Drug interactions
Itraconazole + Osilodrostat
Severity: Major
Itraconazole and Osilodrostat: 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, a strong CYP3A4 inhibitor, may raise osilodrostat exposure. Both drugs can prolong the QT interval, so the combination increases the risk of arrhythmia and adrenal insufficiency from excessive cortisol suppression.
What this interaction means in plain words
Itraconazole and Osilodrostat 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; Osilodrostat belongs to Endocrine.
Why it happens
CYP3A4 inhibition increases osilodrostat exposure, plus additive QT prolongation.
What to do
Halve the osilodrostat dose during itraconazole therapy and monitor ECG, electrolytes and cortisol. Watch for symptoms of hypocortisolism.
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 Osilodrostat
Frequently asked questions
Can I take Itraconazole with Osilodrostat?
MediHelp rates the interaction as major. Itraconazole and Osilodrostat 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, may raise osilodrostat exposure. Both drugs can prolong the QT interval, so the combination increases the risk of arrhythmia and adrenal insufficiency from excessive cortisol suppression.
How serious is the interaction between Itraconazole and Osilodrostat?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Halve the osilodrostat dose during itraconazole therapy and monitor ECG, electrolytes and cortisol. Watch for symptoms of hypocortisolism.
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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