Drug interactions
Itraconazole + Ponesimod
Severity: Moderate
Itraconazole and Ponesimod: moderate interaction.
Last updated
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
Ponesimod can cause bradycardia and slow atrioventricular conduction, and itraconazole can prolong the QT interval, so the combination may add to arrhythmic risk.
What this interaction means in plain words
Itraconazole and Ponesimod can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Itraconazole belongs to Anti Fungals; Ponesimod belongs to Central Nervous System.
Why it happens
Additive cardiac effects: ponesimod-induced bradycardia and conduction slowing together with itraconazole QT prolongation.
What to do
Obtain a baseline ECG before starting and monitor heart rate and QTc, especially during ponesimod initiation. Consider alternative therapy in patients with QT risk factors or bradyarrhythmias.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Ponesimod
- Fingolimod + Ponesimod Contraindicated
- Ponesimod + Siponimod Contraindicated
- Amiodarone + Ponesimod Major
- Amisulpride + Ponesimod Major
- Anagrelide + Ponesimod Major
- Anti-thymocyte + Ponesimod Major
Frequently asked questions
Can I take Itraconazole with Ponesimod?
MediHelp rates the interaction as moderate. Itraconazole and Ponesimod can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Ponesimod can cause bradycardia and slow atrioventricular conduction, and itraconazole can prolong the QT interval, so the combination may add to arrhythmic risk.
How serious is the interaction between Itraconazole and Ponesimod?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain a baseline ECG before starting and monitor heart rate and QTc, especially during ponesimod initiation. Consider alternative therapy in patients with QT risk factors or bradyarrhythmias.
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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