Drug interactions
Fluconazole + Hydroxychloroquine
Severity: Major
Fluconazole and Hydroxychloroquine: 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
Both drugs can prolong the QT interval, and fluconazole carries a risk of torsades de pointes, particularly at higher doses. Combined use increases arrhythmia risk, especially with electrolyte disturbance or cardiac disease.
What this interaction means in plain words
Fluconazole and Hydroxychloroquine 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; Hydroxychloroquine belongs to Musculoskeletal.
Why it happens
Additive potassium channel blockade; fluconazole may also inhibit CYP-mediated metabolism and raise hydroxychloroquine exposure.
What to do
Use an alternative antifungal where possible. If combined, obtain a baseline ECG, correct potassium and magnesium and monitor the QTc.
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 Hydroxychloroquine
- Arsenic trioxide + Hydroxychloroquine Contraindicated
- Cisapride + Hydroxychloroquine Contraindicated
- Dronedarone + Hydroxychloroquine Contraindicated
- Hydroxychloroquine + Pimozide Contraindicated
- Hydroxychloroquine + Thioridazine Contraindicated
- Hydroxychloroquine + Vandetanib Contraindicated
Other interactions of Fluconazole
- Dihydroergotamine intranasal + Fluconazole Contraindicated
- Dihydroergotamine + Fluconazole Contraindicated
- Dofetilide + Fluconazole Contraindicated
- Domperidone + Fluconazole Contraindicated
- Dronedarone + Fluconazole Contraindicated
- Erythromycin + Fluconazole Contraindicated
Frequently asked questions
Can I take Fluconazole with Hydroxychloroquine?
MediHelp rates the interaction as major. Fluconazole and Hydroxychloroquine 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. Both drugs can prolong the QT interval, and fluconazole carries a risk of torsades de pointes, particularly at higher doses. Combined use increases arrhythmia risk, especially with electrolyte disturbance or cardiac disease.
How serious is the interaction between Fluconazole and Hydroxychloroquine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use an alternative antifungal where possible. If combined, obtain a baseline ECG, correct potassium and magnesium and monitor the QTc.
What other medicines interact with Hydroxychloroquine?
MediHelp also lists interactions of Hydroxychloroquine with, for example, Arsenic trioxide, Cisapride, Dronedarone. The full list is on the Hydroxychloroquine page.
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