Drug interactions
Fluconazole + Vincristine
Severity: Moderate
Fluconazole and Vincristine: moderate 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 raise vincristine exposure and increase the risk of neurotoxicity such as peripheral neuropathy, constipation or ileus. The effect is generally smaller than with itraconazole or other strong inhibitors, but vincristine has a narrow therapeutic margin.
What this interaction means in plain words
Fluconazole and Vincristine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Fluconazole belongs to Anti Fungals; Vincristine belongs to Oncology.
Why it happens
Fluconazole inhibits CYP3A4-mediated metabolism of vincristine, and may also affect P-glycoprotein handling.
What to do
Monitor for neuropathy and constipation and consider an alternative antifungal if prolonged co-therapy is needed. Reduce the vincristine dose if neurotoxicity develops.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Vincristine
- Adenovirus types 4 and 7 live + Vincristine Contraindicated
- Apalutamide + Vincristine Major
- Atazanavir + Vincristine Major
- Ceritinib + Vincristine Major
- Chloramphenicol + Vincristine Major
- Clarithromycin + Vincristine Major
Frequently asked questions
Can I take Fluconazole with Vincristine?
MediHelp rates the interaction as moderate. Fluconazole and Vincristine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Fluconazole may raise vincristine exposure and increase the risk of neurotoxicity such as peripheral neuropathy, constipation or ileus. The effect is generally smaller than with itraconazole or other strong inhibitors, but vincristine has a narrow therapeutic margin.
How serious is the interaction between Fluconazole and Vincristine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for neuropathy and constipation and consider an alternative antifungal if prolonged co-therapy is needed. Reduce the vincristine dose if neurotoxicity develops.
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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