Drug interactions
Itraconazole + Pitolisant
Severity: Major
Itraconazole and Pitolisant: major interaction.
Last updated Sources: EMA 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 inhibits CYP3A4, which contributes to pitolisant clearance, and both drugs can prolong the QT interval. This may raise pitolisant levels and arrhythmia risk.
What this interaction means in plain words
Itraconazole and Pitolisant 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; Pitolisant belongs to Central Nervous System.
Why it happens
CYP3A4 inhibition plus additive QT prolongation.
What to do
Avoid the combination if possible, or use ECG monitoring and consider a pitolisant dose adjustment. Choose an alternative antifungal in patients with QT risk factors.
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 Pitolisant
- Alfuzosin + Pitolisant Major
- Amiodarone + Pitolisant Major
- Amisulpride + Pitolisant Major
- Anagrelide + Pitolisant Major
- Asenapine + Pitolisant Major
- Bupropion + Pitolisant Major
Frequently asked questions
Can I take Itraconazole with Pitolisant?
MediHelp rates the interaction as major. Itraconazole and Pitolisant 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 inhibits CYP3A4, which contributes to pitolisant clearance, and both drugs can prolong the QT interval. This may raise pitolisant levels and arrhythmia risk.
How serious is the interaction between Itraconazole and Pitolisant?
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 if possible, or use ECG monitoring and consider a pitolisant dose adjustment. Choose an alternative antifungal in patients with QT risk factors.
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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