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Drug interactions

Fluconazole + Ospemifene

Severity: Major

Fluconazole and Ospemifene: 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 inhibits several enzymes involved in ospemifene clearance and increases its exposure. Labeling advises avoiding fluconazole, which is a dual CYP3A4 and CYP2C9 inhibitor, because of the higher exposure and the risk of adverse effects including thromboembolic events and endometrial effects.

What this interaction means in plain words

Fluconazole and Ospemifene 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; Ospemifene belongs to Endocrine.

Evidence level: Moderate

Why it happens

Fluconazole inhibits CYP3A4, CYP2C9 and CYP2C19, which metabolize ospemifene.

What to do

Avoid concomitant use with fluconazole where possible. If an antifungal is needed, use a short course of an agent that does not inhibit these enzymes or withhold ospemifene.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Fluconazole with Ospemifene?

MediHelp rates the interaction as major. Fluconazole and Ospemifene 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 inhibits several enzymes involved in ospemifene clearance and increases its exposure. Labeling advises avoiding fluconazole, which is a dual CYP3A4 and CYP2C9 inhibitor, because of the higher exposure and the risk of adverse effects including thromboembolic events and endometrial effects.

How serious is the interaction between Fluconazole and Ospemifene?

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 concomitant use with fluconazole where possible. If an antifungal is needed, use a short course of an agent that does not inhibit these enzymes or withhold ospemifene.

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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