Drug interactions
Cilostazol + Itraconazole
Severity: Major
Cilostazol and Itraconazole: major interaction.
Last updated Sources: US FDA label
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 increases cilostazol exposure, which can cause headache, tachycardia, palpitations and diarrhoea. Cilostazol is contraindicated in heart failure, so excess exposure is of concern in patients with cardiac disease.
What this interaction means in plain words
Cilostazol 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.
Cilostazol belongs to Cardiovascular; Itraconazole belongs to Anti Fungals.
Why it happens
Itraconazole inhibits CYP3A4-mediated metabolism of cilostazol and its active metabolites.
What to do
Reduce the cilostazol dose to 50 mg twice daily during itraconazole therapy. Monitor heart rate and tolerability.
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 Itraconazole
- Alfuzosin + Itraconazole Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Avanafil + Itraconazole Contraindicated
- Conivaptan + Itraconazole Contraindicated
- Dihydroergotamine intranasal + Itraconazole Contraindicated
- Dihydroergotamine + Itraconazole Contraindicated
Other interactions of Cilostazol
Frequently asked questions
Can I take Cilostazol with Itraconazole?
MediHelp rates the interaction as major. Cilostazol 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 increases cilostazol exposure, which can cause headache, tachycardia, palpitations and diarrhoea. Cilostazol is contraindicated in heart failure, so excess exposure is of concern in patients with cardiac disease.
How serious is the interaction between Cilostazol 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: Reduce the cilostazol dose to 50 mg twice daily during itraconazole therapy. Monitor heart rate and tolerability.
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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