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Drug interactions

Itraconazole + Procainamide

Severity: Major

Itraconazole and Procainamide: major 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

Both agents can prolong the QT interval, so combining them may increase the risk of torsades de pointes. Itraconazole is also reported to have negative inotropic effects, which may matter in patients with cardiac disease.

What this interaction means in plain words

Itraconazole and Procainamide 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.

Evidence level: Low

Why it happens

Additive pharmacodynamic QT prolongation.

What to do

Avoid the combination where an alternative exists. If it is used, monitor the ECG and maintain normal potassium and magnesium 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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Itraconazole with Procainamide?

MediHelp rates the interaction as major. Itraconazole and Procainamide 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. Both agents can prolong the QT interval, so combining them may increase the risk of torsades de pointes. Itraconazole is also reported to have negative inotropic effects, which may matter in patients with cardiac disease.

How serious is the interaction between Itraconazole and Procainamide?

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 where an alternative exists. If it is used, monitor the ECG and maintain normal potassium and magnesium levels.

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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