Drug Interactions Corner

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New data published on Vinca alkaloid drug interactions


Three recently published papers highlight drug interactions between vincristine and azole antifungals, including posaconazole (Noxafil—Schering-Plough), and between vinorelbine and clarithromycin. These interactions result in increased chemotherapy-associated toxicities and are believed to be mediated by inhibition of cytochrome P450 (CYP) 3A4 and/or P-glycoprotein (Pgp).


Eiden C et al. Posaconazole-increased vincristine neurotoxicity in a child: a case report. J Pediatr Hematol Oncol. 2009;31:292ñ5. 

Harnicar S et al. Modification of vincrisitne dosing during concomitant azole therapy in adult acute lymphoblastic leukemia patients [published online ahead of print March 12, 2009]. J Oncol Pharm Pract. 

Yano R et al. Evaluation of potential interaction between vinorelbine and clarithromycin. Ann Pharmacother. 2009;43:453ñ8.