Drug interactions
Itraconazole + Pirtobrutinib
Severity: Major
Itraconazole and Pirtobrutinib: major interaction.
Last updated Sources: UK SmPC
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 raises pirtobrutinib exposure, which may increase the risk of adverse effects such as infection, bleeding and cytopenias.
What this interaction means in plain words
Itraconazole and Pirtobrutinib 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; Pirtobrutinib belongs to Oncology.
Why it happens
Strong CYP3A4 inhibition decreases pirtobrutinib clearance.
What to do
Avoid if possible; otherwise reduce the pirtobrutinib dose by 50 mg, or interrupt it if the dose is 50 mg daily. Resume the prior dose after the inhibitor has been stopped for about five half-lives.
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 Pirtobrutinib
Frequently asked questions
Can I take Itraconazole with Pirtobrutinib?
MediHelp rates the interaction as major. Itraconazole and Pirtobrutinib 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 raises pirtobrutinib exposure, which may increase the risk of adverse effects such as infection, bleeding and cytopenias.
How serious is the interaction between Itraconazole and Pirtobrutinib?
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 if possible; otherwise reduce the pirtobrutinib dose by 50 mg, or interrupt it if the dose is 50 mg daily. Resume the prior dose after the inhibitor has been stopped for about five half-lives.
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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