Concomitant Drug Within Class | Prevention or Management |
Drug Interactions with Itraconazole Capsules that Increase Concomitant Drug Concentrations and May Increase Risk of Adverse Reactions Associated with the Concomitant Drug |
Alpha Blockers |
Alfuzosin Silodosin Tamsulosin | Not recommended during and 2 weeks after itraconazole capsule treatment. |
Analgesics |
Methadone | Contraindicated during and 2 weeks after itraconazole capsule treatment. |
Fentanyl | Not recommended during and 2 weeks after itraconazole capsule treatment. |
Alfentanil Buprenorphine (IV and sublingual) Oxycodone
Sufentanil | Monitor for adverse reactions. Concomitant drug dose reduction may be necessary. |
Antiarrhythmics |
Disopyramide Dofetilide Dronedarone Quinidine
| Contraindicated during and 2 weeks after itraconazole capsule treatment. |
Digoxin
| Monitor for adverse reactions. Concomitant drug dose reduction may be necessary. |
Antibacterials |
Bedaquiline
| Concomitant itraconazole capsules not recommended for more than 2 weeks at any time during bedaquiline treatment. |
Rifabutin | Not recommended 2 weeks before, during, and 2 weeks after itraconazole capsule treatment. See also Table 2. |
Clarithromycin | Monitor for adverse reactions. Concomitant drug dose reduction may be necessary. See also Table 2. |
Trimetrexate | Monitor for adverse reactions. Concomitant drug dose reduction may be necessary. |
Anticoagulants and Antiplatelets |
Ticagrelor | Contraindicated during and 2 weeks after itraconazole capsule treatment. |
Apixaban Rivaroxaban Vorapaxar | Not recommended during and 2 weeks after itraconazole capsule treatment. |
Cilostazol Dabigatran Warfarin | Monitor for adverse reactions. Concomitant drug dose reduction may be necessary. |
Anticonvulsants |
Carbamazepine | Not recommended 2 weeks before, during, and 2 weeks after itraconazole capsule treatment. See also Table 2. |
Antidiabetic Drugs |
Repaglinide
Saxagliptin | Monitor for adverse reactions. Concomitant drug dose reduction may be necessary. |
Antihelminthics, Antifungals and Antiprotozoals |
Isavuconazonium | Contraindicated during and 2 weeks after itraconazole capsule treatment. |
Praziquantel | Monitor for adverse reactions. Concomitant drug dose reduction may be necessary. |
Artemether-lumefantrine Quinine
| Monitor for adverse reactions. |
Antimigraine Drugs |
Ergot alkaloids (e.g., dihydroergotamine, ergotamine) | Contraindicated during and 2 weeks after itraconazole capsule treatment. |
Eletriptan | Monitor for adverse reactions. Concomitant drug dose reduction may be necessary. |
Antineoplastics |
Irinotecan | Contraindicated during and 2 weeks after itraconazole capsule treatment. |
Axitinib Bosutinib Cabazitaxel Cabozantinib Ceritinib Cobimetinib
Crizotinib Dabrafenib Dasatinib | Docetaxel Ibrutinib Lapatinib Nilotinib Olaparib
Pazopanib Sunitinib Trabectedin Trastuzumab-emtansine Vinca alkaloids | Not recommended during and 2 weeks after itraconazole capsule treatment. |
Bortezomib Brentuximab-vedotin Busulfan
Erlotinib Gefitinib
Idelalisib Imatinib Ixabepilone | Nintedanib Panobinostat Ponatinib Ruxolitinib Sonidegib Vandetanib
| Monitor for adverse reactions. Concomitant drug dose reduction may be necessary. For idelalisib, see also Table 2. |
Antipsychotics, Anxiolytics and Hypnotics |
Alprazolam Aripiprazole Buspirone
Cariprazine Diazepam Haloperidol
| Midazolam (IV) Quetiapine Ramelteon Risperidone
Suvorexant | Monitor for adverse reactions. Concomitant drug dose reduction may be necessary. |
Zopiclone
| Monitor for adverse reactions. Concomitant drug dose reduction may be necessary. |
Lurasidone Midazolam (oral)
Pimozide Triazolam
| Contraindicated during and 2 weeks after itraconazole capsule treatment. |
Antivirals |
Simeprevir | Not recommended during and 2 weeks after itraconazole capsule treatment. |
Daclatasvir Indinavir
Maraviroc | Monitor for adverse reactions. Concomitant drug dose reduction may be necessary. For indinavir, see also Table 2. |
Cobicistat Elvitegravir (ritonavir-boosted) Ombitasvir/Paritaprevir/Ritonavir with or without Dasabuvir Ritonavir Saquinavir (unboosted)
| Monitor for adverse reactions. See also Table 2. |
Elbasvir/grazoprevir Glecaprevir/pibrentasvir Tenofovir disoproxil fumarate | Not recommended during and 2 weeks after itraconazole capsule treatment. Monitor for adverse reactions. Monitor for adverse reactions. |
Beta Blockers |
Nadolol
| Monitor for adverse reactions. Concomitant drug dose reduction may be necessary. |
Calcium Channel Blockers |
Felodipine
Nisoldipine | Contraindicated during and 2 weeks after itraconazole capsule treatment. |
Diltiazem Other dihydropyridines Verapamil | Monitor for adverse reactions. Concomitant drug dose reduction may be necessary. For diltiazem, see also Table 2. |
Cardiovascular Drugs, Miscellaneous |
Ivabradine Ranolazine | Contraindicated during and 2 weeks after itraconazole capsule treatment. |
Aliskiren
Riociguat Sildenafil (for pulmonary hypertension) Tadalafil (for pulmonary hypertension) | Not recommended during and 2 weeks after itraconazole capsule treatment. For sildenafil and tadalafil, see also Urologic Drugs below. |
Bosentan Guanfacine | Monitor for adverse reactions. Concomitant drug dose reduction may be necessary. |
Contraceptives |
Dienogest Ulipristal | Monitor for adverse reactions. |
Diuretics |
Eplerenone | Contraindicated during and 2 weeks after itraconazole capsule treatment. |
Gastrointestinal Drugs |
Cisapride Naloxegol | Contraindicated during and 2 weeks after itraconazole capsule treatment. |
Aprepitant Loperamide
| Monitor for adverse reactions. Concomitant drug dose reduction may be necessary. |
Netupitant | Monitor for adverse reactions. |
Immunosuppressants |
Everolimus Sirolimus Temsirolimus (IV) | Not recommended during and 2 weeks after itraconazole capsule treatment. |
Budesonide (inhalation)
Budesonide (non-inhalation) Ciclesonide (inhalation) Cyclosporine (IV)
Cyclosporine (non-IV) Dexamethasonea
| Fluticasone (inhalation)
Fluticasone (nasal) Methylprednisolone
Tacrolimus (IV)
Tacrolimus (oral) | Monitor for adverse reactions. Concomitant drug dose reduction may be necessary. |
Lipid-Lowering Drugs |
Lomitapide Lovastatin
Simvastatin
| Contraindicated during and 2 weeks after itraconazole capsule treatment. |
Atorvastatin
| Monitor for drug adverse reactions. Concomitant drug dose reduction may be necessary. |
Respiratory Drugs |
Salmeterol | Not recommended during and 2 weeks after itraconazole capsule treatment. |
SSRIs, Tricyclics and Related Antidepressants |
Venlafaxine | Monitor for adverse reactions. Concomitant drug dose reduction may be necessary. |
Urologic Drugs |
Avanafil | Contraindicated during and 2 weeks after itraconazole capsule treatment. |
Fesoterodine | Patients with moderate to severe renal or hepatic impairment: Contraindicated during and 2 weeks after itraconazole capsule treatment. Other patients: Monitor for adverse reactions. Concomitant drug dose reduction may be necessary. |
Solifenacin | Patients with severe renal or moderate to severe hepatic impairment: Contraindicated during and 2 weeks after itraconazole capsule treatment. Other patients: Monitor for adverse reactions. Concomitant drug dose reduction may be necessary. |
Darifenacin Vardenafil | Not recommended during and 2 weeks after itraconazole capsule treatment. |
Dutasteride Oxybutynin
Sildenafil (for erectile dysfunction) Tadalafil (for erectile dysfunction and benign prostatic hyperplasia) Tolterodine | Monitor for adverse reactions. Concomitant drug dose reduction may be necessary. For sildenafil and tadalafil, see also Cardiovascular Drugs above. |
Miscellaneous Drugs and Other Substances |
Colchicine | Patients with renal or hepatic impairment: Contraindicated during and 2 weeks after itraconazole capsule treatment. Other patients: Not recommended during and 2 weeks after itraconazole capsule treatment. |
Eliglustat | CYP2D6 EMs taking a strong or moderate CYP2D6 inhibitor, CYP2D6 IMs, or CYP2D6 PMs: Contraindicated during and 2 weeks after itraconazole capsule treatment. CYP2D6 EMs not taking a strong or moderate CYP2D6 inhibitor: Monitor for adverse reactions. Eliglustat dose reduction may be necessary. |
Lumacaftor/Ivacaftor | Not recommended 2 weeks before, during, and 2 weeks after itraconazole capsule treatment. |
Alitretinoin (oral) Cabergoline Cannabinoids Cinacalcet Galantamine Ivacaftor | Monitor for adverse reactions. Concomitant drug dose reduction may be necessary. |
Vasopressin Receptor Antagonists |
Conivaptan Tolvaptan | Not recommended during and 2 weeks after itraconazole capsule treatment. |
Drug Interactions with Itraconazole Capsules that Decrease Concomitant Drug Concentrations and May Reduce Efficacy of the Concomitant Drug |
Antineoplastics |
Regorafenib | Not recommended during and 2 weeks after itraconazole capsule treatment. |
Gastrointestinal Drugs |
Sacchromyces boulardii | Not recommended during and 2 weeks after itraconazole capsule treatment. |
Nonsteroidal Anti-Inflammatory Drugs |
Meloxicam
| Concomitant drug dose increase may be necessary. |