Drug interactions
Quetiapine + Voriconazole
Severity: Major
Quetiapine 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 inhibits CYP3A4, the main route of quetiapine clearance, and can substantially increase quetiapine exposure. Both drugs also prolong the QT interval, so the risk of sedation, hypotension and torsades de pointes is increased.
What this interaction means in plain words
Quetiapine 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.
Quetiapine belongs to Central Nervous System; Voriconazole belongs to Anti Fungals.
Why it happens
CYP3A4 inhibition raises quetiapine levels, combined with additive QT prolongation.
What to do
Reduce the quetiapine dose substantially during voriconazole therapy and monitor ECG, electrolytes, sedation and blood pressure. Consider an alternative antipsychotic or antifungal where feasible.
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 Quetiapine
- Adagrasib + Quetiapine Major
- Amiodarone + Quetiapine Major
- Amisulpride + Quetiapine Major
- Amoxapine + Quetiapine Major
- Anagrelide + Quetiapine Major
- Apalutamide + Quetiapine Major
Frequently asked questions
Can I take Quetiapine with Voriconazole?
MediHelp rates the interaction as major. Quetiapine 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 inhibits CYP3A4, the main route of quetiapine clearance, and can substantially increase quetiapine exposure. Both drugs also prolong the QT interval, so the risk of sedation, hypotension and torsades de pointes is increased.
How serious is the interaction between Quetiapine 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: Reduce the quetiapine dose substantially during voriconazole therapy and monitor ECG, electrolytes, sedation and blood pressure. Consider an alternative antipsychotic or antifungal where feasible.
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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