Drug interactions
Fluconazole + Hydroxyzine
Severity: Major
Fluconazole and Hydroxyzine: major interaction.
Last updated Sources: Health Canada product monograph
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 are associated with QT prolongation and torsades de pointes. Fluconazole also inhibits CYP3A4, which may raise hydroxyzine exposure. Together they increase the risk of serious ventricular arrhythmia.
What this interaction means in plain words
Fluconazole and Hydroxyzine 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; Hydroxyzine belongs to Respiratory.
Why it happens
Additive QT prolongation, with possible CYP3A4 inhibition by fluconazole increasing hydroxyzine levels.
What to do
Avoid the combination where possible, and use a non-QT-prolonging antifungal or antihistamine. If co-administration is necessary, check an ECG and electrolytes and use the lowest effective hydroxyzine dose.
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 Fluconazole
- Dihydroergotamine intranasal + Fluconazole Contraindicated
- Dihydroergotamine + Fluconazole Contraindicated
- Dofetilide + Fluconazole Contraindicated
- Dronedarone + Fluconazole Contraindicated
- Erythromycin + Fluconazole Contraindicated
- Flibanserin + Fluconazole Contraindicated
Other interactions of Hydroxyzine
- Droperidol + Hydroxyzine Contraindicated
- Hydroxyzine + Pimozide Contraindicated
- Hydroxyzine + Thioridazine Contraindicated
- Hydroxyzine + Vandetanib Contraindicated
- Alfentanil + Hydroxyzine Major
- Amiodarone + Hydroxyzine Major
Frequently asked questions
Can I take Fluconazole with Hydroxyzine?
MediHelp rates the interaction as major. Fluconazole and Hydroxyzine 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 are associated with QT prolongation and torsades de pointes. Fluconazole also inhibits CYP3A4, which may raise hydroxyzine exposure. Together they increase the risk of serious ventricular arrhythmia.
How serious is the interaction between Fluconazole and Hydroxyzine?
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 where possible, and use a non-QT-prolonging antifungal or antihistamine. If co-administration is necessary, check an ECG and electrolytes and use the lowest effective hydroxyzine dose.
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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