Onivyde

Overview

irinotecan

DNA topoisomerase I inhibitor

• CYP3A4 substrate
• UGT1A1 substrate
• BCRP substrate
• OATP1B1 substrate
• fluid/electrolyte loss
• immunosuppressive oncologic agent
• myelosuppressive oncologic agent

Contraindicated

• adenovirus vaccine, live
Onivyde (irinotecan liposomal)

+

adenovirus vaccine, live

1 interaction

Contraindicated

irinotecan + adenovirus vaccine, live

contraindicated; vaccinate at least 4wk before or 3mo after irinotecan tx: combo may result in inadequate vaccine response, incr. risk of disseminated infection (immunosuppressive effects)

• atazanavir
Onivyde (irinotecan liposomal)

+

atazanavir

1 interaction

Contraindicated

irinotecan + atazanavir

contraindicated; D/C atazanavir >1wk prior to irinotecan start: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited, UGT inhibited)

• BCG live intravesical
Onivyde (irinotecan liposomal)

+

BCG live intravesical

1 interaction

Contraindicated

irinotecan + BCG live intravesical

contraindicated: combo may incr. risk of disseminated BCG infection; may decr. immune response (immunosuppressive effects)

• chikungunya vaccine, live
Onivyde (irinotecan liposomal)

+

chikungunya vaccine, live

1 interaction

Contraindicated

irinotecan + chikungunya vaccine, live

contraindicated; vaccinate at least 4wk before or 3mo after irinotecan tx: combo may result in inadequate vaccine response, incr. risk of disseminated infection (immunosuppressive effects)

• cholera vaccine, live
Onivyde (irinotecan liposomal)

+

cholera vaccine, live

1 interaction

Contraindicated

irinotecan + cholera vaccine, live

contraindicated; vaccinate at least 4wk before or 3mo after irinotecan tx: combo may result in inadequate vaccine response, incr. risk of disseminated infection (immunosuppressive effects)

• dengue vaccine, live
Onivyde (irinotecan liposomal)

+

dengue vaccine, live

1 interaction

Contraindicated

irinotecan + dengue vaccine, live

contraindicated; vaccinate at least 4wk before or 3mo after irinotecan tx: combo may result in inadequate vaccine response, incr. risk of disseminated infection (immunosuppressive effects)

• influenza nasal vaccine, live
Onivyde (irinotecan liposomal)

+

influenza nasal vaccine, live

1 interaction

Contraindicated

irinotecan + influenza nasal vaccine, live

contraindicated; vaccinate at least 4wk before or 3mo after irinotecan tx: combo may result in inadequate vaccine response, incr. risk of disseminated infection (immunosuppressive effects)

• itraconazole
Onivyde (irinotecan liposomal)

+

itraconazole

1 interaction

Contraindicated

irinotecan + itraconazole

contraindicated during and x2wk after itraconazole tx; D/C itraconazole >1wk prior to irinotecan start: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited)

• ketoconazole
Onivyde (irinotecan liposomal)

+

ketoconazole

1 interaction

Contraindicated

irinotecan + ketoconazole

contraindicated; D/C ketoconazole >1wk prior to irinotecan start: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited, UGT inhibited)

• measles/mumps/rubella vaccine, live
Onivyde (irinotecan liposomal)

+

measles/ mumps/ rubella vaccine, live

1 interaction

Contraindicated

irinotecan + measles/ mumps/ rubella vaccine, live

contraindicated; vaccinate at least 4wk before or 3mo after irinotecan tx: combo may result in inadequate vaccine response, incr. risk of disseminated infection (immunosuppressive effects)

• rotavirus vaccine, live
Onivyde (irinotecan liposomal)

+

rotavirus vaccine, live

1 interaction

Contraindicated

irinotecan + rotavirus vaccine, live

contraindicated; vaccinate at least 4wk before or 3mo after irinotecan tx: combo may result in inadequate vaccine response, incr. risk of disseminated infection (immunosuppressive effects)

• smallpox vaccine, live
Onivyde (irinotecan liposomal)

+

smallpox vaccine, live

1 interaction

Contraindicated

irinotecan + smallpox vaccine, live

contraindicated; vaccinate at least 4wk before or 3mo after irinotecan tx: combo may result in inadequate vaccine response, incr. risk of disseminated infection (immunosuppressive effects)

• talimogene laherparepvec
Onivyde (irinotecan liposomal)

+

talimogene laherparepvec

1 interaction

Contraindicated

irinotecan + talimogene laherparepvec

contraindicated: combo may incr. risk of disseminated herpetic infection; may decr. immune response (immunosuppressive effects)

• typhoid vaccine, live
Onivyde (irinotecan liposomal)

+

typhoid vaccine, live

1 interaction

Contraindicated

irinotecan + typhoid vaccine, live

contraindicated; vaccinate at least 4wk before or 3mo after irinotecan tx: combo may result in inadequate vaccine response, incr. risk of disseminated infection (immunosuppressive effects)

• varicella vaccine, live
Onivyde (irinotecan liposomal)

+

varicella vaccine, live

1 interaction

Contraindicated

irinotecan + varicella vaccine, live

contraindicated; vaccinate at least 4wk before or 3mo after irinotecan tx: combo may result in inadequate vaccine response, incr. risk of disseminated infection (immunosuppressive effects)

• yellow fever vaccine, live
Onivyde (irinotecan liposomal)

+

yellow fever vaccine, live

1 interaction

Contraindicated

irinotecan + yellow fever vaccine, live

contraindicated; vaccinate at least 4wk before or 3mo after irinotecan tx: combo may result in inadequate vaccine response, incr. risk of disseminated infection (immunosuppressive effects)

Avoid/Use Alternative

• adagrasib
Onivyde (irinotecan liposomal)

+

adagrasib

1 interaction

Avoid/Use Alternative

irinotecan + adagrasib

use alternative or D/C adagrasib >1wk prior to irinotecan start: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited)

• apalutamide
Onivyde (irinotecan liposomal)

+

apalutamide

1 interaction

Avoid/Use Alternative

irinotecan + apalutamide

use alternative or D/C apalutamide >2wk prior to irinotecan start: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• belumosudil
Onivyde (irinotecan liposomal)

+

belumosudil

1 interaction

Avoid/Use Alternative

irinotecan + belumosudil

use alternative: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (UGT inhibited, BCRP-mediated transport inhibited)

• bosentan
Onivyde (irinotecan liposomal)

+

bosentan

1 interaction

Avoid/Use Alternative

irinotecan + bosentan

use alternative or D/C bosentan >2wk prior to irinotecan start: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• butalbital
Onivyde (irinotecan liposomal)

+

butalbital

1 interaction

Avoid/Use Alternative

irinotecan + butalbital

use alternative or D/C butalbital >2wk prior to irinotecan start: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• capivasertib
Onivyde (irinotecan liposomal)

+

capivasertib

1 interaction

Avoid/Use Alternative

irinotecan + capivasertib

use alternative: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (UGT inhibited)

• carbamazepine
Onivyde (irinotecan liposomal)

+

carbamazepine

1 interaction

Avoid/Use Alternative

irinotecan + carbamazepine

use alternative or D/C carbamazepine >2wk prior to irinotecan start: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• cenobamate
Onivyde (irinotecan liposomal)

+

cenobamate

1 interaction

Avoid/Use Alternative

irinotecan + cenobamate

use alternative or D/C cenobamate >2wk prior to irinotecan start: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• ceritinib
Onivyde (irinotecan liposomal)

+

ceritinib

1 interaction

Avoid/Use Alternative

irinotecan + ceritinib

use alternative or D/C ceritinib >1wk prior to irinotecan start: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metab. inhibited)

• chloramphenicol
Onivyde (irinotecan liposomal)

+

chloramphenicol

1 interaction

Avoid/Use Alternative

irinotecan + chloramphenicol

use alternative or D/C chloramphenicol >1wk prior to irinotecan start: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited, additive effects)

• cladribine oral
Onivyde (irinotecan liposomal)

+

cladribine oral

1 interaction

Avoid/Use Alternative

irinotecan + cladribine oral

use alternative: combo may incr. risk of serious infection, myelosuppression (additive effects)

• clarithromycin
Onivyde (irinotecan liposomal)

+

clarithromycin

1 interaction

Avoid/Use Alternative

irinotecan + clarithromycin

use alternative or D/C clarithromycin >1wk prior to irinotecan start: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited)

• cobicistat
Onivyde (irinotecan liposomal)

+

cobicistat

1 interaction

Avoid/Use Alternative

irinotecan + cobicistat

use alternative or D/C cobicistat >1wk prior to irinotecan start: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited, BCRP-mediated transport inhibited)

• dabrafenib
Onivyde (irinotecan liposomal)

+

dabrafenib

1 interaction

Avoid/Use Alternative

irinotecan + dabrafenib

use alternative or D/C dabrafenib >2wk prior to irinotecan start: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• darunavir
Onivyde (irinotecan liposomal)

+

darunavir

1 interaction

Avoid/Use Alternative

irinotecan + darunavir

use alternative or D/C darunavir >1wk prior to irinotecan start: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited)

• deferiprone
Onivyde (irinotecan liposomal)

+

deferiprone

1 interaction

Avoid/Use Alternative

irinotecan + deferiprone

use alternative or monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• dexrazoxane
Onivyde (irinotecan liposomal)

+

dexrazoxane

1 interaction

Avoid/Use Alternative

irinotecan + dexrazoxane

monitor CBC if anthracycline extravasation or doxorubicin cardioprotective use, otherwise avoid combo: combo may incr. risk of myelosuppression; may decr. efficacy of cancer chemotx (additive effects; mechanism unknown)

• efavirenz
Onivyde (irinotecan liposomal)

+

efavirenz

1 interaction

Avoid/Use Alternative

irinotecan + efavirenz

use alternative or D/C efavirenz >2wk prior to irinotecan start: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• encorafenib
Onivyde (irinotecan liposomal)

+

encorafenib

1 interaction

Avoid/Use Alternative

irinotecan + encorafenib

use alternative or D/C encorafenib >2wk prior to irinotecan start: combo may incr. or decr. irinotecan and active metabolite levels, incr. risk of serious infection, myelosuppression, other toxicities or decr. efficacy (BCRP-mediated transport inhibited, hepatic metab. induced)

• enzalutamide
Onivyde (irinotecan liposomal)

+

enzalutamide

1 interaction

Avoid/Use Alternative

irinotecan + enzalutamide

use alternative or D/C enzalutamide >2wk prior to irinotecan start: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• etrasimod
Onivyde (irinotecan liposomal)

+

etrasimod

1 interaction

Avoid/Use Alternative

irinotecan + etrasimod

avoid combo during and x5wk after etrasimod tx: combo may incr. risk of serious infection; infection risk may be prolonged (additive effects)

• etravirine
Onivyde (irinotecan liposomal)

+

etravirine

1 interaction

Avoid/Use Alternative

irinotecan + etravirine

use alternative or D/C etravirine >2wk prior to irinotecan start: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• fexinidazole
Onivyde (irinotecan liposomal)

+

fexinidazole

1 interaction

Avoid/Use Alternative

irinotecan + fexinidazole

use alternative or D/C fexinidazole >2wk prior to irinotecan start: combo may decr. irinotecan and active metabolite levels, efficacy; may incr. risk of myelosuppression (hepatic metab. induced; additive effects)

• fosphenytoin
Onivyde (irinotecan liposomal)

+

fosphenytoin

1 interaction

Avoid/Use Alternative

irinotecan + fosphenytoin

use alternative or D/C fosphenytoin >2wk prior to irinotecan start: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• ganciclovir
Onivyde (irinotecan liposomal)

+

ganciclovir

1 interaction

Avoid/Use Alternative

irinotecan + ganciclovir

use alternative or monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• gemfibrozil
Onivyde (irinotecan liposomal)

+

gemfibrozil

1 interaction

Avoid/Use Alternative

irinotecan + gemfibrozil

use alternative: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (UGT inhibited)

• idelalisib
Onivyde (irinotecan liposomal)

+

idelalisib

1 interaction

Avoid/Use Alternative

irinotecan + idelalisib

use alternative or D/C idelalisib >1wk prior to irinotecan start: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited)

• ivosidenib
Onivyde (irinotecan liposomal)

+

ivosidenib

1 interaction

Avoid/Use Alternative

irinotecan + ivosidenib

use alternative or D/C ivosidenib >2wk prior to irinotecan start: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• lenvatinib
Onivyde (irinotecan liposomal)

+

lenvatinib

1 interaction

Avoid/Use Alternative

irinotecan + lenvatinib

use alternative: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (UGT possibly inhibited)

• levoketoconazole
Onivyde (irinotecan liposomal)

+

levoketoconazole

1 interaction

Avoid/Use Alternative

irinotecan + levoketoconazole

use alternative or D/C levoketoconazole >1wk prior to irinotecan start: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited)

• lonafarnib
Onivyde (irinotecan liposomal)

+

lonafarnib

1 interaction

Avoid/Use Alternative

irinotecan + lonafarnib

use alternative or D/C lonafarnib >1wk prior to irinotecan start: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited, additive effects)

• lopinavir/ritonavir
Onivyde (irinotecan liposomal)

+

lopinavir/ ritonavir

1 interaction

Avoid/Use Alternative

irinotecan + lopinavir/ ritonavir

use alternative or D/C lopinavir/ritonavir >1wk prior to irinotecan start: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited, UGT inhibited, hepatic transport inhibited, BCRP-mediated transport inhibited)

• lorlatinib
Onivyde (irinotecan liposomal)

+

lorlatinib

1 interaction

Avoid/Use Alternative

irinotecan + lorlatinib

use alternative or D/C lorlatinib >2wk prior to irinotecan start: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• lumacaftor/ivacaftor
Onivyde (irinotecan liposomal)

+

lumacaftor/ ivacaftor

1 interaction

Avoid/Use Alternative

irinotecan + lumacaftor/ ivacaftor

use alternative or D/C lumacaftor >2wk prior to irinotecan start: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• magnesium citrate
Onivyde (irinotecan liposomal)

+

magnesium citrate

1 interaction

Avoid/Use Alternative

irinotecan + magnesium citrate

avoid combo if late-onset diarrhea; otherwise, monitor electrolytes, volume status, especially if magnesium citrate bowel prep use: combo may incr. risk of electrolyte abnormalities, dehydration, seizures, cardiac arrhythmias, renal impairment, other adverse effects (additive effects)

• mavacamten
Onivyde (irinotecan liposomal)

+

mavacamten

1 interaction

Avoid/Use Alternative

irinotecan + mavacamten

use alternative or D/C mavacamten >2wk prior to irinotecan start: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• mifepristone
Onivyde (irinotecan liposomal)

+

mifepristone

1 interaction

Avoid/Use Alternative

irinotecan + mifepristone

use alternative or D/C mifepristone >14 days prior to irinotecan start: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited)

• mitapivat
Onivyde (irinotecan liposomal)

+

mitapivat

1 interaction

Avoid/Use Alternative

irinotecan + mitapivat

use alternative or D/C mitapivat >2wk prior to irinotecan start: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• mitotane
Onivyde (irinotecan liposomal)

+

mitotane

1 interaction

Avoid/Use Alternative

irinotecan + mitotane

use alternative or D/C mitotane >2wk prior to irinotecan start: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• modafinil
Onivyde (irinotecan liposomal)

+

modafinil

1 interaction

Avoid/Use Alternative

irinotecan + modafinil

use alternative or D/C modafinil >2wk prior to irinotecan start: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• nafcillin
Onivyde (irinotecan liposomal)

+

nafcillin

1 interaction

Avoid/Use Alternative

irinotecan + nafcillin

use alternative or D/C nafcillin >2wk prior to irinotecan start: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• nefazodone
Onivyde (irinotecan liposomal)

+

nefazodone

1 interaction

Avoid/Use Alternative

irinotecan + nefazodone

use alternative or D/C nefazodone >1wk prior to irinotecan start: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited)

• nelfinavir
Onivyde (irinotecan liposomal)

+

nelfinavir

1 interaction

Avoid/Use Alternative

irinotecan + nelfinavir

use alternative or D/C nelfinavir >1wk prior to irinotecan start: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited)

• pacritinib
Onivyde (irinotecan liposomal)

+

pacritinib

1 interaction

Avoid/Use Alternative

irinotecan + pacritinib

use alternative or D/C pacritinib >2wk prior to irinotecan start: combo may incr. or decr. irinotecan and active metabolite levels, incr. risk of serious infection, myelosuppression, other toxicities or decr. efficacy (BCRP-mediated transport inhibited, hepatic metab. induced)

• palifermin
Onivyde (irinotecan liposomal)

+

palifermin

1 interaction

Avoid/Use Alternative

irinotecan + palifermin

avoid palifermin admin. w/in 24h before, during tx, or w/in 24h after myelotoxic chemo; otherwise, caution advised: combo may incr. severity and duration of oral mucositis (antagonistic effects)

• panitumumab
Onivyde (irinotecan liposomal)

+

panitumumab

1 interaction

Avoid/Use Alternative

irinotecan + panitumumab

avoid combo of panitumumab w/ IFL (irinotecan, bolus fluorouracil, leucovorin): combo may incr. risk and severity of chemo-related diarrhea (additive toxicity)

• penicillamine
Onivyde (irinotecan liposomal)

+

penicillamine

1 interaction

Avoid/Use Alternative

irinotecan + penicillamine

use alternative or monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• pentobarbital
Onivyde (irinotecan liposomal)

+

pentobarbital

1 interaction

Avoid/Use Alternative

irinotecan + pentobarbital

use alternative or D/C pentobarbital >2wk prior to irinotecan start: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• pexidartinib
Onivyde (irinotecan liposomal)

+

pexidartinib

1 interaction

Avoid/Use Alternative

irinotecan + pexidartinib

use alternative or D/C pexidartinib >2wk prior to irinotecan start: combo may decr. irinotecan and active metabolite levels, efficacy; may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. induced; UGT possibly inhibited)

• phenobarbital
Onivyde (irinotecan liposomal)

+

phenobarbital

1 interaction

Avoid/Use Alternative

irinotecan + phenobarbital

use alternative or D/C phenobarbital >2wk prior to irinotecan start: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• phenytoin
Onivyde (irinotecan liposomal)

+

phenytoin

1 interaction

Avoid/Use Alternative

irinotecan + phenytoin

use alternative or D/C phenytoin >2wk prior to irinotecan start: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• pimecrolimus topical
Onivyde (irinotecan liposomal)

+

pimecrolimus topical

1 interaction

Avoid/Use Alternative

irinotecan + pimecrolimus topical

avoid combo: combo may incr. risk of serious infection (additive effects)

• polyethylene glycol
Onivyde (irinotecan liposomal)

+

polyethylene glycol

1 interaction

Avoid/Use Alternative

irinotecan + polyethylene glycol

avoid combo if late-onset diarrhea; otherwise, monitor electrolytes, volume status, especially if polyethylene glycol bowel prep use: combo may incr. risk of electrolyte abnormalities, seizures, cardiac arrhythmias, renal impairment, dehydration, other adverse effects (additive effects)

• polyethylene glycol/electrolytes
Onivyde (irinotecan liposomal)

+

polyethylene glycol/ electrolytes

1 interaction

Avoid/Use Alternative

irinotecan + polyethylene glycol/ electrolytes

avoid combo if late-onset diarrhea; otherwise, monitor electrolytes, volume status: combo may incr. risk of electrolyte abnormalities, seizures, cardiac arrhythmias, renal impairment, dehydration, other adverse effects (additive effects)

• posaconazole
Onivyde (irinotecan liposomal)

+

posaconazole

1 interaction

Avoid/Use Alternative

irinotecan + posaconazole

use alternative or D/C posaconazole >1wk prior to irinotecan start: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited)

• primaquine
Onivyde (irinotecan liposomal)

+

primaquine

1 interaction

Avoid/Use Alternative

irinotecan + primaquine

use alternative or monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• primidone
Onivyde (irinotecan liposomal)

+

primidone

1 interaction

Avoid/Use Alternative

irinotecan + primidone

use alternative or D/C primidone >2wk prior to irinotecan start: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• probenecid
Onivyde (irinotecan liposomal)

+

probenecid

1 interaction

Avoid/Use Alternative

irinotecan + probenecid

use alternative: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (UGT inhibited)

• rabies vaccine
Onivyde (irinotecan liposomal)

+

rabies vaccine

1 interaction

Avoid/Use Alternative

irinotecan + rabies vaccine

if possible, avoid immunosuppressive tx or vaccinate at least 2wk before starting irinotecan tx; otherwise, consider post-immunization titer check or revaccination after immunocompetence restored: combo may result in inadequate vaccine response (immunosuppressive effects)

• radium Ra 223 dichloride
Onivyde (irinotecan liposomal)

+

radium Ra 223 dichloride

1 interaction

Avoid/Use Alternative

irinotecan + radium Ra 223 dichloride

use alternative or monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• regorafenib
Onivyde (irinotecan liposomal)

+

regorafenib

1 interaction

Avoid/Use Alternative

irinotecan + regorafenib

use alternative or monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (UGT inhibited, BCRP-mediated transport inhibited)

• repotrectinib
Onivyde (irinotecan liposomal)

+

repotrectinib

1 interaction

Avoid/Use Alternative

irinotecan + repotrectinib

use alternative or D/C repotrectinib >2wk prior to irinotecan start: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• ribociclib
Onivyde (irinotecan liposomal)

+

ribociclib

1 interaction

Avoid/Use Alternative

irinotecan + ribociclib

use alternative or D/C ribociclib >1wk prior to irinotecan start: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited)

• rifabutin
Onivyde (irinotecan liposomal)

+

rifabutin

1 interaction

Avoid/Use Alternative

irinotecan + rifabutin

use alternative or D/C rifabutin >2wk prior to irinotecan start: combo may decr. irinotecan and active metabolite levels, efficacy; may incr. risk of myelosuppression (hepatic metab. induced; additive effects)

• rifampin
Onivyde (irinotecan liposomal)

+

rifampin

1 interaction

Avoid/Use Alternative

irinotecan + rifampin

use alternative or D/C rifampin >2wk prior to irinotecan start: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• rifapentine
Onivyde (irinotecan liposomal)

+

rifapentine

1 interaction

Avoid/Use Alternative

irinotecan + rifapentine

use alternative or D/C rifapentine >2wk prior to irinotecan start: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• ritonavir
Onivyde (irinotecan liposomal)

+

ritonavir

1 interaction

Avoid/Use Alternative

irinotecan + ritonavir

use alternative or D/C ritonavir >1wk prior to irinotecan start: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited, BCRP-mediated transport inhibited)

• ropeginterferon alfa-2b
Onivyde (irinotecan liposomal)

+

ropeginterferon alfa-2b

1 interaction

Avoid/Use Alternative

irinotecan + ropeginterferon alfa-2b

use alternative or monitor CBC: combo may incr. risk of serious infection, myelosuppression (additive effects)

• sodium phosphate rectal
Onivyde (irinotecan liposomal)

+

sodium phosphate rectal

1 interaction

Avoid/Use Alternative

irinotecan + sodium phosphate rectal

avoid combo if late-onset diarrhea; otherwise, monitor electrolytes, volume status: combo may incr. risk of electrolyte abnormalities, dehydration, other adverse effects (additive effects)

• sodium picosulfate
Onivyde (irinotecan liposomal)

+

sodium picosulfate

1 interaction

Avoid/Use Alternative

irinotecan + sodium picosulfate

avoid combo if late-onset diarrhea; otherwise, monitor electrolytes, volume status: combo may incr. risk of electrolyte abnormalities, dehydration, seizures, cardiac arrhythmias, renal impairment, other adverse effects (additive effects)

• sotorasib
Onivyde (irinotecan liposomal)

+

sotorasib

1 interaction

Avoid/Use Alternative

irinotecan + sotorasib

use alternative or D/C sotorasib >2wk prior to irinotecan start: combo may incr. or decr. irinotecan and active metabolite levels, incr. risk of serious infection, myelosuppression, other toxicities or decr. efficacy (hepatic metab. induced, BCRP-mediated transport inhibited)

• St. John's wort
Onivyde (irinotecan liposomal)

+

St. John's wort

1 interaction

Avoid/Use Alternative

irinotecan + St. John's wort

use alternative or D/C St. John's wort >2wk prior to irinotecan start: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• sulfate bowel prep
Onivyde (irinotecan liposomal)

+

sulfate bowel prep

1 interaction

Avoid/Use Alternative

irinotecan + sulfate bowel prep

avoid combo if late-onset diarrhea; otherwise, monitor electrolytes, volume status: combo may incr. risk of electrolyte abnormalities, seizures, cardiac arrhythmias, renal impairment, dehydration, other adverse effects (additive effects)

• tipranavir
Onivyde (irinotecan liposomal)

+

tipranavir

1 interaction

Avoid/Use Alternative

irinotecan + tipranavir

use alternative or D/C tipranavir >1wk prior to irinotecan start: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited)

• tucatinib
Onivyde (irinotecan liposomal)

+

tucatinib

1 interaction

Avoid/Use Alternative

irinotecan + tucatinib

use alternative or D/C tucatinib >1wk prior to irinotecan start: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metab. inhibited)

• valganciclovir
Onivyde (irinotecan liposomal)

+

valganciclovir

1 interaction

Avoid/Use Alternative

irinotecan + valganciclovir

use alternative or monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• voriconazole
Onivyde (irinotecan liposomal)

+

voriconazole

1 interaction

Avoid/Use Alternative

irinotecan + voriconazole

use alternative or D/C voriconazole >1wk prior to irinotecan start: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited)

Monitor/Modify Tx

• albendazole
Onivyde (irinotecan liposomal)

+

albendazole

1 interaction

Monitor/Modify Tx

irinotecan + albendazole

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• alemtuzumab
Onivyde (irinotecan liposomal)

+

alemtuzumab

1 interaction

Monitor/Modify Tx

irinotecan + alemtuzumab

monitor CBC; myelosuppression risk may be lower w/ alemtuzumab doses used for MS: combo may incr. risk of serious infection, myelosuppression (additive effects)

• allopurinol
Onivyde (irinotecan liposomal)

+

allopurinol

1 interaction

Monitor/Modify Tx

irinotecan + allopurinol

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• anthrax vaccine
Onivyde (irinotecan liposomal)

+

anthrax vaccine

1 interaction

Monitor/Modify Tx

irinotecan + anthrax vaccine

if possible, vaccinate at least 2wk before starting irinotecan tx; otherwise, consider post-immunization titer check or revaccination after immunocompetence restored: combo may result in inadequate vaccine response (immunosuppressive effects)

• anti-thymocyte globulin
Onivyde (irinotecan liposomal)

+

anti-thymocyte globulin

1 interaction

Monitor/Modify Tx

irinotecan + anti-thymocyte globulin

monitor CBC: combo may incr. risk of serious infection, myelosuppression (additive effects)

• aprepitant
Onivyde (irinotecan liposomal)

+

aprepitant

1 interaction

Monitor/Modify Tx

irinotecan + aprepitant

if aprepitant 3-day regimen, monitor CBC; aprepitant single dose-regimen OK: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited)

• asciminib
Onivyde (irinotecan liposomal)

+

asciminib

1 interaction

Monitor/Modify Tx

irinotecan + asciminib

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (BCRP-mediated transport possibly inhibited)

• asenapine
Onivyde (irinotecan liposomal)

+

asenapine

1 interaction

Monitor/Modify Tx

irinotecan + asenapine

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• atidarsagene autotemcel
Onivyde (irinotecan liposomal)

+

atidarsagene autotemcel

1 interaction

Monitor/Modify Tx

irinotecan + atidarsagene autotemcel

monitor CBC, bleeding s/sx: combo may incr. risk of serious infection, myelosuppression (additive effects)

• auranofin
Onivyde (irinotecan liposomal)

+

auranofin

1 interaction

Monitor/Modify Tx

irinotecan + auranofin

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• avacopan
Onivyde (irinotecan liposomal)

+

avacopan

1 interaction

Monitor/Modify Tx

irinotecan + avacopan

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited, additive effects)

• azathioprine
Onivyde (irinotecan liposomal)

+

azathioprine

1 interaction

Monitor/Modify Tx

irinotecan + azathioprine

monitor CBC: combo may incr. risk of serious infection, myelosuppression (additive effects)

• balsalazide
Onivyde (irinotecan liposomal)

+

balsalazide

1 interaction

Monitor/Modify Tx

irinotecan + balsalazide

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• baricitinib
Onivyde (irinotecan liposomal)

+

baricitinib

1 interaction

Monitor/Modify Tx

irinotecan + baricitinib

monitor CBC: combo may incr. risk of serious infection, myelosuppression (additive effects)

• benznidazole
Onivyde (irinotecan liposomal)

+

benznidazole

1 interaction

Monitor/Modify Tx

irinotecan + benznidazole

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• berotralstat
Onivyde (irinotecan liposomal)

+

berotralstat

1 interaction

Monitor/Modify Tx

irinotecan + berotralstat

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited)

• betibeglogene autotemcel
Onivyde (irinotecan liposomal)

+

betibeglogene autotemcel

1 interaction

Monitor/Modify Tx

irinotecan + betibeglogene autotemcel

monitor CBC, bleeding s/sx: combo may incr. risk of myelosuppression (additive effects)

• brigatinib
Onivyde (irinotecan liposomal)

+

brigatinib

1 interaction

Monitor/Modify Tx

irinotecan + brigatinib

monitor CBC: combo may incr. or decr. irinotecan and active metabolite levels, incr. risk of serious infection, myelosuppression, other toxicities or decr. efficacy (BCRP-mediated transport possibly inhibited, hepatic metab. induced)

• capmatinib
Onivyde (irinotecan liposomal)

+

capmatinib

1 interaction

Monitor/Modify Tx

irinotecan + capmatinib

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (BCRP-mediated transport inhibited)

• chikungunya vaccine
Onivyde (irinotecan liposomal)

+

chikungunya vaccine

1 interaction

Monitor/Modify Tx

irinotecan + chikungunya vaccine

if possible, vaccinate at least 2wk before starting irinotecan tx; otherwise, consider post-immunization titer check or revaccination after immunocompetence restored: combo may result in inadequate vaccine response (immunosuppressive effects)

• cidofovir
Onivyde (irinotecan liposomal)

+

cidofovir

1 interaction

Monitor/Modify Tx

irinotecan + cidofovir

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• ciprofloxacin
Onivyde (irinotecan liposomal)

+

ciprofloxacin

1 interaction

Monitor/Modify Tx

irinotecan + ciprofloxacin

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited)

• clofazimine
Onivyde (irinotecan liposomal)

+

clofazimine

1 interaction

Monitor/Modify Tx

irinotecan + clofazimine

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited)

• clozapine
Onivyde (irinotecan liposomal)

+

clozapine

1 interaction

Monitor/Modify Tx

irinotecan + clozapine

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• colchicine
Onivyde (irinotecan liposomal)

+

colchicine

1 interaction

Monitor/Modify Tx

irinotecan + colchicine

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• conivaptan
Onivyde (irinotecan liposomal)

+

conivaptan

1 interaction

Monitor/Modify Tx

irinotecan + conivaptan

monitor CBC during and x7 days after conivaptan tx: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metab. inhibited)

• COVID-19 vaccine
Onivyde (irinotecan liposomal)

+

COVID-19 vaccine

1 interaction

Monitor/Modify Tx

irinotecan + COVID-19 vaccine

if possible, vaccinate at least 2wk before starting irinotecan tx; otherwise, consider post-immunization titer check or revaccination after immunocompetence restored: combo may result in inadequate vaccine response (immunosuppressive effects)

• crizotinib
Onivyde (irinotecan liposomal)

+

crizotinib

1 interaction

Monitor/Modify Tx

irinotecan + crizotinib

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited)

• cyclophosphamide
Onivyde (irinotecan liposomal)

+

cyclophosphamide

1 interaction

Monitor/Modify Tx

irinotecan + cyclophosphamide

monitor CBC: combo may incr. risk of serious infection, myelosuppression (additive effects)

• cyclosporine
Onivyde (irinotecan liposomal)

+

cyclosporine

1 interaction

Monitor/Modify Tx

irinotecan + cyclosporine

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited, hepatic transport inhibited, BCRP-mediated transport inhibited, additive effects)

• danazol
Onivyde (irinotecan liposomal)

+

danazol

1 interaction

Monitor/Modify Tx

irinotecan + danazol

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited)

• danicopan
Onivyde (irinotecan liposomal)

+

danicopan

1 interaction

Monitor/Modify Tx

irinotecan + danicopan

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (BCRP-mediated transport inhibited, additive effects)

• dapsone
Onivyde (irinotecan liposomal)

+

dapsone

1 interaction

Monitor/Modify Tx

irinotecan + dapsone

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• darolutamide
Onivyde (irinotecan liposomal)

+

darolutamide

1 interaction

Monitor/Modify Tx

irinotecan + darolutamide

monitor CBC: combo may incr. or decr. irinotecan and active metabolite levels, incr. risk of serious infection, myelosuppression, other adverse effects or decr. efficacy (BCRP-mediated transport inhibited, hepatic transport inhibited, hepatic metab. induced)

• deferasirox
Onivyde (irinotecan liposomal)

+

deferasirox

1 interaction

Monitor/Modify Tx

irinotecan + deferasirox

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• deuruxolitinib
Onivyde (irinotecan liposomal)

+

deuruxolitinib

1 interaction

Monitor/Modify Tx

irinotecan + deuruxolitinib

monitor CBC: combo may incr. risk of myelosuppression, serious infection (additive effects)

• diltiazem
Onivyde (irinotecan liposomal)

+

diltiazem

1 interaction

Monitor/Modify Tx

irinotecan + diltiazem

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited)

• diphtheria/tetanus vaccine
Onivyde (irinotecan liposomal)

+

diphtheria/ tetanus vaccine

1 interaction

Monitor/Modify Tx

irinotecan + diphtheria/ tetanus vaccine

if possible, vaccinate at least 2wk before starting irinotecan tx; otherwise, consider post-immunization titer check or revaccination after immunocompetence restored: combo may result in inadequate vaccine response (immunosuppressive effects)

• diphtheria/tetanus/pertussis vaccine
Onivyde (irinotecan liposomal)

+

diphtheria/ tetanus/ pertussis vaccine

1 interaction

Monitor/Modify Tx

irinotecan + diphtheria/ tetanus/ pertussis vaccine

if possible, vaccinate at least 2wk before starting irinotecan tx; otherwise, consider post-immunization titer check or revaccination after immunocompetence restored: combo may result in inadequate vaccine response (immunosuppressive effects)

• dronedarone
Onivyde (irinotecan liposomal)

+

dronedarone

1 interaction

Monitor/Modify Tx

irinotecan + dronedarone

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited)

• duvelisib
Onivyde (irinotecan liposomal)

+

duvelisib

1 interaction

Monitor/Modify Tx

irinotecan + duvelisib

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited)

• ebola vaccine, live
Onivyde (irinotecan liposomal)

+

ebola vaccine, live

1 interaction

Monitor/Modify Tx

irinotecan + ebola vaccine, live

consider vaccinating at least 4wk before or 3mo after irinotecan tx: combo may result in inadequate vaccine response; may incr. risk of mild vesicular stomatitis virus infection (immunosuppressive effects, recombinant vaccine w/ vesicular stomatitis virus vector)

• efbemalenograstim alfa
Onivyde (irinotecan liposomal)

+

efbemalenograstim alfa

1 interaction

Monitor/Modify Tx

irinotecan + efbemalenograstim alfa

admin. efbemalenograstim at least 24h after or at least 14 days before myelosuppressive chemo: combo may decr. efbemalenograstim efficacy (antagonistic effects)

• eflapegrastim (G-CSF)
Onivyde (irinotecan liposomal)

+

eflapegrastim (G-CSF)

1 interaction

Monitor/Modify Tx

irinotecan + eflapegrastim (G-CSF)

admin. eflapegrastim >24h after or >14 days before myelosuppressive chemo: combo may decr. eflapegrastim efficacy (antagonistic effects)

• elacestrant
Onivyde (irinotecan liposomal)

+

elacestrant

1 interaction

Monitor/Modify Tx

irinotecan + elacestrant

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (BCRP-mediated transport inhibited)

• elivaldogene autotemcel
Onivyde (irinotecan liposomal)

+

elivaldogene autotemcel

1 interaction

Monitor/Modify Tx

irinotecan + elivaldogene autotemcel

monitor CBC, bleeding s/sx: combo may incr. risk of myelosuppression, serious infection (additive effects)

• eltrombopag
Onivyde (irinotecan liposomal)

+

eltrombopag

1 interaction

Monitor/Modify Tx

irinotecan + eltrombopag

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (BCRP-mediated transport inhibited)

• enasidenib
Onivyde (irinotecan liposomal)

+

enasidenib

1 interaction

Monitor/Modify Tx

irinotecan + enasidenib

monitor CBC: combo may incr. or decr. irinotecan and active metabolite levels, incr. risk of serious infection, myelosuppression, other toxicities or decr. efficacy (BCRP-mediated transport inhibited, hepatic metab. induced)

• erythromycin
Onivyde (irinotecan liposomal)

+

erythromycin

1 interaction

Monitor/Modify Tx

irinotecan + erythromycin

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited)

• everolimus
Onivyde (irinotecan liposomal)

+

everolimus

1 interaction

Monitor/Modify Tx

irinotecan + everolimus

monitor CBC; admin. PCP prophylaxis: combo may incr. risk of serious infection, myelosuppression (additive effects)

• exagamglogene autotemcel
Onivyde (irinotecan liposomal)

+

exagamglogene autotemcel

1 interaction

Monitor/Modify Tx

irinotecan + exagamglogene autotemcel

monitor CBC, bleeding s/sx: combo may incr. risk of myelosuppression, bleeding (additive effects)

• febuxostat
Onivyde (irinotecan liposomal)

+

febuxostat

1 interaction

Monitor/Modify Tx

irinotecan + febuxostat

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (BCRP-mediated transport inhibited)

• fedratinib
Onivyde (irinotecan liposomal)

+

fedratinib

1 interaction

Monitor/Modify Tx

irinotecan + fedratinib

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited)

• filgrastim (G-CSF)
Onivyde (irinotecan liposomal)

+

filgrastim (G-CSF)

1 interaction

Monitor/Modify Tx

irinotecan + filgrastim (G-CSF)

admin. filgrastim at least 24h before or after myelosuppressive chemo: combo may decr. filgrastim efficacy; may incr. risk of pulmonary toxicity (antagonistic effects; mechanism unknown)

• fluconazole
Onivyde (irinotecan liposomal)

+

fluconazole

1 interaction

Monitor/Modify Tx

irinotecan + fluconazole

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited)

• flucytosine
Onivyde (irinotecan liposomal)

+

flucytosine

1 interaction

Monitor/Modify Tx

irinotecan + flucytosine

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• fluphenazine
Onivyde (irinotecan liposomal)

+

fluphenazine

1 interaction

Monitor/Modify Tx

irinotecan + fluphenazine

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• fosamprenavir
Onivyde (irinotecan liposomal)

+

fosamprenavir

1 interaction

Monitor/Modify Tx

irinotecan + fosamprenavir

monitor CBC: combo may incr. or decr. irinotecan and active metabolite levels, incr. risk of serious infection, myelosuppression, other toxicities or decr. efficacy (hepatic metab. altered)

• foscarnet
Onivyde (irinotecan liposomal)

+

foscarnet

1 interaction

Monitor/Modify Tx

irinotecan + foscarnet

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• fostamatinib
Onivyde (irinotecan liposomal)

+

fostamatinib

1 interaction

Monitor/Modify Tx

irinotecan + fostamatinib

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (BCRP-mediated transport inhibited, additive effects)

• futibatinib
Onivyde (irinotecan liposomal)

+

futibatinib

1 interaction

Monitor/Modify Tx

irinotecan + futibatinib

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (BCRP-mediated transport possibly inhibited)

• gilteritinib
Onivyde (irinotecan liposomal)

+

gilteritinib

1 interaction

Monitor/Modify Tx

irinotecan + gilteritinib

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (BCRP-mediated transport possibly inhibited)

• givinostat
Onivyde (irinotecan liposomal)

+

givinostat

1 interaction

Monitor/Modify Tx

irinotecan + givinostat

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• glecaprevir
Onivyde (irinotecan liposomal)

+

glecaprevir

1 interaction

Monitor/Modify Tx

irinotecan + glecaprevir

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (BCRP-mediated transport inhibited)

• Haemophilus b vaccine
Onivyde (irinotecan liposomal)

+

Haemophilus b vaccine

1 interaction

Monitor/Modify Tx

irinotecan + Haemophilus b vaccine

if possible, vaccinate at least 2wk before starting irinotecan tx; otherwise, consider post-immunization titer check or revaccination after immunocompetence restored: combo may result in inadequate vaccine response (immunosuppressive effects)

• hepatitis A vaccine
Onivyde (irinotecan liposomal)

+

hepatitis A vaccine

1 interaction

Monitor/Modify Tx

irinotecan + hepatitis A vaccine

if possible, vaccinate at least 2wk before starting irinotecan tx; otherwise, consider post-immunization titer check or revaccination after immunocompetence restored: combo may result in inadequate vaccine response (immunosuppressive effects)

• hepatitis B vaccine
Onivyde (irinotecan liposomal)

+

hepatitis B vaccine

1 interaction

Monitor/Modify Tx

irinotecan + hepatitis B vaccine

if possible, vaccinate at least 2wk before starting irinotecan tx; otherwise, consider post-immunization titer check or revaccination after immunocompetence restored: combo may result in inadequate vaccine response (immunosuppressive effects)

• human papillomavirus vaccine
Onivyde (irinotecan liposomal)

+

human papillomavirus vaccine

1 interaction

Monitor/Modify Tx

irinotecan + human papillomavirus vaccine

if possible, vaccinate at least 2wk before starting irinotecan tx; otherwise, consider post-immunization titer check or revaccination after immunocompetence restored: combo may result in inadequate vaccine response (immunosuppressive effects)

• hydroxychloroquine
Onivyde (irinotecan liposomal)

+

hydroxychloroquine

1 interaction

Monitor/Modify Tx

irinotecan + hydroxychloroquine

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• hydroxyurea
Onivyde (irinotecan liposomal)

+

hydroxyurea

1 interaction

Monitor/Modify Tx

irinotecan + hydroxyurea

monitor CBC: combo may incr. risk of myelosuppression, serious infection (additive effects)

• ibrutinib
Onivyde (irinotecan liposomal)

+

ibrutinib

1 interaction

Monitor/Modify Tx

irinotecan + ibrutinib

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (BCRP-mediated transport possibly inhibited)

• iloperidone
Onivyde (irinotecan liposomal)

+

iloperidone

1 interaction

Monitor/Modify Tx

irinotecan + iloperidone

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• imatinib
Onivyde (irinotecan liposomal)

+

imatinib

1 interaction

Monitor/Modify Tx

irinotecan + imatinib

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited, BCRP-mediated transport inhibited)

• influenza H5N1 vaccine
Onivyde (irinotecan liposomal)

+

influenza H5N1 vaccine

1 interaction

Monitor/Modify Tx

irinotecan + influenza H5N1 vaccine

if possible, vaccinate at least 2wk before starting irinotecan tx; otherwise, consider post-immunization titer check or revaccination after immunocompetence restored: combo may result in inadequate vaccine response (immunosuppressive effects)

• influenza vaccine
Onivyde (irinotecan liposomal)

+

influenza vaccine

1 interaction

Monitor/Modify Tx

irinotecan + influenza vaccine

if possible, vaccinate at least 2wk before starting irinotecan tx; otherwise, consider vaccination after immunocompetence restored: combo may result in inadequate vaccine response (immunosuppressive effects)

• interferon beta 1a
Onivyde (irinotecan liposomal)

+

interferon beta 1a

1 interaction

Monitor/Modify Tx

irinotecan + interferon beta 1a

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• interferon beta 1b
Onivyde (irinotecan liposomal)

+

interferon beta 1b

1 interaction

Monitor/Modify Tx

irinotecan + interferon beta 1b

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• interferon gamma 1b
Onivyde (irinotecan liposomal)

+

interferon gamma 1b

1 interaction

Monitor/Modify Tx

irinotecan + interferon gamma 1b

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• isavuconazonium
Onivyde (irinotecan liposomal)

+

isavuconazonium

1 interaction

Monitor/Modify Tx

irinotecan + isavuconazonium

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited)

• Japanese encephalitis vaccine
Onivyde (irinotecan liposomal)

+

Japanese encephalitis vaccine

1 interaction

Monitor/Modify Tx

irinotecan + Japanese encephalitis vaccine

if possible, vaccinate at least 2wk before starting irinotecan tx; otherwise, consider post-immunization titer check or revaccination after immunocompetence restored: combo may result in inadequate vaccine response (immunosuppressive effects)

• lazertinib
Onivyde (irinotecan liposomal)

+

lazertinib

1 interaction

Monitor/Modify Tx

irinotecan + lazertinib

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (BCRP-mediated transport inhibited)

• lefamulin
Onivyde (irinotecan liposomal)

+

lefamulin

1 interaction

Monitor/Modify Tx

irinotecan + lefamulin

ORAL LEFAMULIN: monitor CBC; IV lefamulin use OK: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited)

• leflunomide
Onivyde (irinotecan liposomal)

+

leflunomide

1 interaction

Monitor/Modify Tx

irinotecan + leflunomide

monitor CBC: combo may incr. risk of serious infection, myelosuppression (additive effects)

• lenacapavir
Onivyde (irinotecan liposomal)

+

lenacapavir

1 interaction

Monitor/Modify Tx

irinotecan + lenacapavir

monitor CBC during and x9mo after lenacapavir tx: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited, BCRP-mediated transport inhibited)

• leniolisib
Onivyde (irinotecan liposomal)

+

leniolisib

1 interaction

Monitor/Modify Tx

irinotecan + leniolisib

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (BCRP-mediated transport possibly inhibited)

• letermovir
Onivyde (irinotecan liposomal)

+

letermovir

1 interaction

Monitor/Modify Tx

irinotecan + letermovir

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited)

• linezolid
Onivyde (irinotecan liposomal)

+

linezolid

1 interaction

Monitor/Modify Tx

irinotecan + linezolid

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• lovotibeglogene autotemcel
Onivyde (irinotecan liposomal)

+

lovotibeglogene autotemcel

1 interaction

Monitor/Modify Tx

irinotecan + lovotibeglogene autotemcel

monitor CBC, bleeding s/sx: combo may incr. risk of myelosuppression, bleeding (additive effects)

• lumateperone
Onivyde (irinotecan liposomal)

+

lumateperone

1 interaction

Monitor/Modify Tx

irinotecan + lumateperone

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• lymphocyte immune globulin, anti-thymocyte globulin
Onivyde (irinotecan liposomal)

+

lymphocyte immune globulin, anti-thymocyte globulin

1 interaction

Monitor/Modify Tx

irinotecan + lymphocyte immune globulin, anti-thymocyte globulin

monitor CBC: combo may incr. risk of serious infection, myelosuppression (additive effects)

• meningococcal vaccine
Onivyde (irinotecan liposomal)

+

meningococcal vaccine

1 interaction

Monitor/Modify Tx

irinotecan + meningococcal vaccine

if possible, vaccinate at least 2wk before starting irinotecan tx; otherwise, consider post-immunization titer check or revaccination after immunocompetence restored: combo may result in inadequate vaccine response (immunosuppressive effects)

• mercaptopurine
Onivyde (irinotecan liposomal)

+

mercaptopurine

1 interaction

Monitor/Modify Tx

irinotecan + mercaptopurine

monitor CBC: combo may incr. risk of serious infection, myelosuppression (additive effects)

• mesalamine
Onivyde (irinotecan liposomal)

+

mesalamine

1 interaction

Monitor/Modify Tx

irinotecan + mesalamine

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• mesalamine rectal
Onivyde (irinotecan liposomal)

+

mesalamine rectal

1 interaction

Monitor/Modify Tx

irinotecan + mesalamine rectal

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• methotrexate
Onivyde (irinotecan liposomal)

+

methotrexate

1 interaction

Monitor/Modify Tx

irinotecan + methotrexate

monitor CBC: combo may incr. risk of serious infection, myelosuppression (additive effects)

• momelotinib
Onivyde (irinotecan liposomal)

+

momelotinib

1 interaction

Monitor/Modify Tx

irinotecan + momelotinib

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (BCRP-mediated transport inhibited)

• mycophenolate mofetil
Onivyde (irinotecan liposomal)

+

mycophenolate mofetil

1 interaction

Monitor/Modify Tx

irinotecan + mycophenolate mofetil

monitor CBC: combo may incr. risk of serious infection, myelosuppression (additive effects)

• mycophenolic acid
Onivyde (irinotecan liposomal)

+

mycophenolic acid

1 interaction

Monitor/Modify Tx

irinotecan + mycophenolic acid

monitor CBC: combo may incr. risk of serious infection, myelosuppression (additive effects)

• netupitant
Onivyde (irinotecan liposomal)

+

netupitant

1 interaction

Monitor/Modify Tx

irinotecan + netupitant

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited)

• nilotinib
Onivyde (irinotecan liposomal)

+

nilotinib

1 interaction

Monitor/Modify Tx

irinotecan + nilotinib

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited)

• nirogacestat
Onivyde (irinotecan liposomal)

+

nirogacestat

1 interaction

Monitor/Modify Tx

irinotecan + nirogacestat

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited)

• olsalazine
Onivyde (irinotecan liposomal)

+

olsalazine

1 interaction

Monitor/Modify Tx

irinotecan + olsalazine

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• osimertinib
Onivyde (irinotecan liposomal)

+

osimertinib

1 interaction

Monitor/Modify Tx

irinotecan + osimertinib

monitor CBC: combo may incr. irinotecan levels, risk of serious infection, myelosuppression, other adverse effects (BCRP-mediated transport inhibited)

• oteseconazole
Onivyde (irinotecan liposomal)

+

oteseconazole

1 interaction

Monitor/Modify Tx

irinotecan + oteseconazole

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (BCRP-mediated transport inhibited)

• pegfilgrastim (G-CSF)
Onivyde (irinotecan liposomal)

+

pegfilgrastim (G-CSF)

1 interaction

Monitor/Modify Tx

irinotecan + pegfilgrastim (G-CSF)

admin. pegfilgrastim >24h after or >14 days before myelosuppressive chemo: combo may decr. pegfilgrastim efficacy; may incr. risk of pulmonary toxicity (antagonistic effects; mechanism unknown)

• peginterferon alfa 2a
Onivyde (irinotecan liposomal)

+

peginterferon alfa 2a

1 interaction

Monitor/Modify Tx

irinotecan + peginterferon alfa 2a

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• peginterferon beta 1a
Onivyde (irinotecan liposomal)

+

peginterferon beta 1a

1 interaction

Monitor/Modify Tx

irinotecan + peginterferon beta 1a

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• pentamidine
Onivyde (irinotecan liposomal)

+

pentamidine

1 interaction

Monitor/Modify Tx

irinotecan + pentamidine

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• pibrentasvir
Onivyde (irinotecan liposomal)

+

pibrentasvir

1 interaction

Monitor/Modify Tx

irinotecan + pibrentasvir

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (BCRP-mediated transport inhibited)

• pirtobrutinib
Onivyde (irinotecan liposomal)

+

pirtobrutinib

1 interaction

Monitor/Modify Tx

irinotecan + pirtobrutinib

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (BCRP-mediated transport inhibited)

• pneumococcal vaccine
Onivyde (irinotecan liposomal)

+

pneumococcal vaccine

1 interaction

Monitor/Modify Tx

irinotecan + pneumococcal vaccine

if possible, vaccinate at least 2wk before starting irinotecan tx; otherwise, consider post-immunization titer check or revaccination after immunocompetence restored: combo may result in inadequate vaccine response (immunosuppressive effects)

• poliovirus vaccine
Onivyde (irinotecan liposomal)

+

poliovirus vaccine

1 interaction

Monitor/Modify Tx

irinotecan + poliovirus vaccine

if possible, vaccinate at least 2wk before starting irinotecan tx; otherwise, consider post-immunization titer check or revaccination after immunocompetence restored: combo may result in inadequate vaccine response (immunosuppressive effects)

• pretomanid
Onivyde (irinotecan liposomal)

+

pretomanid

1 interaction

Monitor/Modify Tx

irinotecan + pretomanid

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (BCRP-mediated transport possibly inhibited)

• pyrimethamine
Onivyde (irinotecan liposomal)

+

pyrimethamine

1 interaction

Monitor/Modify Tx

irinotecan + pyrimethamine

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• resmetirom
Onivyde (irinotecan liposomal)

+

resmetirom

1 interaction

Monitor/Modify Tx

irinotecan + resmetirom

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (BCRP-mediated transport inhibited)

• respiratory syncytial virus vaccine
Onivyde (irinotecan liposomal)

+

respiratory syncytial virus vaccine

1 interaction

Monitor/Modify Tx

irinotecan + respiratory syncytial virus vaccine

if possible, vaccinate at least 2wk before starting irinotecan tx; otherwise, consider post-immunization titer check or revaccination after immunocompetence restored: combo may result in inadequate vaccine response (immunosuppressive effects)

• ribavirin
Onivyde (irinotecan liposomal)

+

ribavirin

1 interaction

Monitor/Modify Tx

irinotecan + ribavirin

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• rituximab
Onivyde (irinotecan liposomal)

+

rituximab

1 interaction

Monitor/Modify Tx

irinotecan + rituximab

monitor CBC: combo may incr. risk of serious infection, myelosuppression (additive effects)

• rucaparib
Onivyde (irinotecan liposomal)

+

rucaparib

1 interaction

Monitor/Modify Tx

irinotecan + rucaparib

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (BCRP-mediated transport inhibited)

• ruxolitinib topical
Onivyde (irinotecan liposomal)

+

ruxolitinib topical

1 interaction

Monitor/Modify Tx

irinotecan + ruxolitinib topical

monitor CBC: combo may incr. risk of serious infection, myelosuppression (additive effects)

• sargramostim (GM-CSF)
Onivyde (irinotecan liposomal)

+

sargramostim (GM-CSF)

1 interaction

Monitor/Modify Tx

irinotecan + sargramostim (GM-CSF)

admin. sargramostim >24h before or after myelosuppressive chemo: combo may decr. sargramostim efficacy; may incr. risk of pulmonary toxicity (antagonistic effects; mechanism unknown)

• sarilumab
Onivyde (irinotecan liposomal)

+

sarilumab

1 interaction

Monitor/Modify Tx

irinotecan + sarilumab

monitor CBC: combo may decr. irinotecan and active metabolite levels, efficacy; may incr. risk of serious infection, myelosuppression (hepatic metab. altered; sarilumab may reverse inflammatory cytokine-induced downregulation of CYP450 enzymes resulting in relative induction of enzymes upon tx start and downregulation upon D/C; additive effects)

• satralizumab
Onivyde (irinotecan liposomal)

+

satralizumab

1 interaction

Monitor/Modify Tx

irinotecan + satralizumab

monitor CBC: combo may incr. risk of myelosuppression, serious infection (additive effects)

• selpercatinib
Onivyde (irinotecan liposomal)

+

selpercatinib

1 interaction

Monitor/Modify Tx

irinotecan + selpercatinib

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (BCRP-mediated transport inhibited)

• sipuleucel-T
Onivyde (irinotecan liposomal)

+

sipuleucel-T

1 interaction

Monitor/Modify Tx

irinotecan + sipuleucel-T

consider decr. irinotecan dose or D/C during leukapheresis and sipuleucel-T admin.: combo may decr. efficacy of sipuleucel-T; may incr. risk of adverse effects (antagonistic effects)

• sirolimus
Onivyde (irinotecan liposomal)

+

sirolimus

1 interaction

Monitor/Modify Tx

irinotecan + sirolimus

monitor CBC: combo may incr. risk of serious infection, myelosuppression (additive effects)

• smallpox/mpox vaccine, live
Onivyde (irinotecan liposomal)

+

smallpox/ mpox vaccine, live

1 interaction

Monitor/Modify Tx

irinotecan + smallpox/ mpox vaccine, live

consider vaccinating at least 4wk before or 3mo after irinotecan tx: combo may result in inadequate vaccine response (immunosuppressive effects)

• sparsentan
Onivyde (irinotecan liposomal)

+

sparsentan

1 interaction

Monitor/Modify Tx

irinotecan + sparsentan

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (BCRP-mediated transport possibly inhibited)

• stiripentol
Onivyde (irinotecan liposomal)

+

stiripentol

1 interaction

Monitor/Modify Tx

irinotecan + stiripentol

monitor CBC: combo may incr. or decr. irinotecan and active metabolite levels, incr. risk of serious infection, myelosuppression, other toxicities or decr. efficacy (hepatic metab. possibly induced; BCRP-mediated transport possibly inhibited; additive effects)

• succimer
Onivyde (irinotecan liposomal)

+

succimer

1 interaction

Monitor/Modify Tx

irinotecan + succimer

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• sulfasalazine
Onivyde (irinotecan liposomal)

+

sulfasalazine

1 interaction

Monitor/Modify Tx

irinotecan + sulfasalazine

monitor CBC: combo may incr. risk of serious infection, myelosuppression (additive effects)

• telmisartan
Onivyde (irinotecan liposomal)

+

telmisartan

1 interaction

Monitor/Modify Tx

irinotecan + telmisartan

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (BCRP-mediated transport inhibited)

• teplizumab
Onivyde (irinotecan liposomal)

+

teplizumab

1 interaction

Monitor/Modify Tx

irinotecan + teplizumab

monitor CBC: combo may incr. risk of serious infection, myelosuppression (additive effects)

• teriflunomide
Onivyde (irinotecan liposomal)

+

teriflunomide

1 interaction

Monitor/Modify Tx

irinotecan + teriflunomide

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (BCRP-mediated transport inhibited, additive effects)

• thalidomide
Onivyde (irinotecan liposomal)

+

thalidomide

1 interaction

Monitor/Modify Tx

irinotecan + thalidomide

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• ticagrelor
Onivyde (irinotecan liposomal)

+

ticagrelor

1 interaction

Monitor/Modify Tx

irinotecan + ticagrelor

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (BCRP-mediated transport inhibited)

• tick-borne encephalitis vaccine
Onivyde (irinotecan liposomal)

+

tick-borne encephalitis vaccine

1 interaction

Monitor/Modify Tx

irinotecan + tick-borne encephalitis vaccine

if possible, vaccinate at least 2wk before starting irinotecan tx; otherwise, consider post-immunization titer check or revaccination after immunocompetence restored: combo may result in inadequate vaccine response (immunosuppressive effects)

• tocilizumab
Onivyde (irinotecan liposomal)

+

tocilizumab

1 interaction

Monitor/Modify Tx

irinotecan + tocilizumab

monitor CBC: combo may decr. irinotecan and active metabolite levels, efficacy; may incr. risk of serious infection, myelosuppression (hepatic metab. altered; tocilizumab may reverse inflammatory cytokine-induced downregulation of CYP450 enzymes resulting in relative induction of enzymes; additive effects)

• tofacitinib
Onivyde (irinotecan liposomal)

+

tofacitinib

1 interaction

Monitor/Modify Tx

irinotecan + tofacitinib

monitor CBC: combo may incr. risk of serious infection, myelosuppression (additive effects)

• trimethoprim
Onivyde (irinotecan liposomal)

+

trimethoprim

1 interaction

Monitor/Modify Tx

irinotecan + trimethoprim

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• turmeric
Onivyde (irinotecan liposomal)

+

turmeric

1 interaction

Monitor/Modify Tx

irinotecan + turmeric

monitor CBC w/ oral turmeric: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (BCRP-mediated transport inhibited)

• typhoid vaccine
Onivyde (irinotecan liposomal)

+

typhoid vaccine

1 interaction

Monitor/Modify Tx

irinotecan + typhoid vaccine

if possible, vaccinate at least 2wk before starting irinotecan tx; otherwise, consider post-immunization titer check or revaccination after immunocompetence restored: combo may result in inadequate vaccine response (immunosuppressive effects)

• upadacitinib
Onivyde (irinotecan liposomal)

+

upadacitinib

1 interaction

Monitor/Modify Tx

irinotecan + upadacitinib

monitor CBC: combo may incr. risk of myelosuppression, serious infection (additive effects)

• vadadustat
Onivyde (irinotecan liposomal)

+

vadadustat

1 interaction

Monitor/Modify Tx

irinotecan + vadadustat

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (BCRP-mediated transport inhibited)

• valproic acid
Onivyde (irinotecan liposomal)

+

valproic acid

1 interaction

Monitor/Modify Tx

irinotecan + valproic acid

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

• vanzacaftor/tezacaftor/deutivacaftor
Onivyde (irinotecan liposomal)

+

vanzacaftor/ tezacaftor/ deutivacaftor

1 interaction

Monitor/Modify Tx

irinotecan + vanzacaftor/ tezacaftor/ deutivacaftor

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (BCRP-mediated transport possibly inhibited)

• verapamil
Onivyde (irinotecan liposomal)

+

verapamil

1 interaction

Monitor/Modify Tx

irinotecan + verapamil

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metab. inhibited)

• vimseltinib
Onivyde (irinotecan liposomal)

+

vimseltinib

1 interaction

Monitor/Modify Tx

irinotecan + vimseltinib

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (BCRP-mediated transport possibly inhibited)

• voxilaprevir
Onivyde (irinotecan liposomal)

+

voxilaprevir

1 interaction

Monitor/Modify Tx

irinotecan + voxilaprevir

monitor CBC: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (BCRP-mediated transport inhibited)

• zidovudine
Onivyde (irinotecan liposomal)

+

zidovudine

1 interaction

Monitor/Modify Tx

irinotecan + zidovudine

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

Caution Advised

• abatacept
Onivyde (irinotecan liposomal)

+

abatacept

1 interaction

Caution Advised

irinotecan + abatacept

caution advised: combo may incr. risk of serious infection (additive effects)

• abrocitinib
Onivyde (irinotecan liposomal)

+

abrocitinib

1 interaction

Caution Advised

irinotecan + abrocitinib

caution advised: combo may incr. risk of serious infection (additive effects)

• adalimumab
Onivyde (irinotecan liposomal)

+

adalimumab

1 interaction

Caution Advised

irinotecan + adalimumab

caution advised: combo may incr. risk of serious infection (additive effects)

• anakinra
Onivyde (irinotecan liposomal)

+

anakinra

1 interaction

Caution Advised

irinotecan + anakinra

caution advised: combo may incr. risk of serious infection (additive effects)

• anifrolumab
Onivyde (irinotecan liposomal)

+

anifrolumab

1 interaction

Caution Advised

irinotecan + anifrolumab

caution advised: combo may incr. risk of serious infection (additive effects)

• armodafinil
Onivyde (irinotecan liposomal)

+

armodafinil

1 interaction

Caution Advised

irinotecan + armodafinil

caution advised: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• artemether/lumefantrine
Onivyde (irinotecan liposomal)

+

artemether/ lumefantrine

1 interaction

Caution Advised

irinotecan + artemether/ lumefantrine

caution advised: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• atracurium
Onivyde (irinotecan liposomal)

+

atracurium

1 interaction

Caution Advised

irinotecan + atracurium

caution advised: combo may decr. non-depolarizing neuromuscular blocker efficacy (antagonistic effects; irinotecan inhibits cholinesterase)

• basiliximab
Onivyde (irinotecan liposomal)

+

basiliximab

1 interaction

Caution Advised

irinotecan + basiliximab

caution advised: combo may incr. risk of serious infection (additive effects)

• beclomethasone inhaled
Onivyde (irinotecan liposomal)

+

beclomethasone inhaled

1 interaction

Caution Advised

irinotecan + beclomethasone inhaled

caution advised: combo may incr. risk of serious infection (additive effects)

• beclomethasone nasal
Onivyde (irinotecan liposomal)

+

beclomethasone nasal

1 interaction

Caution Advised

irinotecan + beclomethasone nasal

caution advised: combo may incr. risk of serious infection (additive effects)

• belatacept
Onivyde (irinotecan liposomal)

+

belatacept

1 interaction

Caution Advised

irinotecan + belatacept

caution advised: combo may incr. risk of serious infection (additive effects)

• belimumab
Onivyde (irinotecan liposomal)

+

belimumab

1 interaction

Caution Advised

irinotecan + belimumab

caution advised: combo may incr. risk of serious infection (additive effects)

• belzutifan
Onivyde (irinotecan liposomal)

+

belzutifan

1 interaction

Caution Advised

irinotecan + belzutifan

caution advised: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• betamethasone
Onivyde (irinotecan liposomal)

+

betamethasone

1 interaction

Caution Advised

irinotecan + betamethasone

caution advised: combo may incr. risk of serious infection (additive effects)

• bexarotene
Onivyde (irinotecan liposomal)

+

bexarotene

1 interaction

Caution Advised

irinotecan + bexarotene

caution advised: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• bimekizumab
Onivyde (irinotecan liposomal)

+

bimekizumab

1 interaction

Caution Advised

irinotecan + bimekizumab

caution advised: combo may incr. risk of serious infection (additive effects)

• brodalumab
Onivyde (irinotecan liposomal)

+

brodalumab

1 interaction

Caution Advised

irinotecan + brodalumab

caution advised: combo may incr. risk of serious infection (additive effects)

• budesonide
Onivyde (irinotecan liposomal)

+

budesonide

1 interaction

Caution Advised

irinotecan + budesonide

caution advised: combo may incr. risk of serious infection (additive effects)

• budesonide inhaled
Onivyde (irinotecan liposomal)

+

budesonide inhaled

1 interaction

Caution Advised

irinotecan + budesonide inhaled

caution advised: combo may incr. risk of serious infection (additive effects)

• budesonide nasal
Onivyde (irinotecan liposomal)

+

budesonide nasal

1 interaction

Caution Advised

irinotecan + budesonide nasal

caution advised: combo may incr. risk of serious infection (additive effects)

• budesonide rectal
Onivyde (irinotecan liposomal)

+

budesonide rectal

1 interaction

Caution Advised

irinotecan + budesonide rectal

caution advised: combo may incr. risk of serious infection (additive effects)

• canakinumab
Onivyde (irinotecan liposomal)

+

canakinumab

1 interaction

Caution Advised

irinotecan + canakinumab

caution advised: combo may incr. risk of serious infection (additive effects)

• certolizumab pegol
Onivyde (irinotecan liposomal)

+

certolizumab pegol

1 interaction

Caution Advised

irinotecan + certolizumab pegol

caution advised: combo may incr. risk of serious infection (additive effects)

• cisatracurium
Onivyde (irinotecan liposomal)

+

cisatracurium

1 interaction

Caution Advised

irinotecan + cisatracurium

caution advised: combo may decr. non-depolarizing neuromuscular blocker efficacy (antagonistic effects; irinotecan inhibits cholinesterase)

• clobetasol ophthalmic
Onivyde (irinotecan liposomal)

+

clobetasol ophthalmic

1 interaction

Caution Advised

irinotecan + clobetasol ophthalmic

caution advised: combo may incr. risk of serious infection (additive effects)

• corticotropin
Onivyde (irinotecan liposomal)

+

corticotropin

1 interaction

Caution Advised

irinotecan + corticotropin

caution advised: combo may incr. risk of serious infection (additive effects)

• cortisone
Onivyde (irinotecan liposomal)

+

cortisone

1 interaction

Caution Advised

irinotecan + cortisone

caution advised: combo may incr. risk of serious infection (additive effects)

• crovalimab
Onivyde (irinotecan liposomal)

+

crovalimab

1 interaction

Caution Advised

irinotecan + crovalimab

caution advised: combo may incr. risk of serious infection (additive effects)

• danshen
Onivyde (irinotecan liposomal)

+

danshen

1 interaction

Caution Advised

irinotecan + danshen

caution advised: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• deflazacort
Onivyde (irinotecan liposomal)

+

deflazacort

1 interaction

Caution Advised

irinotecan + deflazacort

caution advised: combo may incr. risk of serious infection (additive effects)

• deucravacitinib
Onivyde (irinotecan liposomal)

+

deucravacitinib

1 interaction

Caution Advised

irinotecan + deucravacitinib

caution advised: combo may incr. risk of serious infection (additive effects)

• dexamethasone
Onivyde (irinotecan liposomal)

+

dexamethasone

1 interaction

Caution Advised

irinotecan + dexamethasone

caution advised: combo may incr. risk of serious infection (additive effects)

• dexamethasone ophthalmic
Onivyde (irinotecan liposomal)

+

dexamethasone ophthalmic

1 interaction

Caution Advised

irinotecan + dexamethasone ophthalmic

caution advised: combo may incr. risk of serious infection (additive effects)

• dicloxacillin
Onivyde (irinotecan liposomal)

+

dicloxacillin

1 interaction

Caution Advised

irinotecan + dicloxacillin

caution advised: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• difluprednate ophthalmic
Onivyde (irinotecan liposomal)

+

difluprednate ophthalmic

1 interaction

Caution Advised

irinotecan + difluprednate ophthalmic

caution advised: combo may incr. risk of serious infection (additive effects)

• dimethyl fumarate
Onivyde (irinotecan liposomal)

+

dimethyl fumarate

1 interaction

Caution Advised

irinotecan + dimethyl fumarate

caution advised: combo may incr. risk of serious infection (additive effects)

• diroximel fumarate
Onivyde (irinotecan liposomal)

+

diroximel fumarate

1 interaction

Caution Advised

irinotecan + diroximel fumarate

caution advised: combo may incr. risk of serious infection (additive effects)

• dupilumab
Onivyde (irinotecan liposomal)

+

dupilumab

1 interaction

Caution Advised

irinotecan + dupilumab

caution advised: combo may incr. risk of serious infection (additive effects)

• echinacea
Onivyde (irinotecan liposomal)

+

echinacea

1 interaction

Caution Advised

irinotecan + echinacea

caution advised: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• eculizumab
Onivyde (irinotecan liposomal)

+

eculizumab

1 interaction

Caution Advised

irinotecan + eculizumab

caution advised: combo may incr. risk of serious infection (additive effects)

• efgartigimod alfa
Onivyde (irinotecan liposomal)

+

efgartigimod alfa

1 interaction

Caution Advised

irinotecan + efgartigimod alfa

caution advised: combo may incr. risk of serious infection (additive effects)

• elafibranor
Onivyde (irinotecan liposomal)

+

elafibranor

1 interaction

Caution Advised

irinotecan + elafibranor

caution advised: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• elagolix
Onivyde (irinotecan liposomal)

+

elagolix

1 interaction

Caution Advised

irinotecan + elagolix

caution advised: combo may decr. irinotecan levels, efficacy (hepatic metab. induced)

• emapalumab
Onivyde (irinotecan liposomal)

+

emapalumab

1 interaction

Caution Advised

irinotecan + emapalumab

caution advised: combo may incr. risk of serious infection (additive effects)

• eslicarbazepine acetate
Onivyde (irinotecan liposomal)

+

eslicarbazepine acetate

1 interaction

Caution Advised

irinotecan + eslicarbazepine acetate

caution advised: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• etanercept
Onivyde (irinotecan liposomal)

+

etanercept

1 interaction

Caution Advised

irinotecan + etanercept

caution advised: combo may incr. risk of serious infection (additive effects)

• felbamate
Onivyde (irinotecan liposomal)

+

felbamate

1 interaction

Caution Advised

irinotecan + felbamate

caution advised: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• fingolimod
Onivyde (irinotecan liposomal)

+

fingolimod

1 interaction

Caution Advised

irinotecan + fingolimod

caution advised during and x2mo after fingolimod tx: combo may incr. risk of serious infection; infection risk may be prolonged (additive effects)

• fludrocortisone
Onivyde (irinotecan liposomal)

+

fludrocortisone

1 interaction

Caution Advised

irinotecan + fludrocortisone

caution advised: combo may incr. risk of serious infection (additive effects)

• flunisolide nasal
Onivyde (irinotecan liposomal)

+

flunisolide nasal

1 interaction

Caution Advised

irinotecan + flunisolide nasal

caution advised: combo may incr. risk of serious infection (additive effects)

• fluocinolone intravitreal
Onivyde (irinotecan liposomal)

+

fluocinolone intravitreal

1 interaction

Caution Advised

irinotecan + fluocinolone intravitreal

caution advised: combo may incr. risk of serious infection (additive effects)

• fluorometholone ophthalmic
Onivyde (irinotecan liposomal)

+

fluorometholone ophthalmic

1 interaction

Caution Advised

irinotecan + fluorometholone ophthalmic

caution advised: combo may incr. risk of serious infection (additive effects)

• fluticasone furoate
Onivyde (irinotecan liposomal)

+

fluticasone furoate

1 interaction

Caution Advised

irinotecan + fluticasone furoate

caution advised: combo may incr. risk of serious infection (additive effects)

• fluticasone propionate
Onivyde (irinotecan liposomal)

+

fluticasone propionate

1 interaction

Caution Advised

irinotecan + fluticasone propionate

caution advised: combo may incr. risk of serious infection (additive effects)

• garlic
Onivyde (irinotecan liposomal)

+

garlic

1 interaction

Caution Advised

irinotecan + garlic

caution advised w/ supplemental garlic; dietary intake OK: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• ginkgo
Onivyde (irinotecan liposomal)

+

ginkgo

1 interaction

Caution Advised

irinotecan + ginkgo

caution advised: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• ginseng, Asian
Onivyde (irinotecan liposomal)

+

ginseng, Asian

1 interaction

Caution Advised

irinotecan + ginseng, Asian

caution advised: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• glycerol phenylbutyrate
Onivyde (irinotecan liposomal)

+

glycerol phenylbutyrate

1 interaction

Caution Advised

irinotecan + glycerol phenylbutyrate

caution advised: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• golimumab
Onivyde (irinotecan liposomal)

+

golimumab

1 interaction

Caution Advised

irinotecan + golimumab

caution advised: combo may incr. risk of serious infection (additive effects)

• griseofulvin
Onivyde (irinotecan liposomal)

+

griseofulvin

1 interaction

Caution Advised

irinotecan + griseofulvin

caution advised: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• guselkumab
Onivyde (irinotecan liposomal)

+

guselkumab

1 interaction

Caution Advised

irinotecan + guselkumab

caution advised: combo may incr. risk of serious infection (additive effects)

• hydrocortisone
Onivyde (irinotecan liposomal)

+

hydrocortisone

1 interaction

Caution Advised

irinotecan + hydrocortisone

caution advised: combo may incr. risk of serious infection (additive effects)

• hydrocortisone ophthalmic
Onivyde (irinotecan liposomal)

+

hydrocortisone ophthalmic

1 interaction

Caution Advised

irinotecan + hydrocortisone ophthalmic

caution advised: combo may incr. risk of serious infection (additive effects)

• inebilizumab
Onivyde (irinotecan liposomal)

+

inebilizumab

1 interaction

Caution Advised

irinotecan + inebilizumab

caution advised: combo may incr. risk of serious infection (additive effects)

• infliximab
Onivyde (irinotecan liposomal)

+

infliximab

1 interaction

Caution Advised

irinotecan + infliximab

caution advised: combo may incr. risk of serious infection (additive effects)

• iptacopan
Onivyde (irinotecan liposomal)

+

iptacopan

1 interaction

Caution Advised

irinotecan + iptacopan

caution advised: combo may incr. risk of serious infection (additive effects)

• ixekizumab
Onivyde (irinotecan liposomal)

+

ixekizumab

1 interaction

Caution Advised

irinotecan + ixekizumab

caution advised: combo may incr. risk of serious infection (additive effects)

• lebrikizumab
Onivyde (irinotecan liposomal)

+

lebrikizumab

1 interaction

Caution Advised

irinotecan + lebrikizumab

caution advised: combo may incr. risk of serious infection (additive effects)

• loteprednol ophthalmic
Onivyde (irinotecan liposomal)

+

loteprednol ophthalmic

1 interaction

Caution Advised

irinotecan + loteprednol ophthalmic

caution advised: combo may incr. risk of serious infection (additive effects)

• meropenem
Onivyde (irinotecan liposomal)

+

meropenem

1 interaction

Caution Advised

irinotecan + meropenem

caution advised: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. possibly induced)

• methylprednisolone
Onivyde (irinotecan liposomal)

+

methylprednisolone

1 interaction

Caution Advised

irinotecan + methylprednisolone

caution advised: combo may incr. risk of serious infection (additive effects)

• midostaurin
Onivyde (irinotecan liposomal)

+

midostaurin

1 interaction

Caution Advised

irinotecan + midostaurin

caution advised: combo may incr. irinotecan levels, risk of adverse effects (BCRP-mediated transport inhibited)

• mirikizumab
Onivyde (irinotecan liposomal)

+

mirikizumab

1 interaction

Caution Advised

irinotecan + mirikizumab

caution advised: combo may incr. risk of serious infection (additive effects)

• mitoxantrone
Onivyde (irinotecan liposomal)

+

mitoxantrone

1 interaction

Caution Advised

irinotecan + mitoxantrone

caution advised: combo may incr. risk of serious infection (additive effects)

• mobocertinib
Onivyde (irinotecan liposomal)

+

mobocertinib

1 interaction

Caution Advised

irinotecan + mobocertinib

caution advised: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• mometasone implant
Onivyde (irinotecan liposomal)

+

mometasone implant

1 interaction

Caution Advised

irinotecan + mometasone implant

caution advised: combo may incr. risk of serious infection (additive effects)

• mometasone inhaled
Onivyde (irinotecan liposomal)

+

mometasone inhaled

1 interaction

Caution Advised

irinotecan + mometasone inhaled

caution advised: combo may incr. risk of serious infection (additive effects)

• mometasone nasal
Onivyde (irinotecan liposomal)

+

mometasone nasal

1 interaction

Caution Advised

irinotecan + mometasone nasal

caution advised: combo may incr. risk of serious infection (additive effects)

• monomethyl fumarate
Onivyde (irinotecan liposomal)

+

monomethyl fumarate

1 interaction

Caution Advised

irinotecan + monomethyl fumarate

caution advised: combo may incr. risk of serious infection (additive effects)

• nadofaragene firadenovec intravesical
Onivyde (irinotecan liposomal)

+

nadofaragene firadenovec intravesical

1 interaction

Caution Advised

irinotecan + nadofaragene firadenovec intravesical

caution advised: combo may incr. risk of disseminated adenovirus infection (immunosuppressive effects)

• natalizumab
Onivyde (irinotecan liposomal)

+

natalizumab

1 interaction

Caution Advised

irinotecan + natalizumab

caution advised: combo may incr. risk of serious infection (additive effects)

• nevirapine
Onivyde (irinotecan liposomal)

+

nevirapine

1 interaction

Caution Advised

irinotecan + nevirapine

caution advised: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• ocrelizumab
Onivyde (irinotecan liposomal)

+

ocrelizumab

1 interaction

Caution Advised

irinotecan + ocrelizumab

caution advised: combo may incr. risk of serious infection (additive effects)

• ofatumumab
Onivyde (irinotecan liposomal)

+

ofatumumab

1 interaction

Caution Advised

irinotecan + ofatumumab

caution advised: combo may incr. risk of serious infection (additive effects)

• olutasidenib
Onivyde (irinotecan liposomal)

+

olutasidenib

1 interaction

Caution Advised

irinotecan + olutasidenib

caution advised: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. possibly induced)

• omaveloxolone
Onivyde (irinotecan liposomal)

+

omaveloxolone

1 interaction

Caution Advised

irinotecan + omaveloxolone

caution advised: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• oxcarbazepine
Onivyde (irinotecan liposomal)

+

oxcarbazepine

1 interaction

Caution Advised

irinotecan + oxcarbazepine

caution advised: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• ozanimod
Onivyde (irinotecan liposomal)

+

ozanimod

1 interaction

Caution Advised

irinotecan + ozanimod

caution advised during and x3mo after ozanimod tx: combo may incr. risk of serious infection; infection risk may be prolonged (additive effects)

• pancuronium
Onivyde (irinotecan liposomal)

+

pancuronium

1 interaction

Caution Advised

irinotecan + pancuronium

caution advised: combo may decr. non-depolarizing neuromuscular blocker efficacy (antagonistic effects; irinotecan inhibits cholinesterase)

• pegcetacoplan
Onivyde (irinotecan liposomal)

+

pegcetacoplan

1 interaction

Caution Advised

irinotecan + pegcetacoplan

caution advised: combo may incr. risk of serious infection (additive effects)

• perampanel
Onivyde (irinotecan liposomal)

+

perampanel

1 interaction

Caution Advised

irinotecan + perampanel

caution advised if on perampanel 12 mg/day: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• pioglitazone
Onivyde (irinotecan liposomal)

+

pioglitazone

1 interaction

Caution Advised

irinotecan + pioglitazone

caution advised: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• ponesimod
Onivyde (irinotecan liposomal)

+

ponesimod

1 interaction

Caution Advised

irinotecan + ponesimod

caution advised during and x1-2wk after ponesimod tx: combo may incr. risk of serious infection; infection risk may be prolonged (additive effects)

• pozelimab
Onivyde (irinotecan liposomal)

+

pozelimab

1 interaction

Caution Advised

irinotecan + pozelimab

caution advised: combo may incr. risk of serious infection (additive effects)

• prednisolone
Onivyde (irinotecan liposomal)

+

prednisolone

1 interaction

Caution Advised

irinotecan + prednisolone

caution advised: combo may incr. risk of serious infection (additive effects)

• prednisolone ophthalmic
Onivyde (irinotecan liposomal)

+

prednisolone ophthalmic

1 interaction

Caution Advised

irinotecan + prednisolone ophthalmic

caution advised: combo may incr. risk of serious infection (additive effects)

• prednisone
Onivyde (irinotecan liposomal)

+

prednisone

1 interaction

Caution Advised

irinotecan + prednisone

caution advised: combo may decr. irinotecan and active metabolite levels, efficacy; may incr. risk of serious infection (hepatic metab. induced; additive effects)

• ravulizumab
Onivyde (irinotecan liposomal)

+

ravulizumab

1 interaction

Caution Advised

irinotecan + ravulizumab

caution advised: combo may incr. risk of serious infection (additive effects)

• rilonacept
Onivyde (irinotecan liposomal)

+

rilonacept

1 interaction

Caution Advised

irinotecan + rilonacept

caution advised: combo may incr. risk of serious infection (additive effects)

• risankizumab
Onivyde (irinotecan liposomal)

+

risankizumab

1 interaction

Caution Advised

irinotecan + risankizumab

caution advised: combo may incr. risk of serious infection (additive effects)

• ritlecitinib
Onivyde (irinotecan liposomal)

+

ritlecitinib

1 interaction

Caution Advised

irinotecan + ritlecitinib

caution advised: combo may incr. risk of serious infection (additive effects)

• rocuronium
Onivyde (irinotecan liposomal)

+

rocuronium

1 interaction

Caution Advised

irinotecan + rocuronium

caution advised: combo may decr. non-depolarizing neuromuscular blocker efficacy (antagonistic effects; irinotecan inhibits cholinesterase)

• rolapitant
Onivyde (irinotecan liposomal)

+

rolapitant

1 interaction

Caution Advised

irinotecan + rolapitant

caution advised: combo may incr. irinotecan levels, risk of adverse effects (BCRP-mediated transport inhibited)

• rozanolixizumab
Onivyde (irinotecan liposomal)

+

rozanolixizumab

1 interaction

Caution Advised

irinotecan + rozanolixizumab

caution advised: combo may incr. risk of serious infection (additive effects)

• rufinamide
Onivyde (irinotecan liposomal)

+

rufinamide

1 interaction

Caution Advised

irinotecan + rufinamide

caution advised: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• secukinumab
Onivyde (irinotecan liposomal)

+

secukinumab

1 interaction

Caution Advised

irinotecan + secukinumab

caution advised: combo may incr. risk of serious infection (additive effects)

• siltuximab
Onivyde (irinotecan liposomal)

+

siltuximab

1 interaction

Caution Advised

irinotecan + siltuximab

caution advised: combo may incr. risk of serious infection (additive effects)

• siponimod
Onivyde (irinotecan liposomal)

+

siponimod

1 interaction

Caution Advised

irinotecan + siponimod

caution advised during and x3-4wk after siponimod tx: combo may incr. risk of serious infection; infection risk may be prolonged (additive effects)

• somatropin
Onivyde (irinotecan liposomal)

+

somatropin

1 interaction

Caution Advised

irinotecan + somatropin

caution advised: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• spesolimab
Onivyde (irinotecan liposomal)

+

spesolimab

1 interaction

Caution Advised

irinotecan + spesolimab

caution advised: combo may incr. risk of serious infection (additive effects)

• succinylcholine
Onivyde (irinotecan liposomal)

+

succinylcholine

1 interaction

Caution Advised

irinotecan + succinylcholine

caution advised: combo may prolong neuromuscular blockade (synergistic effects; irinotecan inhibits cholinesterase)

• sutimlimab
Onivyde (irinotecan liposomal)

+

sutimlimab

1 interaction

Caution Advised

irinotecan + sutimlimab

caution advised: combo may incr. risk of serious infection (additive effects)

• suzetrigine
Onivyde (irinotecan liposomal)

+

suzetrigine

1 interaction

Caution Advised

irinotecan + suzetrigine

caution advised: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• tacrolimus
Onivyde (irinotecan liposomal)

+

tacrolimus

1 interaction

Caution Advised

irinotecan + tacrolimus

caution advised: combo may incr. risk of serious infection (additive effects)

• tafamidis
Onivyde (irinotecan liposomal)

+

tafamidis

1 interaction

Caution Advised

irinotecan + tafamidis

caution advised: combo may incr. irinotecan levels, risk of adverse effects (BCRP-mediated transport inhibited)

• tazemetostat
Onivyde (irinotecan liposomal)

+

tazemetostat

1 interaction

Caution Advised

irinotecan + tazemetostat

caution advised: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• tecovirimat
Onivyde (irinotecan liposomal)

+

tecovirimat

1 interaction

Caution Advised

irinotecan + tecovirimat

caution advised: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• telotristat ethyl
Onivyde (irinotecan liposomal)

+

telotristat ethyl

1 interaction

Caution Advised

irinotecan + telotristat ethyl

caution advised: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• tezepelumab
Onivyde (irinotecan liposomal)

+

tezepelumab

1 interaction

Caution Advised

irinotecan + tezepelumab

caution advised: combo may incr. risk of serious infection (possible additive effects)

• tildrakizumab
Onivyde (irinotecan liposomal)

+

tildrakizumab

1 interaction

Caution Advised

irinotecan + tildrakizumab

caution advised: combo may incr. risk of serious infection (additive effects)

• topiramate
Onivyde (irinotecan liposomal)

+

topiramate

1 interaction

Caution Advised

irinotecan + topiramate

caution advised, especially w/ topiramate doses >200 mg/day: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• tovorafenib
Onivyde (irinotecan liposomal)

+

tovorafenib

1 interaction

Caution Advised

irinotecan + tovorafenib

caution advised: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• tralokinumab
Onivyde (irinotecan liposomal)

+

tralokinumab

1 interaction

Caution Advised

irinotecan + tralokinumab

caution advised: combo may incr. risk of serious infection (additive effects)

• triamcinolone
Onivyde (irinotecan liposomal)

+

triamcinolone

1 interaction

Caution Advised

irinotecan + triamcinolone

caution advised: combo may incr. risk of serious infection (additive effects)

• tuberculin purified protein derivative
Onivyde (irinotecan liposomal)

+

tuberculin purified protein derivative

1 interaction

Caution Advised

irinotecan + tuberculin purified protein derivative

caution advised during and x5-6wk after irinotecan tx: combo may interfere w/ test results (antagonistic effects)

• ublituximab
Onivyde (irinotecan liposomal)

+

ublituximab

1 interaction

Caution Advised

irinotecan + ublituximab

caution advised: combo may incr. risk of serious infection (additive effects)

• ustekinumab
Onivyde (irinotecan liposomal)

+

ustekinumab

1 interaction

Caution Advised

irinotecan + ustekinumab

caution advised: combo may incr. risk of serious infection (additive effects)

• vaborbactam
Onivyde (irinotecan liposomal)

+

vaborbactam

1 interaction

Caution Advised

irinotecan + vaborbactam

caution advised: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. possibly induced)

• vamorolone
Onivyde (irinotecan liposomal)

+

vamorolone

1 interaction

Caution Advised

irinotecan + vamorolone

caution advised: combo may decr. irinotecan and active metabolite levels, efficacy; may incr. risk of serious infection (hepatic metab. possibly induced; additive effects)

• vecuronium
Onivyde (irinotecan liposomal)

+

vecuronium

1 interaction

Caution Advised

irinotecan + vecuronium

caution advised: combo may decr. non-depolarizing neuromuscular blocker efficacy (antagonistic effects; irinotecan inhibits cholinesterase)

• vedolizumab
Onivyde (irinotecan liposomal)

+

vedolizumab

1 interaction

Caution Advised

irinotecan + vedolizumab

caution advised: combo may incr. risk of serious infection (additive effects)

• vemurafenib
Onivyde (irinotecan liposomal)

+

vemurafenib

1 interaction

Caution Advised

irinotecan + vemurafenib

caution advised: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• vilobelimab
Onivyde (irinotecan liposomal)

+

vilobelimab

1 interaction

Caution Advised

irinotecan + vilobelimab

caution advised: combo may incr. risk of serious infection (additive effects)

• vinblastine
Onivyde (irinotecan liposomal)

+

vinblastine

1 interaction

Caution Advised

irinotecan + vinblastine

caution advised: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• voclosporin
Onivyde (irinotecan liposomal)

+

voclosporin

1 interaction

Caution Advised

irinotecan + voclosporin

caution advised: combo may incr. risk of serious infection (additive effects)

• vorasidenib
Onivyde (irinotecan liposomal)

+

vorasidenib

1 interaction

Caution Advised

irinotecan + vorasidenib

caution advised: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. possibly induced)

• zanubrutinib
Onivyde (irinotecan liposomal)

+

zanubrutinib

1 interaction

Caution Advised

irinotecan + zanubrutinib

caution advised: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• zilucoplan
Onivyde (irinotecan liposomal)

+

zilucoplan

1 interaction

Caution Advised

irinotecan + zilucoplan

caution advised: combo may incr. risk of serious infection (additive effects)