Sunitinib and Asciminib: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Jul 11, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Sunitinib
Asciminib
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 SUNItinib exposure and an increased risk of SUNItinib-related adverse effects
Interaction Deep Dive
Concomitant use of asciminib (BCRP inhibitor and CYP3A4 inhibitor) with SUNItinib (BCRP and CYP3A4 substrate with NTI) may increase SUNItinib exposure, which may increase the risk of adverse reactions of SUNItinib. Avoid coadministration of asciminib 200 mg twice daily with SUNItinib where minimal concentration changes may lead to serious adverse reactions. In patients receiving a total dose of asciminib 80 mg/day, closely monitor for adverse reactions when coadministered with SUNItinib where minimal concentration changes may lead to serious adverse reactions. Closely monitor for adverse reactions in patients treated with asciminib at all recommended doses with concomitant use of SUNItinib. Reduce the dosage of SUNItinib as recommended when used concomitantly with asciminib at all recommended doses1.
Why it happens (mechanism)
Inhibition of BCRP-mediated efflux transport of SUNItinib; inhibition of CYP3A4-substrate metabolism of SUNItinib
Literature reports
1 report — tap to read
a) Coadministration of asciminib 40 mg twice daily with midazolam (a CYP3A4 substrate) resulted in an increase in the AUC(infinity) of midazolam by 28% and an increase in its Cmax of 11%. When coadministered with asciminib 80 mg once daily, the midazolam AUC(infinity) and Cmax increased by 24% and 17%, respectively, and when coadministered with asciminib 200 mg twice daily, the midazolam AUC(infinity) and Cmax increased by 88% and 58%, respectively 1.
Common questions
Can I take Sunitinib and Asciminib together?
Increased SUNItinib exposure and an increased risk of SUNItinib-related adverse effects Always confirm with your pharmacist or prescriber before making any change.
How serious is the Sunitinib and Asciminib 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 Sunitinib or Asciminib 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: SCEMBLIX® oral tablets, asciminib oral tablets. Novartis Pharmaceuticals Corporation (per FDA), East Hanover, NJ, 2025. DailyMed
Keep reading about Sunitinib
Keep reading about Asciminib
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