Drug Interaction Report

Vinorelbine and Gefitinib: Interaction Details

A pharmacist-reviewed analysis of the Vinorelbine and Gefitinib interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Gefitinib

Iressa Iressa®
+

Vinorelbine

Navelbine
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
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.

Of 5 documented Vinorelbine interactions, 5 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
delayed
Evidence
established
Severity
Major

What happens

Increased risk of severe myelotoxicity, particularly neutropenia

Interaction Deep Dive

In a phase II trial, the neutropenic effect of vinorelbine was exacerbated when used concomitantly with gefitinib2. In this trial, 4 out of 4 patients experienced severe neutropenia, including 1 death 1.

Why it happens (mechanism)

Unknown

Literature reports

1 report — tap to read

a) In a phase II study evaluating the treatment of non-small cell lung cancer (NSCLC) using the combination of gefitinib and vinorelbine, severe myelotoxicity, particularly severe neutropenia, was documented in all 4 patients enrolled, including 1 death. The study was subsequently closed. Patients had received gefitinib for at least 3 weeks without severe toxicity and had adequate bone marrow, liver, and renal function before vinorelbine was started. The treatment schedule was gefitinib 250 mg/m2 orally daily and vinorelbine 25 mg/m(2) intravenously on days 1 and 8 every 3 weeks. Approximately 1 to 2 weeks after receiving venorelbine, life-threatening neutropenia occurred in all 4 patients, and 1 death was reported. Grade 4 leukopenia, neutropenia, thrombocytopenia, and anemia occurred in 2 (50%), 4 (100%), 1 (25%), and 0 (0%) patients, respectively. The worst neutrophil counts during the first cycles were 48 mm(3) (9th day), 44 mm(3) (14th day), 0 mm(3) (12th day, and 136 mm(3) (16th day) in patients 1, 2, 3, and 4, respectively 1.

Common questions

Can I take Vinorelbine and Gefitinib together?

Increased risk of severe myelotoxicity, particularly neutropenia Always confirm with your pharmacist or prescriber before making any change.

How serious is the Vinorelbine and Gefitinib 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 "established". Well documented — supported by controlled studies or strong clinical data.

Questions for your pharmacist

  • Does my dose of Vinorelbine or Gefitinib 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)

  1. Yoshimura M, Imamura F, Ueno K, et al: Severe myelotoxicity in a combination of gefitinib and vinorelbine. Lung Cancer 2004; 45(1):121-123. PubMed
  2. Product Information: IRESSA(R), gefitinib tablets. AstraZeneca Pharmaceuticals LP, Wilmington, DE, USA, 2004. DailyMed
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Beyond drug–drug

These medications also interact with supplements

Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:

Gefitinib + Activated Charcoal Beer Grapefruit Siberian Cocklebur St. John's Wort Wine Acacia Rigidula Adrafinil + 160 more
Vinorelbine + Activated Charcoal Grapefruit St. John's Wort Acacia Rigidula Adrafinil African Wild Potato American Elder Astaxanthin + 130 more

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.