Drug interactions
Itraconazole + Nortriptyline
Severity: Moderate
Itraconazole and Nortriptyline: moderate 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
Both drugs can prolong the QT interval, so their combination may raise the risk of ventricular arrhythmias. Itraconazole may also increase nortriptyline concentrations through metabolic inhibition.
What this interaction means in plain words
Itraconazole and Nortriptyline can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Itraconazole belongs to Anti Fungals; Nortriptyline belongs to Central Nervous System.
Why it happens
Additive QT prolongation, with possible inhibition of CYP3A4/2D6-mediated nortriptyline metabolism by itraconazole.
What to do
Obtain a baseline ECG and correct hypokalemia and hypomagnesemia. Monitor QTc and anticholinergic or tricyclic toxicity, and consider a different antifungal in patients with cardiac risk factors.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Itraconazole and Nortriptyline, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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 Nortriptyline
- Disopyramide + Nortriptyline Contraindicated
- Dofetilide + Nortriptyline Contraindicated
- Dronedarone + Nortriptyline Contraindicated
- Ibutilide + Nortriptyline Contraindicated
- Isocarboxazid + Nortriptyline Contraindicated
- Methylene blue + Nortriptyline Contraindicated
Frequently asked questions
Can I take Itraconazole with Nortriptyline?
MediHelp rates the interaction as moderate. Itraconazole and Nortriptyline can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Both drugs can prolong the QT interval, so their combination may raise the risk of ventricular arrhythmias. Itraconazole may also increase nortriptyline concentrations through metabolic inhibition.
How serious is the interaction between Itraconazole and Nortriptyline?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain a baseline ECG and correct hypokalemia and hypomagnesemia. Monitor QTc and anticholinergic or tricyclic toxicity, and consider a different antifungal in patients with cardiac risk factors.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
