Drug interactions
Fluconazole + Propafenone
Severity: Major
Fluconazole and Propafenone: 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 may increase propafenone levels by inhibiting CYP3A4 and CYP2D6 pathways, raising the risk of proarrhythmia, QT prolongation, bradycardia and conduction disturbances. Fluconazole itself can prolong QT.
What this interaction means in plain words
Fluconazole and Propafenone 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; Propafenone belongs to Cardiovascular.
Why it happens
Fluconazole inhibits CYP3A4 and CYP2D6 metabolism of propafenone, with additive QT effects.
What to do
Avoid the combination if possible, particularly in poor CYP2D6 metabolizers. If used, monitor ECG (QRS and QTc) and consider reducing the propafenone dose.
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 Propafenone
- Dofetilide + Propafenone Contraindicated
- Dronedarone + Propafenone Contraindicated
- Nilotinib + Propafenone Contraindicated
- Nirmatrelvir / ritonavir + Propafenone Contraindicated
- Nirmatrelvir + Propafenone Contraindicated
- Pimozide + Propafenone Contraindicated
Frequently asked questions
Can I take Fluconazole with Propafenone?
MediHelp rates the interaction as major. Fluconazole and Propafenone 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 may increase propafenone levels by inhibiting CYP3A4 and CYP2D6 pathways, raising the risk of proarrhythmia, QT prolongation, bradycardia and conduction disturbances. Fluconazole itself can prolong QT.
How serious is the interaction between Fluconazole and Propafenone?
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 possible, particularly in poor CYP2D6 metabolizers. If used, monitor ECG (QRS and QTc) and consider reducing the propafenone dose.
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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