Drug interactions
Itraconazole + Trastuzumab emtansine
Severity: Major
Itraconazole and Trastuzumab emtansine: 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 raise exposure to DM1, the cytotoxic component released from trastuzumab emtansine. This can increase toxicities such as hepatotoxicity, thrombocytopenia and neuropathy.
What this interaction means in plain words
Itraconazole and Trastuzumab emtansine 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; Trastuzumab emtansine belongs to Oncology.
Why it happens
Strong CYP3A4 inhibition reduces metabolism of DM1.
What to do
Avoid the combination and choose a non-inhibiting antifungal. If unavoidable, delay the infusion until the inhibitor has cleared and monitor 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 Trastuzumab emtansine
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 Trastuzumab emtansine?
MediHelp rates the interaction as major. Itraconazole and Trastuzumab emtansine 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 raise exposure to DM1, the cytotoxic component released from trastuzumab emtansine. This can increase toxicities such as hepatotoxicity, thrombocytopenia and neuropathy.
How serious is the interaction between Itraconazole and Trastuzumab emtansine?
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 and choose a non-inhibiting antifungal. If unavoidable, delay the infusion until the inhibitor has cleared and monitor closely.
What other medicines interact with Trastuzumab emtansine?
MediHelp also lists interactions of Trastuzumab emtansine with, for example, Clarithromycin, Ketoconazole, Ritonavir. The full list is on the Trastuzumab emtansine page.
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