Drug interactions
Fluconazole + Ivosidenib
Severity: Major
Fluconazole and Ivosidenib: major interaction.
Last updated Sources: EMA SmPC
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 prolong the QT interval, increasing arrhythmia risk. Fluconazole may also raise ivosidenib exposure through CYP3A4 inhibition, further increasing QT risk.
What this interaction means in plain words
Fluconazole and Ivosidenib 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; Ivosidenib belongs to Oncology.
Why it happens
Additive QT prolongation, with CYP3A4 inhibition increasing ivosidenib levels.
What to do
Use an alternative antifungal if possible. If unavoidable, reduce ivosidenib dose per labeling and monitor ECG and electrolytes.
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 Ivosidenib
- Alfuzosin + Ivosidenib Major
- Amiodarone + Ivosidenib Major
- Amisulpride + Ivosidenib Major
- Amitriptyline + Ivosidenib Major
- Amobarbital + Ivosidenib Major
- Anagrelide + Ivosidenib Major
Frequently asked questions
Can I take Fluconazole with Ivosidenib?
MediHelp rates the interaction as major. Fluconazole and Ivosidenib 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 prolong the QT interval, increasing arrhythmia risk. Fluconazole may also raise ivosidenib exposure through CYP3A4 inhibition, further increasing QT risk.
How serious is the interaction between Fluconazole and Ivosidenib?
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 if possible. If unavoidable, reduce ivosidenib dose per labeling and monitor ECG and electrolytes.
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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