Drug interactions
Itraconazole + Metronidazole
Severity: Minor
Itraconazole and Metronidazole: minor 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
Metronidazole is not a significant CYP3A4 inhibitor, so a meaningful rise in itraconazole levels is unlikely. Both drugs have been linked to QT prolongation and neurotoxicity, so additive effects are possible but infrequent.
What this interaction means in plain words
Itraconazole and Metronidazole have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Itraconazole belongs to Anti Fungals; Metronidazole belongs to Anti Parasitic.
Why it happens
No well-established pharmacokinetic mechanism; possible additive QT or neurologic effects.
What to do
No routine adjustment; consider an ECG in patients with other QT risk factors.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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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 Metronidazole
- Ethanol + Metronidazole Contraindicated
- Metronidazole + Pimozide Contraindicated
- Amiodarone + Metronidazole Major
- Disulfiram + Metronidazole Major
- Ergotamine + Metronidazole Major
- Lomitapide + Metronidazole Major
Frequently asked questions
Can I take Itraconazole with Metronidazole?
MediHelp rates the interaction as minor. Itraconazole and Metronidazole have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Metronidazole is not a significant CYP3A4 inhibitor, so a meaningful rise in itraconazole levels is unlikely. Both drugs have been linked to QT prolongation and neurotoxicity, so additive effects are possible but infrequent.
How serious is the interaction between Itraconazole and Metronidazole?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: No routine adjustment; consider an ECG in patients with other QT risk factors.
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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