Drug interactions
Busulfan + Itraconazole
Severity: Major
Busulfan and Itraconazole: 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
Itraconazole can decrease busulfan clearance and raise its exposure. This may increase myelosuppression and hepatic veno-occlusive disease, which is of particular concern in transplant conditioning.
What this interaction means in plain words
Busulfan and Itraconazole 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.
Busulfan belongs to Oncology; Itraconazole belongs to Anti Fungals.
Why it happens
Itraconazole inhibits CYP3A4 and glutathione-related busulfan metabolism, reducing busulfan clearance.
What to do
Monitor busulfan levels where available and adjust the dose accordingly. Watch blood counts and liver function closely.
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 Itraconazole
- Alfuzosin + Itraconazole Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Avanafil + Itraconazole Contraindicated
- Conivaptan + Itraconazole Contraindicated
- Dihydroergotamine intranasal + Itraconazole Contraindicated
- Dihydroergotamine + Itraconazole Contraindicated
Other interactions of Busulfan
- Busulfan + Carboplatin Major
- Busulfan + Chlorambucil Major
- Busulfan + Cyclophosphamide Major
- Busulfan + Fingolimod Major
- Busulfan + Hydroxyurea Major
- Busulfan + Ifosfamide Major
Frequently asked questions
Can I take Busulfan with Itraconazole?
MediHelp rates the interaction as major. Busulfan and Itraconazole 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. Itraconazole can decrease busulfan clearance and raise its exposure. This may increase myelosuppression and hepatic veno-occlusive disease, which is of particular concern in transplant conditioning.
How serious is the interaction between Busulfan and Itraconazole?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor busulfan levels where available and adjust the dose accordingly. Watch blood counts and liver function closely.
What other medicines interact with Itraconazole?
MediHelp also lists interactions of Itraconazole with, for example, Alfuzosin, Alprazolam, Avanafil. The full list is on the Itraconazole page.
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