Drug interactions
Itraconazole + Nirogacestat
Severity: Major
Itraconazole and Nirogacestat: major interaction.
Last updated Sources: EMA SmPC
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, a strong CYP3A4 inhibitor, can substantially raise nirogacestat exposure. This increases the risk of nirogacestat adverse effects such as diarrhea, hepatotoxicity and ovarian toxicity.
What this interaction means in plain words
Itraconazole and Nirogacestat 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; Nirogacestat belongs to Oncology.
Why it happens
Inhibition of CYP3A4-mediated metabolism of nirogacestat by itraconazole.
What to do
Avoid concurrent use of strong CYP3A inhibitors and consider an alternative antifungal with less CYP3A inhibition. If it cannot be avoided, follow the labeled nirogacestat dose reduction and monitor for 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 Nirogacestat
Frequently asked questions
Can I take Itraconazole with Nirogacestat?
MediHelp rates the interaction as major. Itraconazole and Nirogacestat 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, a strong CYP3A4 inhibitor, can substantially raise nirogacestat exposure. This increases the risk of nirogacestat adverse effects such as diarrhea, hepatotoxicity and ovarian toxicity.
How serious is the interaction between Itraconazole and Nirogacestat?
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 concurrent use of strong CYP3A inhibitors and consider an alternative antifungal with less CYP3A inhibition. If it cannot be avoided, follow the labeled nirogacestat dose reduction and monitor for 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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