Topotecan and Capmatinib: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Topotecan
Capmatinib
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
Risk of increased adverse reactions
Interaction Deep Dive
Coadministration of capmatinib with a P-gp and BCRP substrate increased the substrate exposure, which may increase the adverse reactions of these substrates. If coadministration is unavoidable between capmatinib and P-gp and BCRP substrates where minimal concentration changes may lead to serious adverse reactions, decrease the P-gp and BCRP substrate dosage as recommended1.
Why it happens (mechanism)
Increased P-gp and BCRP substrate exposure
Literature reports
2 reports — tap to read
a) Coadministration of capmatinib with rosuvastatin (a BCRP substrate) increased rosuvastatin AUC(0 to infinity) by 108% and increased Cmax by 204% 1. Compared with rosuvastatin alone, the rosuvastatin geometric mean ratio for AUC(infinity) was 2.08 (90% CI, 1.56 to 2.76), AUC(last) was 2.03 (90% CI, 1.61 to 2.56), and Cmax was 3.04 (90% CI, 2.36 to 3.92) following coadministration of capmatinib and rosuvastatin in a small prospective single-sequence study in adult patients with MET-dysregulated advanced solid tumors refractory to currently available therapies (N=32); t(1/2) was not affected. Capmatinib 400 mg twice daily for 12 days was coadministered with a single dose of digoxin 0.25 mg and rosuvastatin 10 mg on day 12 2.
b) Coadministration of capmatinib with digoxin (a P-gp substrate) increased digoxin AUC(0 to infinity) by 47% and increased Cmax by 74% 1. Compared with digoxin alone, the digoxin geometric mean ratio for AUC(infinity) was 1.47 (90% CI, 1.28 to 1.68), AUC(last) was 1.63 (90% CI, 1.42 to 1.89), and Cmax was 1.74 (90% CI, 1.43 to 2.13) following coadministration of capmatinib and digoxin in a small prospective single-sequence study in adult patients with MET-dysregulated advanced solid tumors refractory to currently available therapies (N=32). Digoxin t(1/2) was also prolonged with coadministration of capmatinib compared with digoxin alone (61.4 vs 47 hours); Tmax was not affected. Capmatinib 400 mg twice daily for 12 days was coadministered with a single dose of digoxin 0.25 mg and rosuvastatin 10 mg on day 12 2.
Common questions
Can I take Topotecan and Capmatinib together?
Risk of increased adverse reactions Always confirm with your pharmacist or prescriber before making any change.
How serious is the Topotecan and Capmatinib 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 Topotecan or Capmatinib 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 (2)
- Product Information: TABRECTA(TM) oral tablets, capmatinib oral tablets. Novartis Pharmaceuticals Corporation (per FDA), East Hanover, NJ, 2020. DailyMed
- Grande E, Giovannini M, Marriere E, et al: Effect of capmatinib on the pharmacokinetics of digoxin and rosuvastatin administered as a 2-drug cocktail in patients with MET-dysregulated advanced solid tumours: a phase I, multicentre, open-label, single-sequence drug-drug interaction study. Br J Clin Pharmacol 2021; 87(7):2867-2878.
Keep reading about Topotecan
Keep reading about Capmatinib
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