Drug interactions
Itraconazole + Verapamil
Severity: Major
Itraconazole and Verapamil: 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 increases verapamil exposure, causing hypotension, bradycardia, AV block and edema. Itraconazole also has negative inotropic effects that may add to those of verapamil, and verapamil may raise itraconazole levels.
What this interaction means in plain words
Itraconazole and Verapamil 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; Verapamil belongs to Cardiovascular.
Why it happens
Itraconazole inhibits CYP3A4 metabolism of verapamil, with additive negative inotropic effects.
What to do
Monitor blood pressure, heart rate and ECG, and reduce the verapamil dose as needed. Avoid in patients with heart failure or conduction disease.
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 Verapamil
- Dofetilide + Verapamil Contraindicated
- Flibanserin + Verapamil Contraindicated
- Lomitapide + Verapamil Contraindicated
- Lonafarnib + Verapamil Contraindicated
- Pimozide + Verapamil Contraindicated
- Acebutolol + Verapamil Major
Frequently asked questions
Can I take Itraconazole with Verapamil?
MediHelp rates the interaction as major. Itraconazole and Verapamil 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 increases verapamil exposure, causing hypotension, bradycardia, AV block and edema. Itraconazole also has negative inotropic effects that may add to those of verapamil, and verapamil may raise itraconazole levels.
How serious is the interaction between Itraconazole and Verapamil?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood pressure, heart rate and ECG, and reduce the verapamil dose as needed. Avoid in patients with heart failure or conduction disease.
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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