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Drug interactions

Isavuconazonium + Itraconazole

Severity: Major

Isavuconazonium and Itraconazole: 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

Itraconazole may raise exposure to isavuconazole, the active moiety, because it is a CYP3A4 substrate. Overlapping azole use also adds toxicity such as hepatotoxicity and QT shortening, with no clear benefit.

What this interaction means in plain words

Isavuconazonium 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.

Isavuconazonium belongs to Anti Fungals; Itraconazole belongs to Anti Fungals.

Evidence level: Low

Why it happens

Strong CYP3A4 inhibition by itraconazole reduces isavuconazole clearance.

What to do

Avoid concurrent use of two azoles. If switching, monitor liver tests and ECG.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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References

Frequently asked questions

Can I take Isavuconazonium with Itraconazole?

MediHelp rates the interaction as major. Isavuconazonium 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. Itraconazole may raise exposure to isavuconazole, the active moiety, because it is a CYP3A4 substrate. Overlapping azole use also adds toxicity such as hepatotoxicity and QT shortening, with no clear benefit.

How serious is the interaction between Isavuconazonium 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 concurrent use of two azoles. If switching, monitor liver tests and ECG.

What other medicines interact with Itraconazole?

MediHelp also lists interactions of Itraconazole with, for example, Alfuzosin, Alprazolam, Avanafil. The full list is on the Itraconazole page.

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