Drug interactions
Itraconazole + Mefloquine
Severity: Major
Itraconazole and Mefloquine: 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 may raise mefloquine concentrations, and both drugs can prolong the QT interval. This increases the risk of serious arrhythmia and mefloquine neuropsychiatric toxicity.
What this interaction means in plain words
Itraconazole and Mefloquine 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; Mefloquine belongs to Anti Parasitic.
Why it happens
Itraconazole inhibits CYP3A4-mediated mefloquine metabolism, and the two drugs have additive QT-prolonging effects.
What to do
Avoid combining them and use an alternative antimalarial or antifungal. Because mefloquine has a long half-life, the caution persists for weeks after stopping it; if unavoidable, monitor ECG and electrolytes.
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 Mefloquine
- Arsenic trioxide + Mefloquine Contraindicated
- Dronedarone + Mefloquine Contraindicated
- Ibutilide + Mefloquine Contraindicated
- Levoketoconazole + Mefloquine Contraindicated
- Mefloquine + Nilotinib Contraindicated
- Mefloquine + Pimozide Contraindicated
Frequently asked questions
Can I take Itraconazole with Mefloquine?
MediHelp rates the interaction as major. Itraconazole and Mefloquine 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 may raise mefloquine concentrations, and both drugs can prolong the QT interval. This increases the risk of serious arrhythmia and mefloquine neuropsychiatric toxicity.
How serious is the interaction between Itraconazole and Mefloquine?
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 them and use an alternative antimalarial or antifungal. Because mefloquine has a long half-life, the caution persists for weeks after stopping it; if unavoidable, monitor ECG and electrolytes.
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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