Drug interactions
Itraconazole + Rabeprazole
Severity: Major
Itraconazole and Rabeprazole: 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 capsules need gastric acid for dissolution and absorption. Rabeprazole can lower itraconazole levels and risk treatment failure of fungal infection.
What this interaction means in plain words
Itraconazole and Rabeprazole 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; Rabeprazole belongs to Gastrointestinal Tract.
Why it happens
Higher gastric pH reduces dissolution and absorption of itraconazole capsules.
What to do
Avoid the combination with capsules; use the oral solution or SUBA-itraconazole formulation, which is less acid-dependent. Monitor itraconazole levels and clinical response.
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 Rabeprazole
- Rabeprazole + Rilpivirine Contraindicated
- Acalabrutinib + Rabeprazole Major
- Atazanavir + Rabeprazole Major
- Dacomitinib + Rabeprazole Major
- Dasatinib + Rabeprazole Major
- Erlotinib + Rabeprazole Major
Other interactions of Itraconazole
- Alfuzosin + Itraconazole Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Avanafil + Itraconazole Contraindicated
- Conivaptan + Itraconazole Contraindicated
- Dihydroergotamine intranasal + Itraconazole Contraindicated
- Dihydroergotamine + Itraconazole Contraindicated
Frequently asked questions
Can I take Itraconazole with Rabeprazole?
MediHelp rates the interaction as major. Itraconazole and Rabeprazole 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 capsules need gastric acid for dissolution and absorption. Rabeprazole can lower itraconazole levels and risk treatment failure of fungal infection.
How serious is the interaction between Itraconazole and Rabeprazole?
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 with capsules; use the oral solution or SUBA-itraconazole formulation, which is less acid-dependent. Monitor itraconazole levels and clinical response.
What other medicines interact with Rabeprazole?
MediHelp also lists interactions of Rabeprazole with, for example, Rilpivirine, Acalabrutinib, Atazanavir. The full list is on the Rabeprazole page.
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