Drug interactions
Miconazole + Tolvaptan
Severity: Moderate
Miconazole and Tolvaptan: moderate 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
Miconazole may increase tolvaptan exposure, causing excessive aquaresis, dehydration, hypernatremia and rapid sodium correction. Systemic absorption from vaginal products is low, limiting relevance to local use.
What this interaction means in plain words
Miconazole and Tolvaptan can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Miconazole belongs to Anti Fungals; Tolvaptan belongs to Endocrine.
Why it happens
Miconazole inhibits CYP3A4 metabolism of tolvaptan.
What to do
Avoid systemic miconazole with tolvaptan. With vaginal use, monitor serum sodium and fluid status.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Miconazole
Other interactions of Tolvaptan
- Atazanavir + Tolvaptan Contraindicated
- Ceritinib + Tolvaptan Contraindicated
- Cobicistat + Tolvaptan Contraindicated
- Conivaptan + Tolvaptan Contraindicated
- Darunavir + Tolvaptan Contraindicated
- Idelalisib + Tolvaptan Contraindicated
Frequently asked questions
Can I take Miconazole with Tolvaptan?
MediHelp rates the interaction as moderate. Miconazole and Tolvaptan can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Miconazole may increase tolvaptan exposure, causing excessive aquaresis, dehydration, hypernatremia and rapid sodium correction. Systemic absorption from vaginal products is low, limiting relevance to local use.
How serious is the interaction between Miconazole and Tolvaptan?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid systemic miconazole with tolvaptan. With vaginal use, monitor serum sodium and fluid status.
What other medicines interact with Miconazole?
MediHelp also lists interactions of Miconazole with, for example, Cabazitaxel, Dihydroergotamine intranasal, Dihydroergotamine. The full list is on the Miconazole page.
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