Drug interactions
Eplerenone + Posaconazole
Severity: Contraindicated
Eplerenone and Posaconazole: contraindicated interaction.
Last updated Sources: UK SmPC
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
Strong CYP3A4 inhibitors markedly raise eplerenone exposure, increasing the risk of hyperkalemia and associated arrhythmias. Eplerenone labeling contraindicates its use with strong CYP3A4 inhibitors.
What this interaction means in plain words
Eplerenone and Posaconazole are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Eplerenone belongs to Cardiovascular; Posaconazole belongs to Anti Fungals.
Why it happens
Inhibition of CYP3A4 greatly reduces the metabolic clearance of eplerenone.
What to do
Do not combine; use an alternative antifungal or an alternative mineralocorticoid antagonist, and check potassium if exposure has occurred.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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References
- Noxafil 100 mg Gastro-resistant Tablets - SmPC sections 4.3/4.5 (class statement: CYP3A4 substrates; "Posaconazole is a potent inhibitor of CYP3A4. Co-administration of posaconazole with CYP3A4 substrates may result in large increases in exposure to CYP3A4 subst") — electronic medicines compendium (UK SmPC)
Other interactions of Posaconazole
- Artemether + Posaconazole Contraindicated
- Avanafil + Posaconazole Contraindicated
- Cobimetinib + Posaconazole Contraindicated
- Conivaptan + Posaconazole Contraindicated
- Dihydroergotamine intranasal + Posaconazole Contraindicated
- Dihydroergotamine + Posaconazole Contraindicated
Other interactions of Eplerenone
- Amiloride + Eplerenone Contraindicated
- Atazanavir + Eplerenone Contraindicated
- Clarithromycin + Eplerenone Contraindicated
- Cobicistat + Eplerenone Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Eplerenone Contraindicated
- Ensitrelvir + Eplerenone Contraindicated
Frequently asked questions
Can I take Eplerenone with Posaconazole?
MediHelp rates the interaction as contraindicated. Eplerenone and Posaconazole are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Strong CYP3A4 inhibitors markedly raise eplerenone exposure, increasing the risk of hyperkalemia and associated arrhythmias. Eplerenone labeling contraindicates its use with strong CYP3A4 inhibitors.
How serious is the interaction between Eplerenone and Posaconazole?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not combine; use an alternative antifungal or an alternative mineralocorticoid antagonist, and check potassium if exposure has occurred.
What other medicines interact with Posaconazole?
MediHelp also lists interactions of Posaconazole with, for example, Artemether, Avanafil, Cobimetinib. The full list is on the Posaconazole page.
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