Drug interactions
Isavuconazonium + Lurasidone
Severity: Major
Isavuconazonium and Lurasidone: 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
Isavuconazole, the active moiety of isavuconazonium, is a moderate CYP3A4 inhibitor and raises lurasidone exposure, which increases the risk of lurasidone adverse effects such as sedation, akathisia and parkinsonism. Lurasidone is not expected to meaningfully change isavuconazole levels, so the legacy direction appears reversed.
What this interaction means in plain words
Isavuconazonium and Lurasidone 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; Lurasidone belongs to Central Nervous System.
Why it happens
Isavuconazole inhibits CYP3A4, reducing the metabolism of lurasidone, a sensitive CYP3A4 substrate.
What to do
Lurasidone labeling advises a reduced dose with moderate CYP3A4 inhibitors (start at a lower dose, with a lower maximum). Monitor for adverse effects and adjust the dose accordingly.
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 Lurasidone
- Apalutamide + Lurasidone Contraindicated
- Atazanavir + Lurasidone Contraindicated
- Carbamazepine + Lurasidone Contraindicated
- Clarithromycin + Lurasidone Contraindicated
- Cobicistat + Lurasidone Contraindicated
- Conivaptan + Lurasidone Contraindicated
Other interactions of Isavuconazonium
- Amobarbital + Isavuconazonium Contraindicated
- Apalutamide + Isavuconazonium Contraindicated
- Carbamazepine + Isavuconazonium Contraindicated
- Cisapride + Isavuconazonium Contraindicated
- Efavirenz + Isavuconazonium Contraindicated
- Enzalutamide + Isavuconazonium Contraindicated
Frequently asked questions
Can I take Isavuconazonium with Lurasidone?
MediHelp rates the interaction as major. Isavuconazonium and Lurasidone 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. Isavuconazole, the active moiety of isavuconazonium, is a moderate CYP3A4 inhibitor and raises lurasidone exposure, which increases the risk of lurasidone adverse effects such as sedation, akathisia and parkinsonism. Lurasidone is not expected to meaningfully change isavuconazole levels, so the legacy direction appears reversed.
How serious is the interaction between Isavuconazonium and Lurasidone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Lurasidone labeling advises a reduced dose with moderate CYP3A4 inhibitors (start at a lower dose, with a lower maximum). Monitor for adverse effects and adjust the dose accordingly.
What other medicines interact with Lurasidone?
MediHelp also lists interactions of Lurasidone with, for example, Apalutamide, Atazanavir, Carbamazepine. The full list is on the Lurasidone page.
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