Neratinib with Digoxin Interaction Details
Brand Names Associated with Neratinib
- Neratinib
- Nerlynx®
Brand Names Associated with Digoxin
- Cardoxin®
- Digitek®
- Digoxin
- Lanoxicaps®
- Lanoxin®
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Jan 08, 2024
Interaction Effect
Increased exposure to P-gp substrate and risk of toxicity
Interaction Summary
Concomitant use of neratinib with digoxin (a P-gp substrate with a narrow therapeutic index) significantly increased digoxin exposure in a clinical study, which may increase risk for associated toxicities. If coadministration of neratinib with a P-gp substrate with a narrow therapeutic index is needed, monitor for adverse reactions associated with the substrate.
Severity
Major
Onset
Unspecified
Evidence
Probable
How To Manage Interaction
Concomitant use of neratinib with a P-gp substrate increased the plasma concentrations of the P-gp substrate in a clinical study, which may increase risk of associated toxicities. Monitor for adverse reactions of substrates where minimal concentration changes may lead to serious adverse reactions.
Mechanism Of Interaction
Inhibition of efflux transport of the P-gp substrate by neratinib
Literature Reports
A) In a clinical study in healthy subjects (n=18), coadministration of a single oral dose of digoxin 0.5 mg with steady-state neratinib 240 mg once daily increased the mean digoxin Cmax by 54% and AUC by 32% .
Neratinib Overview
-
Neratinib is used to treat a certain type of hormone receptor-positive breast cancer (breast cancer that depends on hormones such as estrogen to grow) in adults after treatment with trastuzumab (Herceptin) and other medications. Neratinib is used along with capecitabine (Xeloda) to treat a certain type of advanced hormone receptor-positive breast cancer or breast cancer that has spread to other parts of the body after treatment with at least two other medications. Neratinib is in a class of medications called kinase inhibitors. It works by blocking the action of an abnormal protein that signals cancer cells to multiply. This helps slow or stop the spread of cancer cells.
Digoxin Overview
-
Digoxin is used to treat heart failure and abnormal heart rhythms (arrhythmias). It helps the heart work better and it helps control your heart rate.
Return To Our Drug Interaction Homepage
Feedback, Question Or Comment About This Information?
Ask Dr. Brian Staiger, PharmD, our medical editor, directly! He's always more than happy to assist.
Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.