Neratinib Maleate interactions
Checked as Neratinib in this data source.
Full monograph for Neratinib MaleateCheck it against another medicine
Medicines
167 documented
| Medicine | Severity | Mechanism | Effect | Sources |
|---|---|---|---|---|
| Apalutamide | Major | Metabolism | Coadministration with potent or moderate inducers of CYP450 3A4 may significantly decrease the plasma concentrations of neratinib, which is primarily… | 6 sources — open the full entry |
| Aprepitant | Major | Metabolism | Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of neratinib, which is primarily… | 7 sources — open the full entry |
| Beclomethasone Dipropionate + Chloramphenicol + Clotrimazole + Lidocaine | Major | Metabolism | Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of neratinib, which is primarily…2 documented mechanisms | 7 sources — open the full entry |
| Betamethasone + Clotrimazole | Major | Metabolism | Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of neratinib, which is primarily… | 7 sources — open the full entry |
| Betamethasone + Clotrimazole + Gentamicin | Major | Metabolism | Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of neratinib, which is primarily… | 7 sources — open the full entry |
| Bosentan Monohydrate | Major | Metabolism | Coadministration with potent or moderate inducers of CYP450 3A4 may significantly decrease the plasma concentrations of neratinib, which is primarily… | 6 sources — open the full entry |
| Calcium Dobesilate + Lidocaine + Dexamethasone | Major | Metabolism | Coadministration with potent or moderate inducers of CYP450 3A4 may significantly decrease the plasma concentrations of neratinib, which is primarily… | 6 sources — open the full entry |
| Carbamazepine | Major | Metabolism | Coadministration with potent or moderate inducers of CYP450 3A4 may significantly decrease the plasma concentrations of neratinib, which is primarily… | 6 sources — open the full entry |
| Cenobamate | Major | Metabolism | Coadministration with potent or moderate inducers of CYP450 3A4 may significantly decrease the plasma concentrations of neratinib, which is primarily… | 6 sources — open the full entry |
| Chloramphenicol (Oral) | Major | Metabolism | Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of neratinib, which is primarily… | 7 sources — open the full entry |
| Chloramphenicol + Lidocaine Hydrochloride | Major | Metabolism | Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of neratinib, which is primarily… | 7 sources — open the full entry |
| CiprofloxacinbaseOphthalmic | Major | Metabolism | Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of neratinib, which is primarily… | 7 sources — open the full entry |
| Ciprofloxacin + Dexamethasone | Major | Metabolism | Coadministration with potent or moderate inducers of CYP450 3A4 may significantly decrease the plasma concentrations of neratinib, which is primarily…2 documented mechanisms | 13 sources — open the full entry |
| Ciprofloxacin + Hydrocortisone Acetate | Major | Metabolism | Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of neratinib, which is primarily… | 7 sources — open the full entry |
| Clarithromycin | Major | Metabolism | Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of neratinib, which is primarily… | 7 sources — open the full entry |
| ClotrimazoleEar dropEye ointmentTopicalVaginal tablet | Major | Metabolism | Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of neratinib, which is primarily… | 7 sources — open the full entry |
| Clotrimazole + Hydrocortisone | Major | Metabolism | Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of neratinib, which is primarily… | 7 sources — open the full entry |
| Colchicine | Major | Excretion | Coadministration with inhibitors of P-glycoprotein (P-gp) may significantly increase the serum concentrations of colchicine. The mechanism involves enhanced… | 78 sources — open the full entry |
| Crizotinib | Major | Metabolism | Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of neratinib, which is primarily… | 7 sources — open the full entry |
| Cyclosporine (Oral) | Major | Metabolism | Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of neratinib, which is primarily… | 7 sources — open the full entry |
| Dexamethasone | Major | Metabolism | Coadministration with potent or moderate inducers of CYP450 3A4 may significantly decrease the plasma concentrations of neratinib, which is primarily… | 6 sources — open the full entry |
| Dexamethasone + Chloramphenicol | Major | Metabolism | Coadministration with potent or moderate inducers of CYP450 3A4 may significantly decrease the plasma concentrations of neratinib, which is primarily…2 documented mechanisms | 13 sources — open the full entry |
| Dexamethasone + Levofloxacin | Major | Metabolism | Coadministration with potent or moderate inducers of CYP450 3A4 may significantly decrease the plasma concentrations of neratinib, which is primarily… | 6 sources — open the full entry |
| Dexamethasone + Neomycin + Glacial Acetic Acid | Major | Metabolism | Coadministration with potent or moderate inducers of CYP450 3A4 may significantly decrease the plasma concentrations of neratinib, which is primarily… | 6 sources — open the full entry |
| Dexamethasone + Neomycin Sulphate + Polymyxin B Sulphate | Major | Metabolism | Coadministration with potent or moderate inducers of CYP450 3A4 may significantly decrease the plasma concentrations of neratinib, which is primarily… | 6 sources — open the full entry |
| Dexamethasone + Tobramycin | Major | Metabolism | Coadministration with potent or moderate inducers of CYP450 3A4 may significantly decrease the plasma concentrations of neratinib, which is primarily… | 6 sources — open the full entry |
| Dexlansoprazole | Major | Absorption | Coadministration with proton pump inhibitors or H2-receptor antagonists may significantly decrease the oral bioavailability of neratinib. The solubility of… | 5 sources — open the full entry |
| Diltiazem Hydrochloride | Major | Metabolism | Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of neratinib, which is primarily… | 7 sources — open the full entry |
| Efavirenz | Major | Metabolism | Coadministration with potent or moderate inducers of CYP450 3A4 may significantly decrease the plasma concentrations of neratinib, which is primarily… | 6 sources — open the full entry |
| Enzalutamide | Major | Metabolism | Coadministration with potent or moderate inducers of CYP450 3A4 may significantly decrease the plasma concentrations of neratinib, which is primarily… | 6 sources — open the full entry |
| ErythromycinLotionOral | Major | Metabolism | Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of neratinib, which is primarily… | 7 sources — open the full entry |
| EsomeprazolebaseMUPS preparation | Major | Absorption | Coadministration with proton pump inhibitors or H2-receptor antagonists may significantly decrease the oral bioavailability of neratinib. The solubility of… | 5 sources — open the full entry |
| Esomeprazole + Amoxicillin + Clarithromycin | Major | Absorption · Metabolism | Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of neratinib, which is primarily…2 documented mechanisms | 12 sources — open the full entry |
| Famotidine | Major | Absorption | Coadministration with proton pump inhibitors or H2-receptor antagonists may significantly decrease the oral bioavailability of neratinib. The solubility of… | 5 sources — open the full entry |
| FluconazolebaseOphthalmic | Major | Metabolism | Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of neratinib, which is primarily… | 7 sources — open the full entry |
| Fluvoxamine Maleate | Major | Metabolism | Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of neratinib, which is primarily… | 7 sources — open the full entry |
| Fosphenytoin Sodium | Major | Metabolism | Coadministration with potent or moderate inducers of CYP450 3A4 may significantly decrease the plasma concentrations of neratinib, which is primarily… | 6 sources — open the full entry |
| Gatifloxacin + Dexamethasone | Major | Metabolism | Coadministration with potent or moderate inducers of CYP450 3A4 may significantly decrease the plasma concentrations of neratinib, which is primarily… | 6 sources — open the full entry |
| Imatinib Mesylate | Major | Metabolism | Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of neratinib, which is primarily… | 7 sources — open the full entry |
| Itraconazole | Major | Metabolism | Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of neratinib, which is primarily… | 7 sources — open the full entry |
| Ketoconazole | Major | Metabolism | Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of neratinib, which is primarily… | 7 sources — open the full entry |
| Ketoconazole + Zinc Pyrithione + Aleovera | Major | Metabolism | Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of neratinib, which is primarily… | 7 sources — open the full entry |
| Lamivudine + Zidovudine + Nevirapine | Major | Metabolism | Coadministration with potent or moderate inducers of CYP450 3A4 may significantly decrease the plasma concentrations of neratinib, which is primarily… | 6 sources — open the full entry |
| Lansoprazole | Major | Absorption | Coadministration with proton pump inhibitors or H2-receptor antagonists may significantly decrease the oral bioavailability of neratinib. The solubility of… | 5 sources — open the full entry |
| Lansoprazole + Amoxicillin + Clarithromycin | Major | Absorption · Metabolism | Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of neratinib, which is primarily…2 documented mechanisms | 12 sources — open the full entry |
| Lopinavir + Ritonavir | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 such as ritonavir may significantly increase the plasma concentrations and risk of toxicity of of… | 9 sources — open the full entry |
| Lorlatinib | Major | Metabolism | Coadministration with potent or moderate inducers of CYP450 3A4 may significantly decrease the plasma concentrations of neratinib, which is primarily… | 6 sources — open the full entry |
| Mifepristone | Major | Metabolism | Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of neratinib, which is primarily… | 7 sources — open the full entry |
| Mifepristone + Misoprostol | Major | Metabolism | Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of neratinib, which is primarily… | 7 sources — open the full entry |
| Morphine Sulfate | Major | Absorption | Coadministration with P-glycoprotein (P-gp) inhibitors may increase the plasma concentrations of morphine and its risk of adverse effects, including… | 7 sources — open the full entry |
Food & lifestyle
grapefruit juice
MajorMetabolism
Grapefruit, grapefruit juice, grapefruit hybrids, pomelos, star-fruit, and Seville oranges may increase the plasma concentrations of neratinib. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in these fruits. Inhibition of hepatic CYP450 3A4 may also contribute.
What to do: The manufacturer recommends administering neratinib with food at approximately the same time every day. Patients should avoid consumption of grapefruit, grapefruit juice, grapefruit hybrids, pomelos, star-fruit, and Seville oranges during treatment with neratinib.
3 sources
- Cerner Multum, Inc. "Australian Product Information." O 0
- Abbas R, Hug BA, Leister C, Burns J, Sonnichsen D "Pharmacokinetics of oral neratinib during co-administration of ketoconazole in healthy subjects." Br J Clin Pharmacol 71 (2011): 522-7
- "Product Information. Nerlynx (neratinib)." Puma Biotechnology, Inc. (2017):
Conditions
Conditions in which Neratinib Maleate needs care, as documented in this source.
Liver Diseases
MajorNeratinib is mainly metabolized in the liver and its use has been associated with hepatotoxicity characterized by increased liver enzymes. Patients with severe, preexisting hepatic impairment (Child Pugh Class C) experienced a reduction in neratinib clearance and an increase in C max and AUC. It is recommended to reduce the starting dose of neratinib to 80 mg in patients with severe hepatic impairment (Child Pugh C). Measure total bilirubin, AST, ALT, and alkaline phosphatase prior to starting treatment and monthly for the first 3 months of treatment, then every 3 months while on treatment and as clinically indicated. No dose modifications are recommended for patients with mild to moderate hepatic impairment (Child Pugh A or B).
1 source
- "Product Information. Nerlynx (neratinib)." Puma Biotechnology, Inc. (2017):