Drug interactions
Itraconazole + Venetoclax
Severity: Contraindicated
Itraconazole and Venetoclax: contraindicated 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 increases venetoclax exposure and risks tumor lysis syndrome during dose initiation, as well as neutropenia and other toxicities. The risk is greatest during the ramp-up phase.
What this interaction means in plain words
Itraconazole and Venetoclax are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Itraconazole belongs to Anti Fungals; Venetoclax belongs to Miscellaneous.
Why it happens
Strong CYP3A4 inhibition (and P-glycoprotein inhibition) by itraconazole reduces venetoclax clearance.
What to do
Do not use during venetoclax initiation and ramp-up; after ramp-up, reduce the venetoclax dose by at least 75% per labeling and monitor for toxicity and blood counts.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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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 Venetoclax
- Clarithromycin + Venetoclax Contraindicated
- Ketoconazole + Venetoclax Contraindicated
- Posaconazole + Venetoclax Contraindicated
- Venetoclax + Voriconazole Contraindicated
- Amiodarone + Venetoclax Major
- Apalutamide + Venetoclax Major
Frequently asked questions
Can I take Itraconazole with Venetoclax?
MediHelp rates the interaction as contraindicated. Itraconazole and Venetoclax are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Itraconazole increases venetoclax exposure and risks tumor lysis syndrome during dose initiation, as well as neutropenia and other toxicities. The risk is greatest during the ramp-up phase.
How serious is the interaction between Itraconazole and Venetoclax?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not use during venetoclax initiation and ramp-up; after ramp-up, reduce the venetoclax dose by at least 75% per labeling and monitor for toxicity and blood counts.
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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