Drug interactions
Itraconazole + Topotecan
Severity: Major
Itraconazole and Topotecan: 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
Itraconazole may increase topotecan exposure, particularly oral topotecan, which raises the risk of myelosuppression and gastrointestinal toxicity.
What this interaction means in plain words
Itraconazole and Topotecan 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; Topotecan belongs to Oncology.
Why it happens
Itraconazole inhibits P-glycoprotein and BCRP-mediated efflux, increasing topotecan absorption and reducing clearance.
What to do
Avoid with oral topotecan and use an alternative antifungal. With IV topotecan, monitor blood counts closely.
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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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 Topotecan
- Adenovirus types 4 and 7 live + Topotecan Contraindicated
- Amiodarone + Topotecan Major
- Cisplatin + Topotecan Major
- Cobicistat + Topotecan Major
- Cyclosporin + Topotecan Major
- Darunavir + Topotecan Major
Frequently asked questions
Can I take Itraconazole with Topotecan?
MediHelp rates the interaction as major. Itraconazole and Topotecan 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 may increase topotecan exposure, particularly oral topotecan, which raises the risk of myelosuppression and gastrointestinal toxicity.
How serious is the interaction between Itraconazole and Topotecan?
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 with oral topotecan and use an alternative antifungal. With IV topotecan, monitor blood counts closely.
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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