Drug interactions
Itraconazole + Liposomal doxorubicin
Severity: Major
Itraconazole and Liposomal doxorubicin: 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
Itraconazole is a strong CYP3A4 and P-glycoprotein inhibitor and may raise doxorubicin exposure, increasing myelosuppression, mucositis and cardiotoxicity. It also has negative inotropic effects relevant in anthracycline-treated patients.
What this interaction means in plain words
Itraconazole and Liposomal doxorubicin 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; Liposomal doxorubicin belongs to Oncology.
Why it happens
Inhibition of CYP3A4 and P-glycoprotein by itraconazole, reducing doxorubicin clearance.
What to do
Prefer an alternative antifungal with less inhibition, such as an echinocandin, where feasible. If used, monitor blood counts, mucositis and cardiac function, and consider reducing the doxorubicin 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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Other interactions of Liposomal doxorubicin
- Dengue vaccine + Liposomal doxorubicin Contraindicated
- Belatacept + Liposomal doxorubicin Major
- Cyclosporine + Liposomal doxorubicin Major
- Dronedarone + Liposomal doxorubicin Major
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Liposomal doxorubicin Major
- Fingolimod + Liposomal doxorubicin Major
Other interactions of Itraconazole
- Alfuzosin + Itraconazole Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Avanafil + Itraconazole Contraindicated
- Conivaptan + Itraconazole Contraindicated
- Dihydroergotamine intranasal + Itraconazole Contraindicated
- Dihydroergotamine + Itraconazole Contraindicated
Frequently asked questions
Can I take Itraconazole with Liposomal doxorubicin?
MediHelp rates the interaction as major. Itraconazole and Liposomal doxorubicin 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 is a strong CYP3A4 and P-glycoprotein inhibitor and may raise doxorubicin exposure, increasing myelosuppression, mucositis and cardiotoxicity. It also has negative inotropic effects relevant in anthracycline-treated patients.
How serious is the interaction between Itraconazole and Liposomal doxorubicin?
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 with less inhibition, such as an echinocandin, where feasible. If used, monitor blood counts, mucositis and cardiac function, and consider reducing the doxorubicin dose.
What other medicines interact with Liposomal doxorubicin?
MediHelp also lists interactions of Liposomal doxorubicin with, for example, Dengue vaccine, Belatacept, Cyclosporine. The full list is on the Liposomal doxorubicin page.
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