Drug interactions
Macitentan + Voriconazole
Severity: Major
Macitentan and Voriconazole: 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
Voriconazole increases macitentan exposure by inhibiting CYP3A4, which may increase adverse effects such as hypotension, anemia and hepatotoxicity.
What this interaction means in plain words
Macitentan and Voriconazole 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; Voriconazole belongs to Anti Fungals.
Why it happens
Voriconazole inhibits CYP3A4-mediated metabolism of macitentan.
What to do
Avoid concomitant use per labeling and choose another antifungal. If it cannot be avoided, monitor blood pressure, hemoglobin and liver tests.
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 Voriconazole
- Avanafil + Voriconazole Contraindicated
- Butabarbital + Voriconazole Contraindicated
- Carbamazepine + Voriconazole Contraindicated
- Conivaptan + Voriconazole Contraindicated
- Dihydroergotamine intranasal + Voriconazole Contraindicated
- Dihydroergotamine + Voriconazole 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 Voriconazole?
MediHelp rates the interaction as major. Macitentan and Voriconazole 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. Voriconazole increases macitentan exposure by inhibiting CYP3A4, which may increase adverse effects such as hypotension, anemia and hepatotoxicity.
How serious is the interaction between Macitentan and Voriconazole?
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 per labeling and choose another antifungal. If it cannot be avoided, monitor blood pressure, hemoglobin and liver tests.
What other medicines interact with Voriconazole?
MediHelp also lists interactions of Voriconazole with, for example, Avanafil, Butabarbital, Carbamazepine. The full list is on the Voriconazole page.
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