Drug interactions
Fluconazole + Gepirone
Severity: Major
Fluconazole and Gepirone: 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
Fluconazole increases gepirone exposure through CYP3A4 inhibition, and both drugs can prolong the QT interval. The combination raises the risk of dose-related adverse effects and of arrhythmia such as torsades de pointes.
What this interaction means in plain words
Fluconazole and Gepirone 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.
Fluconazole belongs to Anti Fungals; Gepirone belongs to Central Nervous System.
Why it happens
CYP3A4 inhibition by fluconazole reduces gepirone clearance, and both drugs have additive QTc-prolonging effects.
What to do
Reduce the gepirone dose by half as labeled for moderate CYP3A4 inhibitors and obtain a baseline and follow-up ECG. Correct potassium and magnesium disturbances, or choose an alternative antifungal.
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 Fluconazole
- Dihydroergotamine intranasal + Fluconazole Contraindicated
- Dihydroergotamine + Fluconazole Contraindicated
- Dofetilide + Fluconazole Contraindicated
- Domperidone + Fluconazole Contraindicated
- Dronedarone + Fluconazole Contraindicated
- Erythromycin + Fluconazole Contraindicated
Other interactions of Gepirone
- Clarithromycin + Gepirone Contraindicated
- Gepirone + Isocarboxazid Contraindicated
- Gepirone + Itraconazole Contraindicated
- Gepirone + Ketoconazole Contraindicated
- Gepirone + Linezolid Contraindicated
- Gepirone + Phenelzine Contraindicated
Frequently asked questions
Can I take Fluconazole with Gepirone?
MediHelp rates the interaction as major. Fluconazole and Gepirone 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. Fluconazole increases gepirone exposure through CYP3A4 inhibition, and both drugs can prolong the QT interval. The combination raises the risk of dose-related adverse effects and of arrhythmia such as torsades de pointes.
How serious is the interaction between Fluconazole and Gepirone?
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 gepirone dose by half as labeled for moderate CYP3A4 inhibitors and obtain a baseline and follow-up ECG. Correct potassium and magnesium disturbances, or choose an alternative antifungal.
What other medicines interact with Fluconazole?
MediHelp also lists interactions of Fluconazole with, for example, Dihydroergotamine intranasal, Dihydroergotamine, Dofetilide. The full list is on the Fluconazole page.
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