Drug interactions
Fluconazole + Irinotecan
Severity: Moderate
Fluconazole and Irinotecan: 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 and its active metabolite SN-38 are affected by CYP3A4 metabolism, and CYP3A4 inhibition can increase exposure to the parent drug and alter SN-38 levels. This may increase the risk of severe diarrhea and neutropenia.
What this interaction means in plain words
Fluconazole and Irinotecan 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; Irinotecan belongs to Oncology.
Why it happens
Fluconazole inhibits CYP3A4, reducing irinotecan clearance by oxidative pathways.
What to do
Monitor for diarrhea, neutropenia, and other irinotecan toxicity during co-therapy. Consider a non-azole antifungal if toxicity occurs.
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 Irinotecan
- Clozapine + Irinotecan Contraindicated
- Irinotecan + Sacituzumab govitecan Contraindicated
- Adenovirus types 4 and 7 live + Irinotecan Major
- Apalutamide + Irinotecan Major
- Atazanavir + Irinotecan Major
- Carbamazepine + Irinotecan Major
Frequently asked questions
Can I take Fluconazole with Irinotecan?
MediHelp rates the interaction as moderate. Fluconazole and Irinotecan 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 and its active metabolite SN-38 are affected by CYP3A4 metabolism, and CYP3A4 inhibition can increase exposure to the parent drug and alter SN-38 levels. This may increase the risk of severe diarrhea and neutropenia.
How serious is the interaction between Fluconazole and Irinotecan?
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 for diarrhea, neutropenia, and other irinotecan toxicity during co-therapy. Consider a non-azole antifungal if toxicity occurs.
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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