Drug interactions
Fluconazole + Protriptyline
Severity: Major
Fluconazole and Protriptyline: 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
Both drugs can prolong the QT interval, and fluconazole may also raise tricyclic antidepressant levels. This increases the risk of arrhythmia and anticholinergic toxicity.
What this interaction means in plain words
Fluconazole and Protriptyline 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.
Why it happens
Additive QT prolongation plus fluconazole inhibition of CYP2C19 and CYP3A4, reducing tricyclic clearance.
What to do
Avoid if possible. If combined, obtain an ECG, monitor for anticholinergic and cardiac toxicity, and consider reducing the protriptyline 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
Frequently asked questions
Can I take Fluconazole with Protriptyline?
MediHelp rates the interaction as major. Fluconazole and Protriptyline 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. Both drugs can prolong the QT interval, and fluconazole may also raise tricyclic antidepressant levels. This increases the risk of arrhythmia and anticholinergic toxicity.
How serious is the interaction between Fluconazole and Protriptyline?
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 if possible. If combined, obtain an ECG, monitor for anticholinergic and cardiac toxicity, and consider reducing the protriptyline 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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