Taletrectinib and Atenolol: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 15, 2026 · Source data updated Jul 11, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Atenolol
Taletrectinib
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.
You've been prescribed atenolol (a blood pressure and heart medicine) and taletrectinib (Ibtrozi, a cancer medicine). Taletrectinib can affect your heart's electrical timing, something doctors call the QT interval. When that rhythm is stretched out too long, it can rarely lead to a dangerous heartbeat.
Atenolol usually slows the heart rate, which by itself can add to that timing concern. This warning is theoretical, meaning it's a caution based on how these drugs work rather than proven cases together. The good news: your care team can manage this safely with heart tracings (ECGs) and blood tests. Keep taking both as prescribed and check in with your pharmacist or doctor.
Effect: Additive QTc prolongation with increased risk of torsades de pointes or sudden death.
Mechanism: Pharmacodynamic additivity. Taletrectinib carries a known QTc-prolonging signal; atenolol contributes via bradycardia, which can potentiate QT-related risk. Neither is a prodrug relevant here.
Evidence: Theoretical; severity rated major; onset unspecified.
Management:
- Avoid concomitant use when feasible.
- Obtain baseline ECG and electrolytes, then monitor periodically.
- Correct K+/Mg2+; watch for clinically significant bradyarrhythmia.
- Withhold taletrectinib if QTc >500 msec or change from baseline >60 msec; resume at same/reduced dose or discontinue per severity.
- Give taletrectinib on an empty stomach.
What happens
Increased risk of QT interval prolongation and torsade de pointes
Interaction Deep Dive
Do not use taletrectinib together with other agents recognized as having QTc-prolonging potential, including antiarrhythmics, because doing so may heighten the likelihood of QTc interval prolongation, a condition that can raise the risk of ventricular tachyarrhythmias (for example, torsades de pointes) or sudden death. When such combined use is unavoidable, modify how often monitoring is performed according to the guidance provided. Discontinue taletrectinib temporarily when the QTc interval exceeds 500 msec or when the change from baseline exceeds 60 msec and produces QTc interval prolongation. Obtain ECGs and check electrolytes before giving taletrectinib, and repeat these assessments periodically throughout therapy as clinically warranted. The frequency of monitoring should be tailored to risk factors, which include known long QT syndromes, clinically significant bradyarrhythmias, severe or uncontrolled heart failure, and the use of concomitant drugs linked to QTc interval prolongation. Give taletrectinib on an empty stomach. Depending on severity, withhold taletrectinib and then restart it at the same or a lowered dose, or stop it permanently1.
Why it happens (mechanism)
Additive QT interval prolongation
How to manage this interaction
Both medicines can be used together when necessary, but your care team will watch your heart rhythm more closely.
- Keep taking both exactly as prescribed unless your prescriber tells you otherwise.
- Expect ECGs (heart tracings) and blood tests for electrolytes before starting and periodically during treatment.
- Your team may adjust monitoring based on heart conditions, slow heart rate, or other QT-affecting medicines.
- The taletrectinib dose may be adjusted and individualized by your team if your ECG shows changes.
Tell your pharmacist or doctor about any dizziness, fainting, or palpitations, and share your full medication list.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) Within the combined safety population, among the 351 patients who had at least one ECG evaluation after baseline, 13% showed an increase in QTcF (QT interval corrected using the Fridericia formula) exceeding 60 msec relative to baseline following taletrectinib, and 2.6% had a QTcF rise to more than 500 msec. In total, 3.4% of patients experienced QTc interval prolongation of Grade greater than and equal to 3. The median interval between the first taletrectinib dose and the appearance of ECG QT prolongation was 22 days (range: 1 day to 38.7 months). QTc prolongation resulted in dose interruption and dose reduction, in 2.8% of patients each who were treated with taletrectinib 1.
Common questions
Can I take Taletrectinib and Atenolol together?
Combining atenolol and taletrectinib can add to heart-rhythm (QT) risk, so your care team will monitor your ECG and electrolytes and adjust as needed. Keep taking both as prescribed and report any fainting or palpitations. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Taletrectinib and Atenolol 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 is the Taletrectinib and Atenolol interaction managed?
Both medicines can be used together when necessary, but your care team will watch your heart rhythm more closely. Keep taking both exactly as prescribed unless your prescriber tells you otherwise. Expect ECGs (heart tracings) and blood tests for electrolytes before starting and periodically during treatment. Your team may adjust monitoring based on heart conditions, slow heart rate, or other QT-af… Management is individual — always follow your own care team's guidance.
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 Taletrectinib or Atenolol 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: IBTROZI(TM) oral capsules, taletrectinib oral capsules. Nuvation Bio Inc. (per Manufacturer), Burlington, MA, 2025. DailyMed
Keep reading about Atenolol
Keep reading about Taletrectinib
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