Drug interactions
Itraconazole + Ombitasvir / paritaprevir / ritonavir and dasabuvir
Severity: Major
Itraconazole and Ombitasvir / paritaprevir / ritonavir and dasabuvir: 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
Ritonavir in this regimen strongly inhibits CYP3A4, and itraconazole is both a CYP3A4 substrate and inhibitor. Exposure to itraconazole and to paritaprevir may rise, increasing the risk of adverse effects.
What this interaction means in plain words
Itraconazole and Ombitasvir / paritaprevir / ritonavir and dasabuvir 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.
Why it happens
Mutual CYP3A4 and P-glycoprotein inhibition between itraconazole and ritonavir-boosted paritaprevir.
What to do
Avoid the combination where possible, or limit the itraconazole dose and monitor itraconazole concentrations, ECG and liver tests. Consider an alternative antifungal.
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
Frequently asked questions
Can I take Itraconazole with Ombitasvir / paritaprevir / ritonavir and dasabuvir?
MediHelp rates the interaction as major. Itraconazole and Ombitasvir / paritaprevir / ritonavir and dasabuvir 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. Ritonavir in this regimen strongly inhibits CYP3A4, and itraconazole is both a CYP3A4 substrate and inhibitor. Exposure to itraconazole and to paritaprevir may rise, increasing the risk of adverse effects.
How serious is the interaction between Itraconazole and Ombitasvir / paritaprevir / ritonavir and dasabuvir?
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, or limit the itraconazole dose and monitor itraconazole concentrations, ECG and liver tests. Consider an alternative antifungal.
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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