Drug interactions
Itraconazole + Mifepristone
Severity: Major
Itraconazole and Mifepristone: 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
Mifepristone is a CYP3A4 inhibitor and itraconazole is a CYP3A4 substrate, so itraconazole exposure may rise. Itraconazole also inhibits CYP3A4, which raises mifepristone levels, and both prolong the QT interval, increasing arrhythmia risk.
What this interaction means in plain words
Itraconazole and Mifepristone 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; Mifepristone belongs to Endocrine.
Why it happens
Mutual CYP3A4 inhibition combined with additive QT prolongation.
What to do
Avoid the combination, especially with high-dose mifepristone used in Cushing's syndrome. If unavoidable, monitor ECG, potassium and magnesium, and watch for itraconazole toxicity.
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 Itraconazole
- Alfuzosin + Itraconazole Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Avanafil + Itraconazole Contraindicated
- Conivaptan + Itraconazole Contraindicated
- Dihydroergotamine intranasal + Itraconazole Contraindicated
- Dihydroergotamine + Itraconazole Contraindicated
Other interactions of Mifepristone
- Apixaban + Mifepristone Contraindicated
- Argatroban + Mifepristone Contraindicated
- Cisapride + Mifepristone Contraindicated
- Cortisone + Mifepristone Contraindicated
- Cyclosporin + Mifepristone Contraindicated
- Dabigatran etexilate + Mifepristone Contraindicated
Frequently asked questions
Can I take Itraconazole with Mifepristone?
MediHelp rates the interaction as major. Itraconazole and Mifepristone 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. Mifepristone is a CYP3A4 inhibitor and itraconazole is a CYP3A4 substrate, so itraconazole exposure may rise. Itraconazole also inhibits CYP3A4, which raises mifepristone levels, and both prolong the QT interval, increasing arrhythmia risk.
How serious is the interaction between Itraconazole and Mifepristone?
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, especially with high-dose mifepristone used in Cushing's syndrome. If unavoidable, monitor ECG, potassium and magnesium, and watch for itraconazole toxicity.
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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