Nilotinib with Pioglitazone Interaction Details

Brand Names Associated with Nilotinib

  • Nilotinib
  • Tasigna®

Brand Names Associated with Pioglitazone

  • Actoplus Met® (as a combination product containing Metformin, Pioglitazone)
  • Actoplus Met® XR (as a combination product containing Metformin, Pioglitazone)
  • Actos®
  • Duetact® (as a combination product containing Glimepiride, Pioglitazone)
  • Oseni® (as a combination product containing Alogliptin, Pioglitazone)
  • Pioglitazone

Medical Content Editor
Last updated Dec 19, 2023

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Interaction Effect

Altered exposure to pioglitazone

Interaction Summary

Nilotinib is a competitive CYP2C8 inhibitor and potentially a CYP2C8 inducer. CYP2C8 along with other CYP enzymes are involved in the metabolism of pioglitazone. Concomitant use of pioglitazone with a strong CYP2C8 inhibitor (gemfibrozil) significantly increased AUC and half-life of pioglitazone. Alternately, induction of CYP2C8 by nilotinib may significantly decrease exposure to pioglitazone. Monitor clinical response of the patient and adjust dose of pioglitazone if necessary, keeping in mind the maximum recommended dose of pioglitazone is 45 mg daily .

Severity

Moderate

Onset

Unspecified

Evidence

Probable

How To Manage Interaction

Use of nilotinib, a competitive CYP2C8 inhibitor and potential CYP2C8 inducer, with pioglitazone, a CYP2C8 substrate, may alter exposure to pioglitazone. Monitor clinical response of the patient and adjust dose of pioglitazone if necessary, keeping in mind the maximum recommended dose of pioglitazone is 45 mg daily .

Mechanism Of Interaction

Inhibition and/or induction of CYP2C8-mediated metabolism of pioglitazone by nilotinib

Nilotinib Overview

  • Nilotinib is used to treat certain types of chronic myeloid leukemia (CML; a type of cancer of the white blood cells) who have recently found to have this condition in adults and children 1 year of age and older. It is also used to treat certain types of CML in adults whose disease could not be treated successfully with imatinib (Gleevec) or adults who cannot take imatinib because of side effects. Nilotinib is also used to treat certain types of CML in children 1 year of age or older whose disease could not be treated successfully with other tyrosine kinase inhibitor therapies or who cannot take these medications because of side effects. Nilotinib is in a class of medications called kinase inhibitors. It works by blocking the action of the abnormal protein that signals cancer cells to multiply. This helps to stop or slow the spread of cancer cells.

See More information Regarding Nilotinib

Pioglitazone Overview

  • Pioglitazone is used with a diet and exercise program and sometimes with other medications, to treat type 2 diabetes (condition in which the body does not use insulin normally and therefore cannot control the amount of sugar in the blood). Pioglitazone is in a class of medications called thiazolidinediones. It works by increasing the body's sensitivity to insulin, a natural substance that helps control blood sugar levels. Pioglitazone is not used to treat type 1 diabetes (condition in which the body does not produce insulin and, therefore, cannot control the amount of sugar in the blood) or diabetic ketoacidosis (a serious condition that may develop if high blood sugar is not treated).

  • Over time, people who have diabetes and high blood sugar can develop serious or life-threatening complications, including heart disease, stroke, kidney problems, nerve damage, and eye problems.Taking medication(s), making lifestyle changes (e.g., diet, exercise, quitting smoking), and regularly checking your blood sugar may help to manage your diabetes and improve your health. This therapy may also decrease your chances of having a heart attack, stroke, or other diabetes-related complications such as kidney failure, nerve damage (numb, cold legs or feet; decreased sexual ability in men and women), eye problems, including changes or loss of vision, or gum disease. Your doctor and other healthcare providers will talk to you about the best way to manage your diabetes.

See More information Regarding Pioglitazone

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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.