Drug interactions
Posaconazole + Propafenone
Severity: Major
Posaconazole and Propafenone: 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 may increase propafenone concentrations by inhibiting CYP3A4, and the risk is greater in CYP2D6 poor metabolisers or those taking CYP2D6 inhibitors. Higher levels raise the risk of proarrhythmia, conduction disturbances and CNS effects, and both drugs may affect the QT interval.
What this interaction means in plain words
Posaconazole and Propafenone 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 belongs to Anti Fungals; Propafenone belongs to Cardiovascular.
Why it happens
Inhibition of CYP3A4 reduces propafenone N-dealkylation, with possible additive QT/conduction effects.
What to do
Avoid if possible; if used together, monitor ECG (QRS and QT) and consider reducing the propafenone dose.
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 Propafenone
- Dofetilide + Propafenone Contraindicated
- Dronedarone + Propafenone Contraindicated
- Nilotinib + Propafenone Contraindicated
- Nirmatrelvir / ritonavir + Propafenone Contraindicated
- Nirmatrelvir + Propafenone Contraindicated
- Pimozide + Propafenone Contraindicated
Frequently asked questions
Can I take Posaconazole with Propafenone?
MediHelp rates the interaction as major. Posaconazole and Propafenone 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 may increase propafenone concentrations by inhibiting CYP3A4, and the risk is greater in CYP2D6 poor metabolisers or those taking CYP2D6 inhibitors. Higher levels raise the risk of proarrhythmia, conduction disturbances and CNS effects, and both drugs may affect the QT interval.
How serious is the interaction between Posaconazole and Propafenone?
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 if possible; if used together, monitor ECG (QRS and QT) and consider reducing the propafenone dose.
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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