Drug interactions
Itraconazole + Sonidegib
Severity: Major
Itraconazole and Sonidegib: 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, a strong CYP3A4 inhibitor, can raise sonidegib plasma concentrations substantially. Higher exposure increases the risk of musculoskeletal toxicity such as myopathy and CK elevation, as well as other dose-related adverse effects.
What this interaction means in plain words
Itraconazole and Sonidegib 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; Sonidegib belongs to Oncology.
Why it happens
Inhibition of CYP3A4-mediated metabolism of sonidegib by itraconazole.
What to do
Avoid concomitant use and choose a non-azole or weaker CYP3A inhibitor antifungal where possible. If a strong inhibitor must be given for a short period, monitor closely for muscle symptoms and check creatine kinase.
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 Sonidegib
- Amiodarone + Sonidegib Major
- Apalutamide + Sonidegib Major
- Aprepitant + Sonidegib Major
- Armodafinil + Sonidegib Major
- Bosentan + Sonidegib Major
- Carbamazepine + Sonidegib Major
Frequently asked questions
Can I take Itraconazole with Sonidegib?
MediHelp rates the interaction as major. Itraconazole and Sonidegib 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, a strong CYP3A4 inhibitor, can raise sonidegib plasma concentrations substantially. Higher exposure increases the risk of musculoskeletal toxicity such as myopathy and CK elevation, as well as other dose-related adverse effects.
How serious is the interaction between Itraconazole and Sonidegib?
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 concomitant use and choose a non-azole or weaker CYP3A inhibitor antifungal where possible. If a strong inhibitor must be given for a short period, monitor closely for muscle symptoms and check creatine kinase.
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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