Drug interactions
Fluconazole + Ifosfamide
Severity: Moderate
Fluconazole and Ifosfamide: 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
Ifosfamide is a prodrug activated mainly by CYP3A4 and CYP2B6, and also converted by CYP3A4 to neurotoxic chloroacetaldehyde. Fluconazole inhibition may reduce activation, potentially lowering efficacy, while shifting metabolism toward the toxic pathway, which may increase neurotoxicity and nephrotoxicity.
What this interaction means in plain words
Fluconazole and Ifosfamide 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.
Fluconazole belongs to Anti Fungals; Ifosfamide belongs to Oncology.
Why it happens
Fluconazole inhibits CYP3A4 (and CYP2C9/2C19), altering ifosfamide bioactivation and metabolite formation.
What to do
Where feasible, use an antifungal with less CYP3A4 inhibition during ifosfamide cycles. Monitor for neurotoxicity, renal function, and therapeutic response.
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 Fluconazole
- Dihydroergotamine intranasal + Fluconazole Contraindicated
- Dihydroergotamine + Fluconazole Contraindicated
- Dofetilide + Fluconazole Contraindicated
- Domperidone + Fluconazole Contraindicated
- Dronedarone + Fluconazole Contraindicated
- Erythromycin + Fluconazole Contraindicated
Other interactions of Ifosfamide
- Adenovirus types 4 and 7 live + Ifosfamide Contraindicated
- Ifosfamide + Measles mumps and rubella vaccine Contraindicated
- Ifosfamide + Measles mumps and rubella vaccine live Contraindicated
- Ifosfamide + Measles mumps rubella and varicella vaccine live Contraindicated
- Ifosfamide + Measles vaccine Contraindicated
- Ifosfamide + Rotavirus oral vaccine live Contraindicated
Frequently asked questions
Can I take Fluconazole with Ifosfamide?
MediHelp rates the interaction as moderate. Fluconazole and Ifosfamide 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. Ifosfamide is a prodrug activated mainly by CYP3A4 and CYP2B6, and also converted by CYP3A4 to neurotoxic chloroacetaldehyde. Fluconazole inhibition may reduce activation, potentially lowering efficacy, while shifting metabolism toward the toxic pathway, which may increase neurotoxicity and nephrotoxicity.
How serious is the interaction between Fluconazole and Ifosfamide?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Where feasible, use an antifungal with less CYP3A4 inhibition during ifosfamide cycles. Monitor for neurotoxicity, renal function, and therapeutic response.
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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