Drug interactions
Isavuconazonium + Vinblastine
Severity: Major
Isavuconazonium and Vinblastine: 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
Isavuconazole is a moderate CYP3A4 inhibitor and P-gp inhibitor, so it may raise vinblastine exposure and neurotoxicity. The legacy direction is reversed, since vinblastine does not meaningfully affect isavuconazole.
What this interaction means in plain words
Isavuconazonium and Vinblastine 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; Vinblastine belongs to Oncology.
Why it happens
Isavuconazole inhibits CYP3A4 and P-gp, reducing vinblastine clearance.
What to do
Monitor for neurotoxicity, constipation or ileus and myelosuppression, and consider vinblastine dose reduction. Consider an alternative antifungal with less CYP3A4 inhibition if feasible.
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 Vinblastine
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 Vinblastine?
MediHelp rates the interaction as major. Isavuconazonium and Vinblastine 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 is a moderate CYP3A4 inhibitor and P-gp inhibitor, so it may raise vinblastine exposure and neurotoxicity. The legacy direction is reversed, since vinblastine does not meaningfully affect isavuconazole.
How serious is the interaction between Isavuconazonium and Vinblastine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for neurotoxicity, constipation or ileus and myelosuppression, and consider vinblastine dose reduction. Consider an alternative antifungal with less CYP3A4 inhibition if feasible.
What other medicines interact with Vinblastine?
MediHelp also lists interactions of Vinblastine with, for example, Adenovirus types 4 and 7 live, Apalutamide, Atazanavir. The full list is on the Vinblastine page.
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