Drug interactions
Itraconazole + Loperamide
Severity: Major
Itraconazole and Loperamide: 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 markedly raises loperamide exposure and also has its own QT-prolonging potential. This increases the risk of loperamide-related cardiac toxicity and central opioid effects.
What this interaction means in plain words
Itraconazole and Loperamide 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; Loperamide belongs to Gastrointestinal Tract.
Why it happens
Itraconazole inhibits CYP3A4 and P-glycoprotein, reducing loperamide metabolism and efflux, with additive QT effects.
What to do
Avoid combining where possible, or limit loperamide to the lowest dose for the shortest time. Monitor ECG and for signs of arrhythmia or CNS/respiratory depression.
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 Loperamide
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 Loperamide?
MediHelp rates the interaction as major. Itraconazole and Loperamide 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 markedly raises loperamide exposure and also has its own QT-prolonging potential. This increases the risk of loperamide-related cardiac toxicity and central opioid effects.
How serious is the interaction between Itraconazole and Loperamide?
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 combining where possible, or limit loperamide to the lowest dose for the shortest time. Monitor ECG and for signs of arrhythmia or CNS/respiratory depression.
What other medicines interact with Loperamide?
MediHelp also lists interactions of Loperamide with, for example, Amiodarone, Amisulpride, Anagrelide. The full list is on the Loperamide page.
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