Drug Interaction Report

Nilotinib and Doxorubicin: Interaction Details

A pharmacist-reviewed analysis of the Nilotinib and Doxorubicin 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

Nilotinib

No brand names on record
+

Doxorubicin

Adriamycin Adriamycin® Caelyx Doxil Rubex®
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 116 documented Nilotinib interactions, 107 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 DOXOrubicin exposure and an increased risk of DOXOrubicin-related adverse reactions

Interaction Deep Dive

Avoid concurrent use of DOXOrubicin (a CYP3A4 and P-gp substrate) with nilotinib (a CYP3A4 and P-gp inhibitor), as increased DOXOrubicin exposure may occur21. Concomitant use may increase the incidence and severity of adverse reactions 1. Although this interaction has not been specifically studied, coadministration of nilotinib with midazolam (another CYP3A4 substrate) resulted in significantly increased midazolam exposure in patients with chronic myeloid leukemia. Dose adjustments may be required if coadministration is indicated 2.

Why it happens (mechanism)

Inhibition of CYP3A4-mediated metabolism of DOXOrubicin; inhibition of P-gp efflux transport of DOXOrubicin

Literature reports

1 report — tap to read

a) Multiple doses of nilotinib (a moderate CYP3A4 inhibitor) increased the systemic exposure of midazolam (a CYP3A4 substrate) by 2.6-fold in patients with chronic myeloid leukemia 2.

Common questions

Can I take Nilotinib and Doxorubicin together?

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

How serious is the Nilotinib and Doxorubicin 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 Nilotinib or Doxorubicin 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 (2)

  1. Product Information: Doxorubicin hydrochloride intravenous injection, doxorubicin hydrochloride intravenous injection. Pfizer Labs (per Dailymed), New York, NY, 2024. DailyMed
  2. Product Information: TASIGNA(R) oral capsules, nilotinib oral capsules. Novartis Pharmaceuticals Corporation (per FDA), East Hanover, NJ, 2014. DailyMed
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Nilotinib

Keep reading about Nilotinib

All Nilotinib interactions (116)
Also serious with: Lefamulin Ketoconazole Topical Entrectinib Oxaliplatin Injection
Doxorubicin

Keep reading about Doxorubicin

All Doxorubicin interactions (237) Doxorubicin drug information
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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:

Nilotinib + Activated Charcoal American Hellebore Arsenic Beer Cesium Ephedra Grapefruit Siberian Cocklebur + 213 more
Doxorubicin + Grapefruit St. John's Wort Acacia Rigidula Acerola Adrafinil African Wild Potato Alpha-lipoic Acid American Elder + 131 more

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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.