Drug interactions
Fluconazole + Nevirapine
Severity: Moderate
Fluconazole and Nevirapine: 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
Fluconazole increases nevirapine concentrations, as nevirapine is metabolized by CYP3A4 and CYP2B6. Higher exposure raises the risk of hepatotoxicity and rash, and both drugs are hepatotoxic.
What this interaction means in plain words
Fluconazole and Nevirapine 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; Nevirapine belongs to Anti Virals.
Why it happens
Fluconazole inhibits CYP3A4 and CYP2C9, reducing nevirapine clearance, with additive hepatotoxic potential.
What to do
Monitor liver enzymes and for rash during co-therapy, especially in the first weeks. Stop nevirapine if significant hepatotoxicity or severe skin reaction develops.
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 Nevirapine
- Elbasvir / grazoprevir + Nevirapine Contraindicated
- Nevirapine + Ranolazine Contraindicated
- Nevirapine + St john's wort Contraindicated
- Abemaciclib + Nevirapine Major
- Acalabrutinib + Nevirapine Major
- Amobarbital + Nevirapine Major
Frequently asked questions
Can I take Fluconazole with Nevirapine?
MediHelp rates the interaction as moderate. Fluconazole and Nevirapine 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 increases nevirapine concentrations, as nevirapine is metabolized by CYP3A4 and CYP2B6. Higher exposure raises the risk of hepatotoxicity and rash, and both drugs are hepatotoxic.
How serious is the interaction between Fluconazole and Nevirapine?
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 liver enzymes and for rash during co-therapy, especially in the first weeks. Stop nevirapine if significant hepatotoxicity or severe skin reaction develops.
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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