promacta Promacta®
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
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.

Of 96 documented Irinotecan Injection interactions, 73 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
unspecified
Evidence
theoretical
Severity
Major

What happens

Increased irinotecan exposure and an increased risk of irinotecan-related adverse reactions

Interaction Deep Dive

Exert caution if eltrombopag is coadministered with irinotecan (OATP1B1 and BCRP substrate) as it may result in increased irinotecan exposure. If concomitant use is required, monitor patients closely for signs and symptoms of excessive irinotecan exposure. Consider reducing irinotecan dose if necessary. In a drug interaction study, rosuvastatin (an OATP1B1 and BCRP substrate) AUC(0 to inf) and Cmax increased by 55% and 103%, respectively, following coadministration of eltrombopag (an OATP1B1 and BCRP inhibitor) 75 mg/day for 5 days and a single dose of rosuvastatin 10 mg in a clinical study1.

Why it happens (mechanism)

Inhibition of OATP1B1-mediated efflux transport of irinotecan; inhibition of BCRP-mediated efflux transport of irinotecan

Literature reports

1 report — tap to read

a) In a drug interaction study, rosuvastatin (an OATP1B1 and BCRP substrate) AUC(0 to inf) and Cmax increased by 55% and 103%, respectively, following coadministration of eltrombopag (an OATP1B1 and BCRP inhibitor) 75 mg/day for 5 days and a single dose of rosuvastatin 10 mg in a clinical study 1.

Common questions

Can I take Irinotecan Injection and Eltrombopag together?

Increased irinotecan exposure and an increased risk of irinotecan-related adverse reactions Always confirm with your pharmacist or prescriber before making any change.

How serious is the Irinotecan Injection and Eltrombopag 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 "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.

Questions for your pharmacist

  • Does my dose of Irinotecan Injection or Eltrombopag 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)

  1. Product Information: PROMACTA(R) oral tablets, oral suspension, eltrombopag oral tablets, oral suspension. Novartis Pharmaceuticals Corporation (per FDA), East Hanover, NJ, 2025. DailyMed
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Beyond drug–drug

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:

Eltrombopag + Activated Charcoal Beer Siberian Cocklebur Wine Ashwagandha Black Cohosh Boldo Buchu + 47 more

major · moderate · minor — check everything you take with our drug–supplement interaction checker.

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.