Drug interactions
Fluconazole + Quinine
Severity: Major
Fluconazole and Quinine: 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
Quinine markedly prolongs the QT interval and can cause torsades de pointes. Fluconazole adds QT risk and, by inhibiting CYP3A4, may increase quinine concentrations.
What this interaction means in plain words
Fluconazole and Quinine 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; Quinine belongs to Anti Parasitic.
Why it happens
Additive QT prolongation, plus CYP3A4 inhibition by fluconazole raising quinine exposure.
What to do
Avoid the combination when alternatives exist. If needed, obtain ECG and electrolytes at baseline and monitor for arrhythmia symptoms.
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 Quinine
- Arsenic trioxide + Quinine Contraindicated
- Dofetilide + Quinine Contraindicated
- Dronedarone + Quinine Contraindicated
- Ibutilide + Quinine Contraindicated
- Mefloquine + Quinine Contraindicated
- Nilotinib + Quinine Contraindicated
Frequently asked questions
Can I take Fluconazole with Quinine?
MediHelp rates the interaction as major. Fluconazole and Quinine 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. Quinine markedly prolongs the QT interval and can cause torsades de pointes. Fluconazole adds QT risk and, by inhibiting CYP3A4, may increase quinine concentrations.
How serious is the interaction between Fluconazole and Quinine?
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 when alternatives exist. If needed, obtain ECG and electrolytes at baseline and monitor for arrhythmia symptoms.
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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