Drug interactions
Midostaurin + Posaconazole
Severity: Major
Midostaurin and Posaconazole: major interaction.
Last updated Sources: Health Canada product monograph
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 increases midostaurin and its active metabolite exposure by inhibiting CYP3A4. This may increase adverse reactions such as nausea, infections and QT prolongation.
What this interaction means in plain words
Midostaurin 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.
Midostaurin belongs to Oncology; Posaconazole belongs to Anti Fungals.
Why it happens
Strong CYP3A4 inhibition reduces midostaurin clearance.
What to do
Consider an alternative antifungal. If coadministered, monitor for midostaurin toxicity closely, especially in the first week, and obtain ECGs if QT prolongation is a concern.
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 Posaconazole
- Artemether + Posaconazole Contraindicated
- Avanafil + Posaconazole Contraindicated
- Cobimetinib + Posaconazole Contraindicated
- Conivaptan + Posaconazole Contraindicated
- Dihydroergotamine intranasal + Posaconazole Contraindicated
- Dihydroergotamine + Posaconazole Contraindicated
Other interactions of Midostaurin
Frequently asked questions
Can I take Midostaurin with Posaconazole?
MediHelp rates the interaction as major. Midostaurin 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 increases midostaurin and its active metabolite exposure by inhibiting CYP3A4. This may increase adverse reactions such as nausea, infections and QT prolongation.
How serious is the interaction between Midostaurin 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: Consider an alternative antifungal. If coadministered, monitor for midostaurin toxicity closely, especially in the first week, and obtain ECGs if QT prolongation is a concern.
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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