Drug interactions
Irinotecan liposomal + Posaconazole
Severity: Major
Irinotecan liposomal and Posaconazole: major interaction.
Last updated Sources: US FDA label
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
Posaconazole can increase exposure to irinotecan and its active metabolite SN-38 by inhibiting CYP3A4. This increases the risk of severe neutropenia and diarrhea.
What this interaction means in plain words
Irinotecan liposomal 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.
Why it happens
Strong CYP3A4 inhibition diverts irinotecan metabolism away from inactive oxidative metabolites, increasing active SN-38 exposure.
What to do
Avoid concurrent use and consider an alternative antifungal, and stop strong CYP3A4 inhibitors before starting irinotecan where feasible. If given together, monitor blood counts and diarrhea closely.
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 Posaconazole
- Artemether + Posaconazole Contraindicated
- Avanafil + Posaconazole Contraindicated
- Cobimetinib + Posaconazole Contraindicated
- Conivaptan + Posaconazole Contraindicated
- Dihydroergotamine intranasal + Posaconazole Contraindicated
- Dihydroergotamine + Posaconazole Contraindicated
Frequently asked questions
Can I take Irinotecan liposomal with Posaconazole?
MediHelp rates the interaction as major. Irinotecan liposomal 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. Posaconazole can increase exposure to irinotecan and its active metabolite SN-38 by inhibiting CYP3A4. This increases the risk of severe neutropenia and diarrhea.
How serious is the interaction between Irinotecan liposomal 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: Avoid concurrent use and consider an alternative antifungal, and stop strong CYP3A4 inhibitors before starting irinotecan where feasible. If given together, monitor blood counts and diarrhea closely.
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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