Drug interactions
Itraconazole + Omeprazole
Severity: Major
Itraconazole and Omeprazole: 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 capsules require gastric acid for absorption, and omeprazole can markedly reduce their exposure, risking antifungal treatment failure.
What this interaction means in plain words
Itraconazole and Omeprazole 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; Omeprazole belongs to Gastrointestinal Tract.
Why it happens
Elevated gastric pH decreases dissolution and absorption of itraconazole capsules.
What to do
Avoid with capsules; use oral solution or SUBA-itraconazole, which are less affected, or give capsules with an acidic beverage, and monitor itraconazole levels.
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 Omeprazole
- Mavacamten + Omeprazole Contraindicated
- Omeprazole + Rilpivirine Contraindicated
- Acalabrutinib + Omeprazole Major
- Atazanavir + Omeprazole Major
- Citalopram + Omeprazole Major
- Clopidogrel + Omeprazole Major
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 Omeprazole?
MediHelp rates the interaction as major. Itraconazole and Omeprazole 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 capsules require gastric acid for absorption, and omeprazole can markedly reduce their exposure, risking antifungal treatment failure.
How serious is the interaction between Itraconazole and Omeprazole?
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 with capsules; use oral solution or SUBA-itraconazole, which are less affected, or give capsules with an acidic beverage, and monitor itraconazole levels.
What other medicines interact with Omeprazole?
MediHelp also lists interactions of Omeprazole with, for example, Mavacamten, Rilpivirine, Acalabrutinib. The full list is on the Omeprazole page.
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