Drug interactions
Doxepin + Itraconazole
Severity: Moderate
Doxepin and Itraconazole: moderate 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
Both drugs can prolong the QT interval, so combined use may increase the risk of torsades de pointes. Itraconazole may also modestly raise doxepin levels via CYP3A4 and CYP2C19 effects, adding to anticholinergic and sedative effects.
What this interaction means in plain words
Doxepin and Itraconazole can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Doxepin belongs to Dermatology; Itraconazole belongs to Anti Fungals.
Why it happens
Additive QTc prolongation, with possible metabolic inhibition raising doxepin exposure.
What to do
Check baseline ECG and electrolytes, and monitor QTc especially in patients with cardiac disease or other QT-prolonging drugs. Use the lowest effective doxepin dose.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Doxepin
- Doxepin + Isocarboxazid Contraindicated
- Doxepin + Phenelzine Contraindicated
- Doxepin + Procarbazine Contraindicated
- Doxepin + Safinamide Contraindicated
- Doxepin + Selegiline Contraindicated
- Doxepin + Tranylcypromine Contraindicated
Frequently asked questions
Can I take Doxepin with Itraconazole?
MediHelp rates the interaction as moderate. Doxepin and Itraconazole can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Both drugs can prolong the QT interval, so combined use may increase the risk of torsades de pointes. Itraconazole may also modestly raise doxepin levels via CYP3A4 and CYP2C19 effects, adding to anticholinergic and sedative effects.
How serious is the interaction between Doxepin and Itraconazole?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check baseline ECG and electrolytes, and monitor QTc especially in patients with cardiac disease or other QT-prolonging drugs. Use the lowest effective doxepin dose.
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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