Drug interactions
Cobimetinib + Itraconazole
Severity: Major
Cobimetinib 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 markedly increases cobimetinib exposure, raising the risk of serious adverse effects such as hemorrhage, rhabdomyolysis, cardiomyopathy and severe skin toxicity.
What this interaction means in plain words
Cobimetinib 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.
Cobimetinib belongs to Oncology; Itraconazole belongs to Anti Fungals.
Why it happens
Itraconazole strongly inhibits CYP3A4, the main metabolic pathway for cobimetinib.
What to do
Avoid the combination and use an alternative antifungal. If a strong inhibitor is unavoidable, use a reduced cobimetinib dose per labeling and monitor 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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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 Cobimetinib
- Cobimetinib + Efavirenz Contraindicated
- Cobimetinib + Posaconazole Contraindicated
- Amobarbital + Cobimetinib Major
- Apalutamide + Cobimetinib Major
- Aprepitant + Cobimetinib Major
- Bosentan + Cobimetinib Major
Frequently asked questions
Can I take Cobimetinib with Itraconazole?
MediHelp rates the interaction as major. Cobimetinib 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 markedly increases cobimetinib exposure, raising the risk of serious adverse effects such as hemorrhage, rhabdomyolysis, cardiomyopathy and severe skin toxicity.
How serious is the interaction between Cobimetinib 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: Avoid the combination and use an alternative antifungal. If a strong inhibitor is unavoidable, use a reduced cobimetinib dose per labeling and monitor 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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