Drug interactions
Isavuconazonium + Vincristine
Severity: Major
Isavuconazonium and Vincristine: 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 can raise vincristine exposure, increasing the risk of neurotoxicity and ileus. The legacy direction of the effect is reversed, as the azole is the inhibitor.
What this interaction means in plain words
Isavuconazonium and Vincristine 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; Vincristine belongs to Oncology.
Why it happens
Isavuconazole inhibits CYP3A4 and P-glycoprotein, reducing vincristine clearance.
What to do
Avoid the combination if possible by using a non-azole antifungal. If unavoidable, monitor closely for neuropathy and constipation or ileus and reduce the vincristine dose.
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 Vincristine
- Adenovirus types 4 and 7 live + Vincristine Contraindicated
- Apalutamide + Vincristine Major
- Atazanavir + Vincristine Major
- Ceritinib + Vincristine Major
- Chloramphenicol + Vincristine Major
- Clarithromycin + Vincristine Major
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 Vincristine?
MediHelp rates the interaction as major. Isavuconazonium and Vincristine 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 can raise vincristine exposure, increasing the risk of neurotoxicity and ileus. The legacy direction of the effect is reversed, as the azole is the inhibitor.
How serious is the interaction between Isavuconazonium and Vincristine?
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 the combination if possible by using a non-azole antifungal. If unavoidable, monitor closely for neuropathy and constipation or ileus and reduce the vincristine dose.
What other medicines interact with Vincristine?
MediHelp also lists interactions of Vincristine with, for example, Adenovirus types 4 and 7 live, Apalutamide, Atazanavir. The full list is on the Vincristine page.
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