Drug interactions
Macitentan + Posaconazole
Severity: Major
Macitentan and Posaconazole: 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
Posaconazole raises macitentan exposure by inhibiting CYP3A4. Higher levels may increase adverse effects such as anemia, hypotension and edema.
What this interaction means in plain words
Macitentan and Posaconazole 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.
Macitentan belongs to Cardiovascular; Posaconazole belongs to Anti Fungals.
Why it happens
Strong CYP3A4 inhibition reduces macitentan clearance.
What to do
Avoid concomitant use where possible. If needed, monitor blood pressure and hemoglobin, and watch for fluid retention.
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 Posaconazole
- Artemether + Posaconazole Contraindicated
- Avanafil + Posaconazole Contraindicated
- Cobimetinib + Posaconazole Contraindicated
- Conivaptan + Posaconazole Contraindicated
- Dihydroergotamine intranasal + Posaconazole Contraindicated
- Dihydroergotamine + Posaconazole Contraindicated
Other interactions of Macitentan
- Amiodarone + Macitentan Major
- Apalutamide + Macitentan Major
- Bosentan + Macitentan Major
- Carbamazepine + Macitentan Major
- Clarithromycin + Macitentan Major
- Efavirenz + Macitentan Major
Frequently asked questions
Can I take Macitentan with Posaconazole?
MediHelp rates the interaction as major. Macitentan and Posaconazole 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. Posaconazole raises macitentan exposure by inhibiting CYP3A4. Higher levels may increase adverse effects such as anemia, hypotension and edema.
How serious is the interaction between Macitentan and Posaconazole?
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 concomitant use where possible. If needed, monitor blood pressure and hemoglobin, and watch for fluid retention.
What other medicines interact with Posaconazole?
MediHelp also lists interactions of Posaconazole with, for example, Artemether, Avanafil, Cobimetinib. The full list is on the Posaconazole page.
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