Drug interactions
Itraconazole + Mitotane
Severity: Major
Itraconazole and Mitotane: 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
Mitotane strongly induces CYP3A4 and can substantially lower itraconazole concentrations, risking antifungal treatment failure. The induction can persist for weeks after mitotane is stopped.
What this interaction means in plain words
Itraconazole and Mitotane 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; Mitotane belongs to Oncology.
Why it happens
CYP3A4 induction by mitotane increases itraconazole clearance.
What to do
Avoid the combination where possible and choose an antifungal less affected by induction. If used, measure itraconazole serum levels and adjust the dose.
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 Mitotane
- Doravirine + Mitotane Contraindicated
- Fostemsavir + Mitotane Contraindicated
- Lorlatinib + Mitotane Contraindicated
- Abiraterone + Mitotane Major
- Apixaban + Mitotane Major
- Aprepitant + Mitotane Major
Frequently asked questions
Can I take Itraconazole with Mitotane?
MediHelp rates the interaction as major. Itraconazole and Mitotane 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. Mitotane strongly induces CYP3A4 and can substantially lower itraconazole concentrations, risking antifungal treatment failure. The induction can persist for weeks after mitotane is stopped.
How serious is the interaction between Itraconazole and Mitotane?
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 where possible and choose an antifungal less affected by induction. If used, measure itraconazole serum levels and adjust the dose.
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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