Drug interactions
Itraconazole + Nimodipine
Severity: Major
Itraconazole and Nimodipine: 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 can substantially increase nimodipine concentrations, causing marked hypotension, flushing, headache and oedema. Negative inotropic effects of both agents may add together.
What this interaction means in plain words
Itraconazole and Nimodipine 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; Nimodipine belongs to Cardiovascular.
Why it happens
Itraconazole inhibits CYP3A4 first-pass and systemic metabolism of nimodipine, with additive negative inotropy.
What to do
Monitor blood pressure closely and reduce the nimodipine dose if hypotension occurs. Consider an alternative antifungal, particularly in subarachnoid haemorrhage where hypotension is harmful.
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 Nimodipine
- Apalutamide + Nimodipine Major
- Carbamazepine + Nimodipine Major
- Ceritinib + Nimodipine Major
- Clarithromycin + Nimodipine Major
- Cobicistat + Nimodipine Major
- Darunavir + Nimodipine Major
Frequently asked questions
Can I take Itraconazole with Nimodipine?
MediHelp rates the interaction as major. Itraconazole and Nimodipine 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 can substantially increase nimodipine concentrations, causing marked hypotension, flushing, headache and oedema. Negative inotropic effects of both agents may add together.
How serious is the interaction between Itraconazole and Nimodipine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood pressure closely and reduce the nimodipine dose if hypotension occurs. Consider an alternative antifungal, particularly in subarachnoid haemorrhage where hypotension is harmful.
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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