Drug interactions
Fluconazole + Nilotinib
Severity: Major
Fluconazole and Nilotinib: 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
Nilotinib carries a boxed warning for QT prolongation and sudden death, and fluconazole adds further QT risk. Fluconazole also inhibits CYP3A4, which can raise nilotinib concentrations and amplify the QT effect.
What this interaction means in plain words
Fluconazole and Nilotinib 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; Nilotinib belongs to Oncology.
Why it happens
Additive QT prolongation combined with moderate CYP3A4 inhibition by fluconazole that reduces nilotinib clearance.
What to do
Avoid the combination where possible and use a non-interacting antifungal. If unavoidable, monitor ECG and electrolytes closely and consider reducing the nilotinib dose per labeling.
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 Nilotinib
- Amiodarone + Nilotinib Contraindicated
- Arsenic trioxide + Nilotinib Contraindicated
- Disopyramide + Nilotinib Contraindicated
- Dofetilide + Nilotinib Contraindicated
- Dronedarone + Nilotinib Contraindicated
- Droperidol + Nilotinib Contraindicated
Frequently asked questions
Can I take Fluconazole with Nilotinib?
MediHelp rates the interaction as major. Fluconazole and Nilotinib 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. Nilotinib carries a boxed warning for QT prolongation and sudden death, and fluconazole adds further QT risk. Fluconazole also inhibits CYP3A4, which can raise nilotinib concentrations and amplify the QT effect.
How serious is the interaction between Fluconazole and Nilotinib?
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 the combination where possible and use a non-interacting antifungal. If unavoidable, monitor ECG and electrolytes closely and consider reducing the nilotinib dose per labeling.
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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