Drug interactions
Itraconazole + Zanubrutinib
Severity: Major
Itraconazole and Zanubrutinib: major interaction.
Last updated Sources: UK SmPC
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 raises zanubrutinib exposure substantially. This increases the risk of adverse effects such as bleeding, cytopenias, and infection.
What this interaction means in plain words
Itraconazole and Zanubrutinib 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; Zanubrutinib belongs to Oncology.
Why it happens
Strong CYP3A4 inhibition by itraconazole decreases zanubrutinib metabolism.
What to do
Reduce zanubrutinib to 80 mg once daily during itraconazole use. Monitor blood counts and bleeding, and resume the prior dose after itraconazole is stopped.
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 Zanubrutinib
Frequently asked questions
Can I take Itraconazole with Zanubrutinib?
MediHelp rates the interaction as major. Itraconazole and Zanubrutinib 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 raises zanubrutinib exposure substantially. This increases the risk of adverse effects such as bleeding, cytopenias, and infection.
How serious is the interaction between Itraconazole and Zanubrutinib?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce zanubrutinib to 80 mg once daily during itraconazole use. Monitor blood counts and bleeding, and resume the prior dose after itraconazole is stopped.
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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