Drug interactions
Itraconazole + Lemborexant
Severity: Major
Itraconazole and Lemborexant: 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 substantially raises lemborexant exposure, which may cause excessive somnolence, next-day impairment and complex sleep behaviors. The labeling advises against use with strong CYP3A inhibitors.
What this interaction means in plain words
Itraconazole and Lemborexant 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; Lemborexant belongs to Central Nervous System.
Why it happens
Strong CYP3A4 inhibition decreases lemborexant metabolism.
What to do
Avoid the combination and consider an alternative hypnotic or antifungal. If unavoidable, use the lowest lemborexant dose and monitor for sedation.
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 Lemborexant
Frequently asked questions
Can I take Itraconazole with Lemborexant?
MediHelp rates the interaction as major. Itraconazole and Lemborexant 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 substantially raises lemborexant exposure, which may cause excessive somnolence, next-day impairment and complex sleep behaviors. The labeling advises against use with strong CYP3A inhibitors.
How serious is the interaction between Itraconazole and Lemborexant?
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 and consider an alternative hypnotic or antifungal. If unavoidable, use the lowest lemborexant dose and monitor for sedation.
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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