Nilotinib and Lefamulin: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Nilotinib
No brand names on recordLefamulin
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 lefamulin exposure, an increased risk of lefamulin-related adverse reactions, an increased sensitive CYP3A4 substrate exposure and an increased risk of QT interval prolongation
Interaction Deep Dive
Concomitant use of lefamulin with strong and moderate CYP3A4 inhibitors that are sensitive CYP3A4 substrate and prolong QT is contraindicated. Lefamulin (oral or IV) has the potential to prolong the QT interval in some patients. Concomitant use may increase lefamulin exposure and may also increase risk of lefamulin-related adverse reactions. It may also increase sensitive CYP3A4 substrate exposure and may increase risk sensitive CYP3A4 substrate-related adverse reactions. ECG monitoring is recommended if coadministration cannot be avoided. The magnitude of QT prolongation may increase with increasing concentration of lefamulin or increasing the rate of infusion of the IV formulation. Therefore, do not exceed recommended dose and infusion rate. The pharmacodynamic interaction potential to prolong the QT interval of the electrocardiogram between lefamulin and other drugs that effect cardiac conduction is unknown1.
Why it happens (mechanism)
Inhibition of CYP3A4-substrate metabolism by lefamulin; inhibition of CYP3A4-mediated metabolism of lefamulin; additive QT interval prolongation
Literature reports
2 reports — tap to read
a) In a drug interaction study, oral ketoconazole (strong inhibitor) increased the mean lefamulin AUC (0 to inf) and Cmax by 31% and 6%, respectively, when administered concomitantly with IV lefamulin. Additionally, oral ketoconazole (strong inhibitor) increased the lefamulin (0 to inf) and Cmax by 165% and 58%, respectively, when administered inf concomitantly with oral lefamulin 1.
b) In a drug interaction study, mean AUC and Cmax of midazolam (sensitive CYP3A4 substrate) were increased by approximately 200% and 100%, respectively, when oral midazolam was administered concomitantly with and at 2 or 4 hours after administration of oral lefamulin 1.
Common questions
Can I take Nilotinib and Lefamulin together?
Increased lefamulin exposure, an increased risk of lefamulin-related adverse reactions, an increased sensitive CYP3A4 substrate exposure and an increased risk of QT interval prolongation Always confirm with your pharmacist or prescriber before making any change.
How serious is the Nilotinib and Lefamulin interaction?
It is rated contraindicated. These should generally not be used together.
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 Lefamulin 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: XENLETA(R) oral tablets, intravenous injection, lefamulin oral tablets, intravenous injection. Nabriva Therapeutics US Inc (per FDA), King of Prussia, PA, 2021. DailyMed
Keep reading about Nilotinib
Keep reading about Lefamulin
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.
Check another combination
Our instant two-drug interaction checker is almost here.
Still have questions about this combination?
Every question gets a real answer from a licensed pharmacist — free, and usually within a day.
Ask the pharmacist