Drug interactions
Itraconazole + Nefazodone
Severity: Major
Itraconazole and Nefazodone: 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 raises nefazodone and its active metabolite concentrations through CYP3A4 inhibition, which may cause excess sedation, hypotension and serotonergic effects. Nefazodone is itself a CYP3A4 inhibitor and may increase itraconazole exposure.
What this interaction means in plain words
Itraconazole and Nefazodone 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.
Why it happens
Mutual CYP3A4 inhibition reduces clearance of both drugs.
What to do
Avoid the combination if possible and use an alternative antidepressant or antifungal. If used, start with a low nefazodone dose and monitor for sedation, hypotension and 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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Other interactions of Itraconazole
- Alfuzosin + Itraconazole Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Avanafil + Itraconazole Contraindicated
- Conivaptan + Itraconazole Contraindicated
- Dihydroergotamine intranasal + Itraconazole Contraindicated
- Dihydroergotamine + Itraconazole Contraindicated
Frequently asked questions
Can I take Itraconazole with Nefazodone?
MediHelp rates the interaction as major. Itraconazole and Nefazodone 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 raises nefazodone and its active metabolite concentrations through CYP3A4 inhibition, which may cause excess sedation, hypotension and serotonergic effects. Nefazodone is itself a CYP3A4 inhibitor and may increase itraconazole exposure.
How serious is the interaction between Itraconazole and Nefazodone?
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 use an alternative antidepressant or antifungal. If used, start with a low nefazodone dose and monitor for sedation, hypotension and 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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