Which drugs should not be used together with crizotinib?

Crizotinib, as a targeted therapy, is mainly used to treat anaplastic lymphoma kinase (ALK)-positive locally advanced or metastatic non-small cell lung cancer. However, when using crizotinib, patients need to be aware that certain drugs used concurrently with it may interact, affect the efficacy of the drug, or increase the risk of adverse reactions.

1.CytochromeP450（CYP） 3AStrong inhibitors: including clarithromycin, indinavir, itraconazole, ketoconazole, nefazodone, nelfinavir, ritonavir, saquinavir, ditroleandomycin, voriconazole, etc. When crizotinib is used concomitantly with these drugs, it may result in increased plasma concentrations of crizotinib and increase the risk of adverse reactions.

2.CYP3AStrong inducers: such as carbamazepine, phenobarbital, phenytoin, rifampicin, rifabutin, etc. These drugs may reduce the plasma concentration of crizotinib and thus reduce its efficacy.

3.Drugs that are easily altered by crizotinib (CYP3Asubstrates): including alfentanil, cyclosporine, dihydroergotamine, ergotamine, fentanyl, pimozide, quinidine, sirolimus, tacrolimus, etc. Crizotinib may alter the plasma concentrations of these drugs, increasing the risk of adverse reactions.

4.Drugs that can prolong the QT interval: Crizotinib itself can prolong the QT/QTc interval, so combination with other drugs that can prolong the QT interval should be avoided to reduce the risk of arrhythmia.

5.Drugs that can cause bradycardia: such as metoprolol, bisoprolol, verapamil, clonidine and digoxin. Coadministration of crizotinib with these drugs may increase the risk of bradycardia.

In addition, drugs such as anlotinib hydrochloride capsules and doxorubicin hydrochloride liposome injection should not be used at the same time as crizotinib because they may interact, affect the therapeutic effect or harm health.