Drug interactions
Brexpiprazole + Fluconazole
Severity: Moderate
Brexpiprazole and Fluconazole: moderate 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 moderately inhibits CYP3A4 and also inhibits CYP2C19, which may raise brexpiprazole exposure. The effect is most significant if a CYP2D6 inhibitor is also present or the patient is a CYP2D6 poor metabolizer, increasing risk of adverse effects such as akathisia and sedation.
What this interaction means in plain words
Brexpiprazole and Fluconazole can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Brexpiprazole belongs to Central Nervous System; Fluconazole belongs to Anti Fungals.
Why it happens
Inhibition of CYP3A4 by fluconazole reduces brexpiprazole metabolism.
What to do
Reduce the brexpiprazole dose to a quarter of the usual dose if fluconazole is combined with a CYP2D6 inhibitor, otherwise monitor for adverse effects and consider dose reduction.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Brexpiprazole
Frequently asked questions
Can I take Brexpiprazole with Fluconazole?
MediHelp rates the interaction as moderate. Brexpiprazole and Fluconazole can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Fluconazole moderately inhibits CYP3A4 and also inhibits CYP2C19, which may raise brexpiprazole exposure. The effect is most significant if a CYP2D6 inhibitor is also present or the patient is a CYP2D6 poor metabolizer, increasing risk of adverse effects such as akathisia and sedation.
How serious is the interaction between Brexpiprazole and Fluconazole?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce the brexpiprazole dose to a quarter of the usual dose if fluconazole is combined with a CYP2D6 inhibitor, otherwise monitor for adverse effects and consider dose reduction.
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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