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Drug interactions

Itraconazole + Sotalol

Severity: Major

Itraconazole and Sotalol: major interaction.

Last updated

Itraconazole + Sotalol | MediHelp

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 drugs can prolong the QT interval, and itraconazole has negative inotropic effects. Together they may raise the risk of torsades de pointes, particularly with hypokalaemia, bradycardia or renal impairment.

What this interaction means in plain words

Itraconazole and Sotalol 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; Sotalol belongs to Cardiovascular.

Evidence level: Moderate

Why it happens

Additive prolongation of cardiac repolarization (potassium channel blockade) plus negative inotropy.

What to do

Avoid the combination where possible and use a non-QT-prolonging antifungal. If unavoidable, monitor ECG and keep potassium and magnesium normal.

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 Sotalol?

MediHelp rates the interaction as major. Itraconazole and Sotalol 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 drugs can prolong the QT interval, and itraconazole has negative inotropic effects. Together they may raise the risk of torsades de pointes, particularly with hypokalaemia, bradycardia or renal impairment.

How serious is the interaction between Itraconazole and Sotalol?

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 possible and use a non-QT-prolonging antifungal. If unavoidable, monitor ECG and keep potassium and magnesium normal.

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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