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Drug interactions

Itraconazole + Olaparib

Severity: Major

Itraconazole and Olaparib: 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 increases olaparib plasma concentrations by blocking its main metabolic pathway. Higher exposure can worsen anemia, neutropenia, nausea and fatigue.

What this interaction means in plain words

Itraconazole and Olaparib 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; Olaparib belongs to Oncology.

Evidence level: High

Why it happens

Strong CYP3A4 inhibition by itraconazole reduces olaparib clearance.

What to do

Avoid the combination where possible. If unavoidable, reduce olaparib to the labeled dose for strong CYP3A inhibitors (tablets 100 mg twice daily, capsules 150 mg twice daily) and monitor blood counts.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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References

Frequently asked questions

Can I take Itraconazole with Olaparib?

MediHelp rates the interaction as major. Itraconazole and Olaparib 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 increases olaparib plasma concentrations by blocking its main metabolic pathway. Higher exposure can worsen anemia, neutropenia, nausea and fatigue.

How serious is the interaction between Itraconazole and Olaparib?

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 where possible. If unavoidable, reduce olaparib to the labeled dose for strong CYP3A inhibitors (tablets 100 mg twice daily, capsules 150 mg twice daily) and monitor blood counts.

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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