Drug interactions
Hydroxychloroquine + Itraconazole
Severity: Major
Hydroxychloroquine and Itraconazole: 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 are associated with QT prolongation, and itraconazole is also a strong CYP3A4 and P-gp inhibitor that may raise hydroxychloroquine exposure. Together they increase the risk of torsades de pointes.
What this interaction means in plain words
Hydroxychloroquine and Itraconazole 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.
Hydroxychloroquine belongs to Musculoskeletal; Itraconazole belongs to Anti Fungals.
Why it happens
Additive hERG-mediated QT prolongation, with possible pharmacokinetic increase in hydroxychloroquine levels through CYP3A4 inhibition.
What to do
Avoid if an alternative antifungal can be used; otherwise obtain a baseline ECG, correct electrolytes and monitor QTc during therapy.
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 Hydroxychloroquine
- Arsenic trioxide + Hydroxychloroquine Contraindicated
- Cisapride + Hydroxychloroquine Contraindicated
- Dronedarone + Hydroxychloroquine Contraindicated
- Hydroxychloroquine + Pimozide Contraindicated
- Hydroxychloroquine + Thioridazine Contraindicated
- Hydroxychloroquine + Vandetanib Contraindicated
Other interactions of Itraconazole
- Alfuzosin + Itraconazole Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Avanafil + Itraconazole Contraindicated
- Conivaptan + Itraconazole Contraindicated
- Dihydroergotamine intranasal + Itraconazole Contraindicated
- Dihydroergotamine + Itraconazole Contraindicated
Frequently asked questions
Can I take Hydroxychloroquine with Itraconazole?
MediHelp rates the interaction as major. Hydroxychloroquine and Itraconazole 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 are associated with QT prolongation, and itraconazole is also a strong CYP3A4 and P-gp inhibitor that may raise hydroxychloroquine exposure. Together they increase the risk of torsades de pointes.
How serious is the interaction between Hydroxychloroquine and Itraconazole?
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 an alternative antifungal can be used; otherwise obtain a baseline ECG, correct electrolytes and monitor QTc during therapy.
What other medicines interact with Hydroxychloroquine?
MediHelp also lists interactions of Hydroxychloroquine with, for example, Arsenic trioxide, Cisapride, Dronedarone. The full list is on the Hydroxychloroquine page.
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