Nitrendipine and Epirubicin: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Epirubicin
Nitrendipine
No brand names on record
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 risk of heart failure
Interaction Deep Dive
Epirubicin may cause delayed cardiac toxicity and concomitant use of epirubicin with other cardioactive compounds that could cause heart failure (eg, calcium channel blockers) requires close monitoring of cardiac function throughout treatment1. The AUC of epirubicin metabolites was increased with concurrent verapamil therapy in a study of 10 patients, which may cause increased cardiotoxicity 2; however, a randomized phase II trial if 51 patients demonstrated no difference in efficacy or toxicity with the combination compared with epirubicin alone 3.
Why it happens (mechanism)
An unknown mechanism
Literature reports
1 report — tap to read
a) The AUC of epirubicin metabolites was increased with concurrent verapamil therapy in a study of 10 patients with advanced breast cancer. Suggested mechanisms for these altered metabolite values were enzyme induction, increased liver blood flow, or reduced plasma clearance associated with the presence of verapamil 2.
Common questions
Can I take Nitrendipine and Epirubicin together?
Increased risk of heart failure Always confirm with your pharmacist or prescriber before making any change.
How serious is the Nitrendipine and Epirubicin interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "delayed". Effects tend to build up gradually over days to weeks.
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 Nitrendipine or Epirubicin 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 (3)
- Product Information: ELLENCE(R) intravenous injection, epirubicin HCl intravenous injection. Pharmacia & Upjohn Co (per FDA), New York, NY, 2019. DailyMed
- Mross K, Hamm K, & Hossfeld DK: Effects of verapamil on the pharmacokinetics and metabolism of epirubicin. Cancer Chemother Pharmacol 1993; 31:369-375. PubMed
- Mross K, Bohn L, Edler W, et al: Randomized phase II study of single-agent epirubicin +/- verapamil in patients with advanced metastatic breast cancer. An AIO clinical trial. Arbeitsgemeinschaft Internistische Onkologie of the German Cancer Society. Ann Oncol 1993a; 4(1):45-50. PubMed
Keep reading about Epirubicin
Keep reading about Nitrendipine
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