Drug interactions
Itraconazole + Maprotiline
Severity: Major
Itraconazole and Maprotiline: 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
Both agents can prolong the QT interval, so combined use raises the risk of ventricular arrhythmias including torsades de pointes. Itraconazole may also increase maprotiline levels.
What this interaction means in plain words
Itraconazole and Maprotiline 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; Maprotiline belongs to Central Nervous System.
Why it happens
Additive QT prolongation, with possible CYP inhibition by itraconazole (CYP3A4/2D6 involvement) raising maprotiline concentrations.
What to do
Avoid the combination if possible and choose an alternative antifungal or antidepressant. If both are required, check a baseline ECG, correct electrolytes and monitor QTc.
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 Itraconazole
- Alfuzosin + Itraconazole Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Avanafil + Itraconazole Contraindicated
- Conivaptan + Itraconazole Contraindicated
- Dihydroergotamine intranasal + Itraconazole Contraindicated
- Dihydroergotamine + Itraconazole Contraindicated
Other interactions of Maprotiline
- Arsenic trioxide + Maprotiline Contraindicated
- Disopyramide + Maprotiline Contraindicated
- Dofetilide + Maprotiline Contraindicated
- Ibutilide + Maprotiline Contraindicated
- Isocarboxazid + Maprotiline Contraindicated
- Maprotiline + Methylene blue Contraindicated
Frequently asked questions
Can I take Itraconazole with Maprotiline?
MediHelp rates the interaction as major. Itraconazole and Maprotiline 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. Both agents can prolong the QT interval, so combined use raises the risk of ventricular arrhythmias including torsades de pointes. Itraconazole may also increase maprotiline levels.
How serious is the interaction between Itraconazole and Maprotiline?
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 and choose an alternative antifungal or antidepressant. If both are required, check a baseline ECG, correct electrolytes and monitor QTc.
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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