Drug interactions
Arsenic trioxide + Fluconazole
Severity: Major
Arsenic trioxide and Fluconazole: major interaction.
Last updated Sources: Health Canada product monograph
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
Arsenic trioxide causes marked QT prolongation and torsades de pointes, and fluconazole adds to this risk. The combination can be life-threatening.
What this interaction means in plain words
Arsenic trioxide 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.
Arsenic trioxide belongs to Oncology; Fluconazole belongs to Anti Fungals.
Why it happens
Additive QT prolongation through effects on cardiac repolarization.
What to do
Avoid fluconazole where possible and use a non-QT-prolonging antifungal. If unavoidable, monitor ECG and keep potassium and magnesium within normal range.
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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References
Other interactions of Fluconazole
- Dihydroergotamine intranasal + Fluconazole Contraindicated
- Dihydroergotamine + Fluconazole Contraindicated
- Dofetilide + Fluconazole Contraindicated
- Domperidone + Fluconazole Contraindicated
- Dronedarone + Fluconazole Contraindicated
- Erythromycin + Fluconazole Contraindicated
Other interactions of Arsenic trioxide
- Amiodarone + Arsenic trioxide Contraindicated
- Amisulpride + Arsenic trioxide Contraindicated
- Arsenic trioxide + Clomipramine Contraindicated
- Arsenic trioxide + Dronedarone Contraindicated
- Arsenic trioxide + Fluphenazine Contraindicated
- Arsenic trioxide + Gemifloxacin Contraindicated
Frequently asked questions
Can I take Arsenic trioxide with Fluconazole?
MediHelp rates the interaction as major. Arsenic trioxide 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. Arsenic trioxide causes marked QT prolongation and torsades de pointes, and fluconazole adds to this risk. The combination can be life-threatening.
How serious is the interaction between Arsenic trioxide 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 fluconazole where possible and use a non-QT-prolonging antifungal. If unavoidable, monitor ECG and keep potassium and magnesium within normal range.
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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