Drug interactions
Fluconazole + Irinotecan liposomal
Severity: Moderate
Fluconazole and Irinotecan liposomal: 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
Irinotecan is converted to its active metabolite SN-38 and is also cleared via CYP3A4 into inactive metabolites. Strong CYP3A4 inhibitors raise SN-38 exposure and toxicity in some reports, and fluconazole as a moderate inhibitor may increase the risk of severe neutropenia and diarrhea.
What this interaction means in plain words
Fluconazole and Irinotecan liposomal 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.
Why it happens
Fluconazole inhibits CYP3A4, altering irinotecan metabolism and potentially increasing exposure to irinotecan and SN-38.
What to do
Monitor blood counts and for diarrhea closely. Consider an alternative antifungal if a strong interaction is a concern.
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
- Dronedarone + Fluconazole Contraindicated
- Erythromycin + Fluconazole Contraindicated
- Flibanserin + Fluconazole Contraindicated
Frequently asked questions
Can I take Fluconazole with Irinotecan liposomal?
MediHelp rates the interaction as moderate. Fluconazole and Irinotecan liposomal 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. Irinotecan is converted to its active metabolite SN-38 and is also cleared via CYP3A4 into inactive metabolites. Strong CYP3A4 inhibitors raise SN-38 exposure and toxicity in some reports, and fluconazole as a moderate inhibitor may increase the risk of severe neutropenia and diarrhea.
How serious is the interaction between Fluconazole and Irinotecan liposomal?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood counts and for diarrhea closely. Consider an alternative antifungal if a strong interaction is a concern.
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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