Drug interactions
Vincristine liposomal + Voriconazole
Severity: Major
Vincristine liposomal 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 can raise vincristine exposure, and severe neurotoxicity including neuropathy, ileus and seizures has been reported with azole combinations. Liposomal formulation labeling advises avoiding strong CYP3A4 inhibitors.
What this interaction means in plain words
Vincristine liposomal 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.
Why it happens
Voriconazole inhibits CYP3A4 metabolism of vincristine, and may also inhibit P-glycoprotein-mediated clearance.
What to do
Avoid concurrent use where possible and choose an antifungal with less CYP3A4 inhibition, such as an echinocandin. If unavoidable, monitor closely for neurotoxicity and constipation.
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
Frequently asked questions
Can I take Vincristine liposomal with Voriconazole?
MediHelp rates the interaction as major. Vincristine liposomal 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 can raise vincristine exposure, and severe neurotoxicity including neuropathy, ileus and seizures has been reported with azole combinations. Liposomal formulation labeling advises avoiding strong CYP3A4 inhibitors.
How serious is the interaction between Vincristine liposomal 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 concurrent use where possible and choose an antifungal with less CYP3A4 inhibition, such as an echinocandin. If unavoidable, monitor closely for neurotoxicity and constipation.
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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