Drug interactions
Amiodarone + Fluconazole
Severity: Major
Amiodarone and Fluconazole: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Fluconazole inhibits the metabolism of amiodarone and also prolongs the QT interval itself. Together they raise the risk of marked QT prolongation and torsades de pointes.
What this interaction means in plain words
Amiodarone and Fluconazole can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Amiodarone belongs to Cardiovascular; Fluconazole belongs to Anti Fungals.
Why it happens
Fluconazole inhibits CYP3A4 (and CYP2C9) raising amiodarone exposure, with additive QT-prolonging pharmacodynamic effects.
What to do
Avoid the combination where possible, or obtain a baseline ECG and monitor QTc and electrolytes closely. Correct hypokalemia and hypomagnesemia and consider an alternative antifungal.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Fluconazole
- Dihydroergotamine intranasal + Fluconazole Contraindicated
- Dihydroergotamine + Fluconazole Contraindicated
- Dofetilide + Fluconazole Contraindicated
- Dronedarone + Fluconazole Contraindicated
- Erythromycin + Fluconazole Contraindicated
- Flibanserin + Fluconazole Contraindicated
Other interactions of Amiodarone
- Amiodarone + Amisulpride Contraindicated
- Amiodarone + Arsenic trioxide Contraindicated
- Amiodarone + Dofetilide Contraindicated
- Amiodarone + Dronedarone Contraindicated
- Amiodarone + Droperidol Contraindicated
- Amiodarone + Eliglustat Contraindicated
Frequently asked questions
Can I take Amiodarone with Fluconazole?
MediHelp rates the interaction as major. Amiodarone and Fluconazole can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Fluconazole inhibits the metabolism of amiodarone and also prolongs the QT interval itself. Together they raise the risk of marked QT prolongation and torsades de pointes.
How serious is the interaction between Amiodarone and Fluconazole?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination where possible, or obtain a baseline ECG and monitor QTc and electrolytes closely. Correct hypokalemia and hypomagnesemia and consider an alternative antifungal.
What other medicines interact with Fluconazole?
MediHelp also lists interactions of Fluconazole with, for example, Dihydroergotamine intranasal, Dihydroergotamine, Dofetilide. The full list is on the Fluconazole page.
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