Drug interactions
Dabigatran + Itraconazole
Severity: Major
Dabigatran 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
Dabigatran etexilate is a P-glycoprotein substrate, and itraconazole inhibits P-gp, raising dabigatran levels and bleeding risk. The effect is greater with renal impairment.
What this interaction means in plain words
Dabigatran 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.
Why it happens
Itraconazole inhibits intestinal and renal P-glycoprotein efflux, increasing dabigatran absorption and exposure.
What to do
Avoid the combination in patients with significant renal impairment (CrCl below 30 mL/min for atrial fibrillation, below 50 mL/min for VTE treatment). Otherwise monitor for bleeding and consider an alternative antifungal or anticoagulant.
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
Frequently asked questions
Can I take Dabigatran with Itraconazole?
MediHelp rates the interaction as major. Dabigatran 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. Dabigatran etexilate is a P-glycoprotein substrate, and itraconazole inhibits P-gp, raising dabigatran levels and bleeding risk. The effect is greater with renal impairment.
How serious is the interaction between Dabigatran 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 in patients with significant renal impairment (CrCl below 30 mL/min for atrial fibrillation, below 50 mL/min for VTE treatment). Otherwise monitor for bleeding and consider an alternative antifungal or anticoagulant.
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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