Drug interactions
Ibrutinib + Posaconazole
Severity: Major
Ibrutinib and Posaconazole: 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
Ibrutinib is extensively metabolized by CYP3A4, and posaconazole greatly increases its exposure. This raises the risk of bleeding, arrhythmias such as atrial fibrillation, infection and cytopenias.
What this interaction means in plain words
Ibrutinib and Posaconazole 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.
Ibrutinib belongs to Oncology; Posaconazole belongs to Anti Fungals.
Why it happens
Posaconazole strongly inhibits CYP3A4, markedly reducing ibrutinib first-pass and systemic clearance.
What to do
Reduce the ibrutinib dose according to labeling for the posaconazole dose and formulation, and monitor for bleeding and cardiac toxicity. Resume the usual ibrutinib dose after posaconazole is stopped.
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 Posaconazole
- Artemether + Posaconazole Contraindicated
- Avanafil + Posaconazole Contraindicated
- Cobimetinib + Posaconazole Contraindicated
- Conivaptan + Posaconazole Contraindicated
- Dihydroergotamine intranasal + Posaconazole Contraindicated
- Dihydroergotamine + Posaconazole Contraindicated
Other interactions of Ibrutinib
- Abciximab + Ibrutinib Major
- Acetylsalicylic acid + Ibrutinib Major
- Alteplase + Ibrutinib Major
- Amobarbital + Ibrutinib Major
- Apalutamide + Ibrutinib Major
- Apixaban + Ibrutinib Major
Frequently asked questions
Can I take Ibrutinib with Posaconazole?
MediHelp rates the interaction as major. Ibrutinib and Posaconazole 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. Ibrutinib is extensively metabolized by CYP3A4, and posaconazole greatly increases its exposure. This raises the risk of bleeding, arrhythmias such as atrial fibrillation, infection and cytopenias.
How serious is the interaction between Ibrutinib and Posaconazole?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce the ibrutinib dose according to labeling for the posaconazole dose and formulation, and monitor for bleeding and cardiac toxicity. Resume the usual ibrutinib dose after posaconazole is stopped.
What other medicines interact with Posaconazole?
MediHelp also lists interactions of Posaconazole with, for example, Artemether, Avanafil, Cobimetinib. The full list is on the Posaconazole page.
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