Drug interactions
Fluconazole + Naloxegol
Severity: Major
Fluconazole and Naloxegol: 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
Fluconazole can increase naloxegol concentrations, raising the risk of opioid withdrawal-like symptoms such as abdominal pain, diarrhea and sweating. Naloxegol is a CYP3A4 substrate with exposure sensitive to inhibitors.
What this interaction means in plain words
Fluconazole and Naloxegol 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; Naloxegol belongs to Gastrointestinal Tract.
Why it happens
Fluconazole inhibits CYP3A4 metabolism of naloxegol, increasing its systemic exposure.
What to do
Avoid if possible; if needed, reduce naloxegol to 12.5 mg once daily and monitor for gastrointestinal adverse effects and opioid withdrawal symptoms.
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
- Domperidone + Fluconazole Contraindicated
- Dronedarone + Fluconazole Contraindicated
- Erythromycin + Fluconazole Contraindicated
Other interactions of Naloxegol
- Clarithromycin + Naloxegol Contraindicated
- Itraconazole + Naloxegol Contraindicated
- Ketoconazole + Naloxegol Contraindicated
- Naloxegol + Posaconazole Contraindicated
- Naloxegol + Voriconazole Contraindicated
- Bupropion-naltrexone + Naloxegol Major
Frequently asked questions
Can I take Fluconazole with Naloxegol?
MediHelp rates the interaction as major. Fluconazole and Naloxegol 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 can increase naloxegol concentrations, raising the risk of opioid withdrawal-like symptoms such as abdominal pain, diarrhea and sweating. Naloxegol is a CYP3A4 substrate with exposure sensitive to inhibitors.
How serious is the interaction between Fluconazole and Naloxegol?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid if possible; if needed, reduce naloxegol to 12.5 mg once daily and monitor for gastrointestinal adverse effects and opioid withdrawal symptoms.
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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