Drug interactions
Itraconazole + Nifedipine
Severity: Major
Itraconazole and Nifedipine: 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
Itraconazole markedly increases nifedipine exposure, which may cause severe hypotension, peripheral edema and reflex tachycardia. Itraconazole's negative inotropic effect may also add to that of dihydropyridines and precipitate heart failure.
What this interaction means in plain words
Itraconazole and Nifedipine 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; Nifedipine belongs to Cardiovascular.
Why it happens
Itraconazole strongly inhibits CYP3A4 metabolism of nifedipine, with additive negative inotropy.
What to do
Start nifedipine at the lowest dose and titrate according to blood pressure; monitor for edema and heart failure. Consider an alternative antifungal or antihypertensive in patients with heart failure.
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 Nifedipine
Frequently asked questions
Can I take Itraconazole with Nifedipine?
MediHelp rates the interaction as major. Itraconazole and Nifedipine 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 markedly increases nifedipine exposure, which may cause severe hypotension, peripheral edema and reflex tachycardia. Itraconazole's negative inotropic effect may also add to that of dihydropyridines and precipitate heart failure.
How serious is the interaction between Itraconazole and Nifedipine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start nifedipine at the lowest dose and titrate according to blood pressure; monitor for edema and heart failure. Consider an alternative antifungal or antihypertensive in patients with heart failure.
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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