Drug interactions
Brexpiprazole + Voriconazole
Severity: Major
Brexpiprazole and Voriconazole: 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
Voriconazole is a strong CYP3A4 inhibitor and raises brexpiprazole exposure, increasing adverse effects such as sedation, akathisia and orthostasis. The effect is greater with concurrent CYP2D6 inhibition or poor-metabolizer status.
What this interaction means in plain words
Brexpiprazole and Voriconazole 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.
Brexpiprazole belongs to Central Nervous System; Voriconazole belongs to Anti Fungals.
Why it happens
Voriconazole inhibits CYP3A4, reducing brexpiprazole clearance.
What to do
Reduce the brexpiprazole dose to half, and to a quarter if a CYP2D6 inhibitor is also used; restore the dose after stopping voriconazole.
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 Voriconazole
- Avanafil + Voriconazole Contraindicated
- Butabarbital + Voriconazole Contraindicated
- Carbamazepine + Voriconazole Contraindicated
- Conivaptan + Voriconazole Contraindicated
- Dihydroergotamine intranasal + Voriconazole Contraindicated
- Dihydroergotamine + Voriconazole Contraindicated
Other interactions of Brexpiprazole
Frequently asked questions
Can I take Brexpiprazole with Voriconazole?
MediHelp rates the interaction as major. Brexpiprazole and Voriconazole 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. Voriconazole is a strong CYP3A4 inhibitor and raises brexpiprazole exposure, increasing adverse effects such as sedation, akathisia and orthostasis. The effect is greater with concurrent CYP2D6 inhibition or poor-metabolizer status.
How serious is the interaction between Brexpiprazole and Voriconazole?
MediHelp rates it major, 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 half, and to a quarter if a CYP2D6 inhibitor is also used; restore the dose after stopping voriconazole.
What other medicines interact with Voriconazole?
MediHelp also lists interactions of Voriconazole with, for example, Avanafil, Butabarbital, Carbamazepine. The full list is on the Voriconazole page.
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