Drug interactions
Fluconazole + Nirogacestat
Severity: Major
Fluconazole and Nirogacestat: 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
Fluconazole is expected to raise nirogacestat concentrations, which may increase adverse effects such as diarrhea, hepatotoxicity and ovarian toxicity. Nirogacestat is primarily cleared by CYP3A4.
What this interaction means in plain words
Fluconazole and Nirogacestat 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; Nirogacestat belongs to Oncology.
Why it happens
Fluconazole inhibits CYP3A4 metabolism of nirogacestat, increasing exposure.
What to do
Avoid the combination; if a moderate CYP3A inhibitor is required, follow labeling for nirogacestat dose reduction and monitor liver tests and gastrointestinal tolerability.
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 Nirogacestat
Frequently asked questions
Can I take Fluconazole with Nirogacestat?
MediHelp rates the interaction as major. Fluconazole and Nirogacestat 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 is expected to raise nirogacestat concentrations, which may increase adverse effects such as diarrhea, hepatotoxicity and ovarian toxicity. Nirogacestat is primarily cleared by CYP3A4.
How serious is the interaction between Fluconazole and Nirogacestat?
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; if a moderate CYP3A inhibitor is required, follow labeling for nirogacestat dose reduction and monitor liver tests and gastrointestinal tolerability.
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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