Drug interactions
Fluconazole + Ixabepilone
Severity: Major
Fluconazole and Ixabepilone: major 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
Ixabepilone is extensively metabolized by CYP3A4, and strong inhibitors raise its exposure considerably. Fluconazole, a moderate inhibitor, may increase ixabepilone levels and the risk of neuropathy and myelosuppression.
What this interaction means in plain words
Fluconazole and Ixabepilone 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.
Why it happens
Fluconazole inhibits CYP3A4, decreasing ixabepilone clearance.
What to do
Prefer an antifungal that does not inhibit CYP3A4 during ixabepilone therapy. If unavoidable, monitor blood counts and neuropathy closely and consider reducing the ixabepilone 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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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 Ixabepilone?
MediHelp rates the interaction as major. Fluconazole and Ixabepilone 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. Ixabepilone is extensively metabolized by CYP3A4, and strong inhibitors raise its exposure considerably. Fluconazole, a moderate inhibitor, may increase ixabepilone levels and the risk of neuropathy and myelosuppression.
How serious is the interaction between Fluconazole and Ixabepilone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer an antifungal that does not inhibit CYP3A4 during ixabepilone therapy. If unavoidable, monitor blood counts and neuropathy closely and consider reducing the ixabepilone 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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