Drug interactions
Fluconazole + Romidepsin
Severity: Major
Fluconazole and Romidepsin: major interaction.
Last updated Sources: Health Canada product monograph
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 can increase romidepsin exposure, and both drugs can prolong the QT interval. This may increase the risk of toxicity including arrhythmia.
What this interaction means in plain words
Fluconazole and Romidepsin 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
Fluconazole inhibits CYP3A4, reducing romidepsin metabolism, and both agents have additive QT-prolonging effects.
What to do
Avoid if possible or monitor ECG and electrolytes (potassium, magnesium) closely. Watch for romidepsin toxicity such as myelosuppression and nausea.
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
- Domperidone + Fluconazole Contraindicated
- Dronedarone + Fluconazole Contraindicated
- Erythromycin + Fluconazole Contraindicated
Frequently asked questions
Can I take Fluconazole with Romidepsin?
MediHelp rates the interaction as major. Fluconazole and Romidepsin 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 can increase romidepsin exposure, and both drugs can prolong the QT interval. This may increase the risk of toxicity including arrhythmia.
How serious is the interaction between Fluconazole and Romidepsin?
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 or monitor ECG and electrolytes (potassium, magnesium) closely. Watch for romidepsin toxicity such as myelosuppression and nausea.
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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