Drug interactions
Itraconazole + Ivosidenib
Severity: Major
Itraconazole and Ivosidenib: major interaction.
Last updated Sources: EMA SmPC
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 raises ivosidenib exposure through CYP3A4 inhibition, which can intensify QT prolongation and differentiation syndrome risk. Ivosidenib is a CYP3A4 inducer and may in turn lower itraconazole levels, risking antifungal failure.
What this interaction means in plain words
Itraconazole and Ivosidenib 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 belongs to Anti Fungals; Ivosidenib belongs to Oncology.
Why it happens
Itraconazole inhibits CYP3A4 metabolism of ivosidenib, while ivosidenib induces CYP3A4 and may lower itraconazole concentrations.
What to do
Prefer an alternative antifungal. If unavoidable, reduce ivosidenib to 250 mg daily, monitor ECG and electrolytes, and monitor antifungal response.
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 Itraconazole
- Alfuzosin + Itraconazole Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Avanafil + Itraconazole Contraindicated
- Conivaptan + Itraconazole Contraindicated
- Dihydroergotamine intranasal + Itraconazole Contraindicated
- Dihydroergotamine + Itraconazole Contraindicated
Other interactions of Ivosidenib
- Alfuzosin + Ivosidenib Major
- Amiodarone + Ivosidenib Major
- Amisulpride + Ivosidenib Major
- Amitriptyline + Ivosidenib Major
- Amobarbital + Ivosidenib Major
- Anagrelide + Ivosidenib Major
Frequently asked questions
Can I take Itraconazole with Ivosidenib?
MediHelp rates the interaction as major. Itraconazole and Ivosidenib 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 raises ivosidenib exposure through CYP3A4 inhibition, which can intensify QT prolongation and differentiation syndrome risk. Ivosidenib is a CYP3A4 inducer and may in turn lower itraconazole levels, risking antifungal failure.
How serious is the interaction between Itraconazole and Ivosidenib?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer an alternative antifungal. If unavoidable, reduce ivosidenib to 250 mg daily, monitor ECG and electrolytes, and monitor antifungal response.
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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