Drug interactions
Itraconazole + Vincristine
Severity: Major
Itraconazole and Vincristine: 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 can greatly increase vincristine exposure, with reports of severe neurotoxicity including neuropathy, seizures, and paralytic ileus. This is a clinically important interaction in oncology patients.
What this interaction means in plain words
Itraconazole and Vincristine 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; Vincristine belongs to Oncology.
Why it happens
Inhibition of CYP3A4 and P-glycoprotein reduces vincristine clearance.
What to do
Avoid itraconazole during vincristine therapy and choose an antifungal with less CYP3A4 inhibition, such as an echinocandin. If unavoidable, monitor neurologic and bowel function 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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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 Vincristine
- Adenovirus types 4 and 7 live + Vincristine Contraindicated
- Apalutamide + Vincristine Major
- Atazanavir + Vincristine Major
- Ceritinib + Vincristine Major
- Chloramphenicol + Vincristine Major
- Clarithromycin + Vincristine Major
Frequently asked questions
Can I take Itraconazole with Vincristine?
MediHelp rates the interaction as major. Itraconazole and Vincristine 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 can greatly increase vincristine exposure, with reports of severe neurotoxicity including neuropathy, seizures, and paralytic ileus. This is a clinically important interaction in oncology patients.
How serious is the interaction between Itraconazole and Vincristine?
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 itraconazole during vincristine therapy and choose an antifungal with less CYP3A4 inhibition, such as an echinocandin. If unavoidable, monitor neurologic and bowel function 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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