Sporanox, Onmel, Tolsura (itraconazole) dosing, indications, interactions, adverse effects, and more

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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

capsule

65mg (Tolsura)
100mg (Sporanox, generic)

oral solution

10mg/mL (Sporanox, generic)

tablet

200mg (Onmel)

Life-threatening Infections

Recommended loading dose based on pharmacokinetic data

Sporanox

Loading dose: 200 mg (2 capsules) PO TID (600 mg/day) for the first 3 days, followed by recommended dosing based on indication

Tolsura

Loading dose: 130 mg (2 x 65 mg capsules) PO TID (390 mg/day) for the first 3 days, followed by recommended dosing based on indication

Continue for a minimum of 3 months and until active fungal infection has subsided; an inadequate period of treatment may lead to recurrence of active infection

Blastomycosis

Indicated for treatment of blastomycosis, including pulmonary and extrapulmonary infections in immunocompromised and nonimmunocompromised adults

Sporanox

200 mg PO qDay
If no improvement, or evidence of progressive fungal disease, increase dose in 100-mg increments to a maximum of 400 mg/day
Divide doses >200 mg/day into 2 doses

Tolsura

130 mg PO qDay
If no improvement, or evidence of progressive fungal disease, increase dose in 65 mg increments to a maximum of 260 mg/day (130 mg BID)
Divide doses >130 mg/day into 2 doses

Aspergillosis

Indicated for treatment of pulmonary and extrapulmonary aspergillosis in immunocompromised and nonimmunocompromised adults who are intolerant of or refractory to amphotericin B therapy

Sporanox

200-400 mg/day PO; may be used in combination with corticosteroids

Tolsura

130 mg PO qDay or BID

Histoplasmosis

Indicated for treatment of histoplasmosis, including chronic cavitary pulmonary disease and disseminated, nonmeningeal histoplasmosis in immunocompromised and nonimmunocompromised adults

Sporanox

200 mg PO qDay
If no improvement, or evidence of progressive fungal disease, increase dose in 100-mg increments to a maximum of 400 mg/day
Divide doses >200 mg/day into 2 doses

Tolsura

130 mg PO qDay
If no improvement, or evidence of progressive fungal disease, increase dose in 65 mg increments to a maximum of 260 mg/day (130 mg BID)
Divide doses >130 mg/day into 2 doses

Onychomycosis

Indicated for treatment of onychomycosis of the toenail due to Trichophyton rubrum or T. mentagrophytes in nonimmunocompromised patients

Fingernails (Sporanox only): 2 treatment pulses, each consisting of 200 mg q12hr for 1 week; pulses are separated by a 3-week period without Sporanox

Toenails, with or without fingernail involvement (Sporanox, Onmel): 200 mg/day PO for 12 weeks

Candidiasis

Indicated for treatment of oropharyngeal and esophageal candidiasis

Esophageal candidiasis

100 mg (10 mL) PO qDay for a minimum of 3 weeks; continue treatment for 2 weeks following resolution of symptoms
Doses ≤200 mg/day (20 mL) may be used based on medical judgment of the patient’s response to therapy

Oropharyngeal candidiasis

Oral solution only: 200 mg (20 mL) PO qDay for 1-2 weeks; signs and symptoms of oropharyngeal candidiasis generally resolve within several days
Unresponsive/refractory to fluconazole: 100 mg (10 mL) PO BID
Clinical response will be seen in 2-4 weeks
May be expected to relapse shortly after discontinuing therapy
Limited data on safety of long-term use (>6 months) of oral solution are available at this time

Otomycosis (Orphan)

Suspension: Topical treatment of fungal otitis externa (otomycosis)

Orphan indication sponsor

Fairfield Clinical Trials, LLC; 200 Steep Hill Road; Weston, CT 06883

Dosage Modifications

Renal impairment

Limited data are available on use of oral itraconazole in patients with renal impairment
Exercise caution when administered in this patient population

Hepatic impairment

Limited data are available on use of oral itraconazole in patients with hepatic impairment
Tolsura: In patients with elevated or abnormal liver enzymes or active liver disease, or who have experienced liver toxicity with other drugs, treatment is strongly discouraged unless there is a serious or life-threatening situation where the expected benefit exceeds the risk; monitor liver function

Dosing Considerations

In some immunocompromised patients (e.g., neutropenic, AIDS or organ transplant patients), oral bioavailability for drug may be decreased; adjust dose based on clinical response in these patients

Do not use Sporanox capsules and oral solution interchangeably; only the oral solution has been demonstrated effective for oral and/or esophageal candidiasis

Limitations of use (Tolsura)

Not indicated for onychomycosis
NOT interchangeable or substitutable with other itraconazole products due to differences in dosing; follow specific dosage recommendations for Tolsura

Safety and efficacy not established

Interaction Checker

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Contraindicated (45)

alfuzosin
itraconazole increases levels of alfuzosin by decreasing metabolism. Contraindicated.

alfuzosin and itraconazole both increase QTc interval. Contraindicated.
avanafil
itraconazole will increase the level or effect of avanafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration with strong CYP3A4 is contraindicated during and 2 weeks after itraconazole.
conivaptan
conivaptan will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Not recommended during, and 2 weeks after itraconazole.
dihydroergotamine
itraconazole will increase the level or effect of dihydroergotamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Increased risk of ergotism leading to cerebral ischemia and/or ischemia of the extremities
dihydroergotamine intranasal
itraconazole will increase the level or effect of dihydroergotamine intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Increased risk of ergotism leading to cerebral ischemia and/or ischemia of the extremities
disopyramide
itraconazole will increase the level or effect of disopyramide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

disopyramide and itraconazole both increase QTc interval. Contraindicated.
dofetilide
dofetilide and itraconazole both increase QTc interval. Contraindicated.

itraconazole will increase the level or effect of dofetilide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Both drugs will increase QT interval
dronedarone
itraconazole will increase the level or effect of dronedarone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Contraindicated during and 2 weeks after itraconazole treatment.

itraconazole and dronedarone both increase QTc interval. Contraindicated.
eliglustat
itraconazole will increase the level or effect of eliglustat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Strong CYP3A4 inhibitors are contraindicated with eliglustat poor or intermediate metabolizers; reduce eliglustat dose from 84 mg BID to 84 mg once daily in extensive metabolizers; eliglustat is contraindiated if strong or moderate CYP2D6 inhibitors are given concomitantly with strong or moderate CYP3A inhibitors

itraconazole and eliglustat both increase QTc interval. Contraindicated.
eplerenone
itraconazole will increase the level or effect of eplerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. May increase the risk of hyperkalemia and hypotension
ergoloid mesylates
itraconazole will increase the level or effect of ergoloid mesylates by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
ergotamine
itraconazole will increase the level or effect of ergotamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Increased risk of ergotism leading to cerebral ischemia and/or ischemia of the extremities
estazolam
itraconazole will increase the level or effect of estazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
felodipine
felodipine will increase the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Contraindicated.

itraconazole will increase the level or effect of felodipine by Other (see comment). Contraindicated. CCBs elicit negative inotropic effects which may be additive to those of itraconazole; additionally, itraconazole can inhibit the metabolism of calcium channel blockers. Coadministration is contraindicated during and 2 weeks after itraconazole treatment.
fesoterodine
itraconazole will increase the level or effect of fesoterodine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration in patients with renal or hepatic impairment may result in increased fesoterodine levels and increased risk for potentially fatal adverse events.
finerenone
itraconazole will increase the level or effect of finerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
flibanserin
itraconazole will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of flibanserin with moderate or strong CYP3A4 inhibitors is contraindicated. Severe hypotension or syncope can occur.
indapamide
indapamide and itraconazole both increase QTc interval. Contraindicated.
irinotecan
itraconazole will increase the level or effect of irinotecan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Strong CYP3A4 Inhibitors may increase the serum concentration of SN-38 (active metabolite for irinotecan products). Contraindicated during and 2 weeks after itraconazole treatment.
irinotecan liposomal
itraconazole will increase the level or effect of irinotecan liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Contraindicated during and 2 weeks after itraconazole treatment. Strong CYP3A4 Inhibitors may increase the serum concentration of SN-38 (active metabolite for irinotecan products).
isavuconazonium sulfate
itraconazole will increase the level or effect of isavuconazonium sulfate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
ivabradine
itraconazole will increase the level or effect of ivabradine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of ivabradine with itraconazole is contraindicated during and 2 weeks after of itraconazole treatment.
lomitapide
itraconazole increases levels of lomitapide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of lomitapide with itraconazole is contraindicated during and 2 weeks after of itraconazole treatment.
lonafarnib
itraconazole will increase the level or effect of lonafarnib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Lonafarnib is a sensitive CYP3A4 substrate. Coadministration with strong or moderate CYP3A4 inhibitors is contraindicated.
lovastatin
itraconazole will increase the level or effect of lovastatin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of lovastatin with itraconazole is contraindicated during and 2 weeks after of itraconazole treatment.
lurasidone
itraconazole will increase the level or effect of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of lurasidone and strong CYP3A4 inhibitors is contraindicated.
mavacamten
itraconazole will increase the level or effect of mavacamten by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Strong CYP3A4 inhibitors may increase mavacamten systemic exposure, resulting in heart failure due to systolic dysfunction.
methadone
itraconazole will increase the level or effect of methadone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. QT interval prolongation and serious arrhythmia (torsades de pointes) have occurred in patients using methadone concomitantly with oral itraconazole and/or other CYP3A4 inhibitors.
methylergonovine
itraconazole increases effects of methylergonovine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Increased risk of ergotism leading to cerebral ischemia and/or ischemia of the extremities.
midazolam
itraconazole will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of oral midazolam and itraconazole is contraindicated during and 2 weeks after itraconazole treatment. Use IV midazolam with great caution in patients receiving itraconazole, consider reduced initial doses whenever possible and closely monitor.
naloxegol
itraconazole will increase the level or effect of naloxegol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of naloxegol with strong CYP3A4 inhibitors can significantly increase naloxegol systemic exposure which may precipitate opioid withdrawal symptoms
nisoldipine
itraconazole will increase the level or effect of nisoldipine by Other (see comment). Contraindicated. CCBs elicit negative inotropic effects which may be additive to those of itraconazole; additionally, itraconazole can inhibit the metabolism of calcium channel blockers. Coadministration is contraindicated during and 2 weeks after itraconazole treatment.
pacritinib
itraconazole will increase the level or effect of pacritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
pimozide
itraconazole will increase the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Both drugs will increase QT interval. Coadministration of pimozide and itraconazole is contraindicated during and 2 weeks after itraconazole treatment.
quinidine
itraconazole will increase the level or effect of quinidine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Both drugs will increase QT interval. Coadministration of quinidine and itraconazole is contraindicated during and 2 weeks after itraconazole treatment.

quinidine will increase the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Contraindicated. Both drugs will increase QT interval

quinidine and itraconazole both increase QTc interval. Contraindicated.
ranolazine
itraconazole will increase the level or effect of ranolazine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. May increase risk of cardiovascular events, including prolonged QTc. Coadministration of ranolazine and itraconazole is contraindicated during and 2 weeks after itraconazole treatment.

ranolazine will increase the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Contraindicated.
silodosin
itraconazole will increase the level or effect of silodosin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Not recommended during and 2 weeks after itraconazole treatment.

itraconazole will increase the level or effect of silodosin by P-glycoprotein (MDR1) efflux transporter. Contraindicated. Not recommended during and 2 weeks after itraconazole treatment.
simvastatin
itraconazole will increase the level or effect of simvastatin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Contraindicated during and 2 weeks after itraconazole treatment. Increased risk for rhabdomyolysis with drugs that increase simvastatin systemic exposure.
solifenacin
itraconazole will increase the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration in patients with renal or hepatic impairment may result in increased solifenacin levels and increased risk for potentially fatal adverse events.
ticagrelor
itraconazole increases levels of ticagrelor by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Contraindicated during and 2 weeks after itraconazole treatment.
tolvaptan
itraconazole will increase the level or effect of tolvaptan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Larger doses of strong CYP3A4 inhibitors may produce larger increases in tolvaptan exposure. Concomitant use of tolvaptan with strong CYP3A4 inhibitors is contraindicated.
triazolam
itraconazole will increase the level or effect of triazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Both drugs will increase QT interval

itraconazole increases levels of triazolam by decreasing metabolism. Contraindicated.
ubrogepant
itraconazole will increase the level or effect of ubrogepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
venetoclax
itraconazole will increase the level or effect of venetoclax by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Use of strong CYP3A4 inhibitors is contraindicated with venetoclax during the initial ramp-up dosing phase. If a strong CYP3A inhibitor must be used after the ramp-up phase, reduce the venetoclax dose by at least 75%.
voclosporin
itraconazole will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

itraconazole and voclosporin both increase QTc interval. Contraindicated.

Serious - Use Alternative (215)

abametapir
abametapir will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates. If not feasible, avoid use of abametapir.
acalabrutinib
itraconazole will increase the level or effect of acalabrutinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of acalabrutinib with strong CYP3A inhibitors. If a strong CYP3A inhibitor must be used short-term (eg, up to 7 days), temporarily interrupt treatment with acalabrutinib.
adagrasib
itraconazole will increase the level or effect of adagrasib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of adagrasib, a CYP3A4 substrate, with strong CYP3A4 inhibitors until adagrasib concentrations have reached steady-state (after ~8 days). If steady state is not reached, concomitant use of strong CYP3A4 inhibitors will increase adagrasib concentrations and risk of its toxicities
ado-trastuzumab emtansine
itraconazole increases levels of ado-trastuzumab emtansine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Consider an alternate medication with no or minimal potential to inhibit CYP3A4. If concomitant use of strong CYP3A4 inhibitors is unavoidable, consider delaying ado-trastuzumab until the strong CYP3A4 inhibitors have cleared from the circulation (~3 elimination half-lives of the inhibitors) when possible. If a strong CYP3A4 inhibitor is coadministered and ado-trastuzumab cannot be delayed, closely monitor for adverse reactions.
afatinib
itraconazole increases levels of afatinib by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. Reduce afatinib daily dose by 10 mg if not tolerated when coadministered with P-gp inhibitors.
aliskiren
itraconazole will increase the level or effect of aliskiren by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. Consider an alternative with no or minimal potential to inhibit CYP3A4. If concomitant use of strong CYP3A4 inhibitors is unavoidable, closely monitor for respiratory depression and sedation, and consider decreasing alfentanil dose necessary.
almotriptan
itraconazole will increase the level or effect of almotriptan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Start almotriptan dose at 6.25 mg when coadministered with potent CYP3A4 inhibitors. Do not exceed 12.5 mg/day. Avoid concomitant use of almotriptan and potent CYP3A4 inhibitors in patients with renal or hepatic impairment.
alprazolam
itraconazole increases levels of alprazolam by decreasing metabolism. Avoid or Use Alternate Drug.
amiodarone
itraconazole will increase the level or effect of amiodarone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

amiodarone and itraconazole both increase QTc interval. Avoid or Use Alternate Drug. Coadministration of amiodarone and a QT prolonging agent may result in additive effects on the QT interval and increase risk of torsades de pointes.
amisulpride
amisulpride and itraconazole both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.
anagrelide
itraconazole and anagrelide both increase QTc interval. Avoid or Use Alternate Drug.
apalutamide
apalutamide will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid concurrent use 2 weeks before and during itraconazole treatment. Evaluate for loss of therapeutic effect if medication must be coadministered.
aprepitant
itraconazole will increase the level or effect of aprepitant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
aripiprazole
aripiprazole and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
artemether
artemether and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
artemether/lumefantrine
artemether/lumefantrine and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
asenapine
itraconazole and asenapine both increase QTc interval. Avoid or Use Alternate Drug.
asenapine transdermal
asenapine transdermal and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
atorvastatin
itraconazole will increase the level or effect of atorvastatin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Limit atorvastatin dose to 20 mg/day
avapritinib
itraconazole will increase the level or effect of avapritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of avapritinib with strong CYP3A4 inhibitors.
axitinib
itraconazole increases levels of axitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If unable to avoid coadministration with strong CYP3A4 inhibitors, reduce axitinib dose by 50%.
bazedoxifene/conjugated estrogens
itraconazole will increase the level or effect of bazedoxifene/conjugated estrogens by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
bedaquiline
itraconazole will increase the level or effect of bedaquiline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of bedaquiline with strong CYP3A4 inhibitors for >14 consecutive days, unless the benefit of treatment outweighs the risk

bedaquiline and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
bosutinib
itraconazole increases levels of bosutinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors increases bosutinib plasma concentration ~5-fold.

itraconazole increases levels of bosutinib by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.

itraconazole and bosutinib both increase QTc interval. Avoid or Use Alternate Drug.
brigatinib
itraconazole will increase the level or effect of brigatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If concomitant use of a strong CYP3A inhibitor cannot be avoided, reduce the brigatinib once daily dose by about 50% (ie, from 180 mg to 90 mg, or from 90 mg to 60 mg). After discontinuation of a strong CYP3A inhibitor, resume the brigatinib dose that was tolerated prior to initiating the strong CYP3A inhibitor.
bromocriptine
itraconazole will increase the level or effect of bromocriptine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
budesonide
itraconazole will increase the level or effect of budesonide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration is necessary, closely monitor for signs and symptoms of corticosteroid excess.
buprenorphine
itraconazole will increase the level or effect of buprenorphine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

itraconazole and buprenorphine both increase QTc interval. Avoid or Use Alternate Drug.
buprenorphine buccal
buprenorphine buccal and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
buprenorphine subdermal implant
buprenorphine subdermal implant and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
buprenorphine transdermal
itraconazole will increase the level or effect of buprenorphine transdermal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

buprenorphine transdermal and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
buprenorphine, long-acting injection
buprenorphine, long-acting injection and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
cabazitaxel
itraconazole will increase the level or effect of cabazitaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of cabazitaxel with strong CYP3A4 inhibitors. If patients require coadministration of a strong CYP3A inhibitor, consider a 25% cabazitaxel dose reduction.
cabozantinib
itraconazole will increase the level or effect of cabozantinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of cabozantinib with strong CYP3A4 inhibitors. If a strong CYP3A4 inhibitor is required, decrease cabozantinib dose by 40 mg/day (Cometriq) or by 20 mg/day (Cabometyx). Resume previous dose 2-3 days after strong CYP3A4 inhibitor discontinued.
calcitriol
itraconazole will increase the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
carbamazepine
itraconazole will increase the level or effect of carbamazepine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Not recommended 2 weeks before, during, and 2 weeks after itraconazole.

carbamazepine will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Not recommended 2 weeks before, during, and 2 weeks after itraconazole.
ceritinib
itraconazole increases levels of ceritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid if possible; if concomitant use is unavoidable, reduce ceritinib dose by ~33%; after discontinuation of strong CYP3A inhibitor, resume at previous dose.

ceritinib and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.

ceritinib will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
chloroquine
itraconazole will increase the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

chloroquine and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
citalopram
citalopram and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
clarithromycin
itraconazole will increase the level or effect of clarithromycin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
clozapine
itraconazole will increase the level or effect of clozapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

clozapine and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
cobicistat
itraconazole will increase the level or effect of cobicistat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
cobimetinib
itraconazole will increase the level or effect of cobimetinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration with strong CYP3A4 inhibitors with (increases cobimetinib systemic exposure by 6.7-fold).
colchicine
itraconazole will increase the level or effect of colchicine by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. Avoid use of colchicine with P-gp inhibitors. If coadministration is necessary, decrease colchicine dose or frequency as recommended in prescribing information. Use of any colchicine product in conjunction with P-gp inhibitors is contraindicated in patients with renal or hepatic impairment.

itraconazole will increase the level or effect of colchicine by Other (see comment). Avoid or Use Alternate Drug. Colchicine is a P-gp and CYP3A4 substrate. Avoid use with drugs that are both P-gp and strong CYP3A4 inhibitors. If coadministration is necessary, decrease colchicine dose or frequency as recommended in prescribing information. Use of any colchicine product in conjunction with strong CYP3A4 inhibitors is contraindicated in patients with renal or hepatic impairment.
conjugated estrogens
itraconazole will increase the level or effect of conjugated estrogens by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
conjugated estrogens, vaginal
itraconazole will increase the level or effect of conjugated estrogens, vaginal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
copanlisib
itraconazole will increase the level or effect of copanlisib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If concomitant use with strong CYP3A inhibitors cannot be avoided, reduce copanlisib dose to 45 mg.
crizotinib
itraconazole increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If combination cannot be avoided, decrease crizotinib dose to 250 mg daily. Monitor for increased crizotinib toxicities, including QTc interval prolongation and ventricular arrhythmias. .

crizotinib and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
dabrafenib
itraconazole will increase the level or effect of dabrafenib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Not recommended during and 2 weeks after itraconazole.

itraconazole and dabrafenib both increase QTc interval. Avoid or Use Alternate Drug.
daridorexant
itraconazole will increase the level or effect of daridorexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
darifenacin
itraconazole will increase the level or effect of darifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Not recommended during and 2 weeks after itraconazole.
dasatinib
itraconazole will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Not recommended during and 2 weeks after itraconazole.

itraconazole and dasatinib both increase QTc interval. Avoid or Use Alternate Drug.
desflurane
desflurane and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
dexlansoprazole
dexlansoprazole will decrease the level or effect of itraconazole by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
docetaxel
itraconazole will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration is unavoidable, consider a 50% docetaxel dose reduction and monitor for increased docetaxel toxicities.
doxorubicin
itraconazole will increase the level or effect of doxorubicin by Other (see comment). Avoid or Use Alternate Drug. Doxorubicin is a CYP3A4 and P-gp substrate. Avoid use in combination with CYP3A4 and P-gp inhibitors due to the potential for increased doxorubicin systemic exposure and effects.
droperidol
itraconazole and droperidol both increase QTc interval. Avoid or Use Alternate Drug.
edoxaban
itraconazole will increase the level or effect of edoxaban by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. Dose adjustment may be required with strong P-gp inhibitors. DVT/PE treatment: Decrease dose to 30 mg PO once daily. NVAF: No dose reduction recommended
efavirenz
itraconazole will increase the level or effect of efavirenz by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Not recommended 2 weeks before and during itraconazole.

efavirenz will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Not recommended 2 weeks before and during itraconazole.

efavirenz and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
elacestrant
itraconazole will increase the level or effect of elacestrant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
elbasvir/grazoprevir
itraconazole will increase the level or effect of elbasvir/grazoprevir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
eletriptan
itraconazole increases levels of eletriptan by decreasing metabolism. Contraindicated. Use of eletriptan within at least 72 hr of treatment with a strong CYP3A4 inhibitor is contraindicated.
elvitegravir/cobicistat/emtricitabine/tenofovir DF
itraconazole will increase the level or effect of elvitegravir/cobicistat/emtricitabine/tenofovir DF by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
encorafenib
itraconazole will increase the level or effect of encorafenib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If concomitant use of a strong CYP3A4 inhibitor is unavoidable, reduce encorafenib dose to one-third of the dose (eg, reduce from 450 mg/day to 150 mg/day). After discontinuing the inhibitor for 3-5 elimination half-lives, resume previous encorafenib dose.

encorafenib and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
entrectinib
itraconazole will increase the level or effect of entrectinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of strong CYP3A4 inhibitors with entrectinib, a CYP3A4 substrate. If coadministration unavoidable, reduce entrectinib dose to 100 mg/day for patients aged 12 y or older with BSA >1.50m2. Resume previous entrectinib dose after discontinuing strong CYP3A inhibitor for 3-5 elimination half-lives.

entrectinib and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
enzalutamide
itraconazole will increase the level or effect of enzalutamide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

enzalutamide will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
erdafitinib
itraconazole will increase the level or effect of erdafitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If unable to avoid coadministration with strong CYP3A4 inhibitors, monitor closely for adverse reactions and consider decreasing dose accordingly. If strong CYP3A4 inhibitor is discontinued, consider increasing erdafitinib dose in the absence of any drug-related toxicities.
eribulin
eribulin and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
erlotinib
itraconazole will increase the level or effect of erlotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. When combination must be used, closely monitor for severe adverse reactions (eg, severe diarrhea, severe skin reactions). If severe adverse reactions do occur, reduce erlotinib dose (in 50 mg decrements).
erythromycin base
itraconazole will increase the level or effect of erythromycin base by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

itraconazole and erythromycin base both increase QTc interval. Avoid or Use Alternate Drug.
erythromycin ethylsuccinate
itraconazole will increase the level or effect of erythromycin ethylsuccinate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

itraconazole and erythromycin ethylsuccinate both increase QTc interval. Avoid or Use Alternate Drug.
erythromycin lactobionate
itraconazole will increase the level or effect of erythromycin lactobionate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

itraconazole and erythromycin lactobionate both increase QTc interval. Avoid or Use Alternate Drug.
erythromycin stearate
itraconazole will increase the level or effect of erythromycin stearate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

itraconazole and erythromycin stearate both increase QTc interval. Avoid or Use Alternate Drug.
esomeprazole
esomeprazole will decrease the level or effect of itraconazole by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
eszopiclone
itraconazole will increase the level or effect of eszopiclone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
everolimus
itraconazole will increase the level or effect of everolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Not recommended during and 2 weeks after itraconazole.

itraconazole will increase the level or effect of everolimus by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. Not recommended during and 2 weeks after itraconazole.
famotidine
famotidine will decrease the level or effect of itraconazole by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
fedratinib
itraconazole will increase the level or effect of fedratinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If unable to avoid fedratinib coadministration with strong CYP3A4 inhibitors, decrease fedratinib dose to 200 mg/day. If CYP3A4 inhibitor discontinued, increase fedratinib dose to 300 mg/day for 2 weeks, and then 400 mg/day thereafter as tolerated.
felbamate
itraconazole will increase the level or effect of felbamate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
fentanyl
itraconazole will increase the level or effect of fentanyl by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Not recommended during and 2 weeks after itraconazole. If coadministration with fentanyl is necessary, closely monitor for respiratory depression and sedation and consider fentanyl dose adjustments until stable drug effects are achieved.
fentanyl intranasal
itraconazole will increase the level or effect of fentanyl intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Not recommended during and 2 weeks after itraconazole. If coadministration with fentanyl is necessary, closely monitor for respiratory depression and sedation and consider fentanyl dose adjustments until stable drug effects are achieved.
fentanyl transdermal
itraconazole will increase the level or effect of fentanyl transdermal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Not recommended during and 2 weeks after itraconazole. If coadministration with fentanyl is necessary, closely monitor for respiratory depression and sedation and consider fentanyl dose adjustments until stable drug effects are achieved.
fentanyl transmucosal
itraconazole will increase the level or effect of fentanyl transmucosal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Not recommended during and 2 weeks after itraconazole. If coadministration with fentanyl is necessary, closely monitor for respiratory depression and sedation and consider fentanyl dose adjustments until stable drug effects are achieved.
fexinidazole
itraconazole will decrease the level or effect of fexinidazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If unable to avoid coadministration, monitor fexinidazole for decreased efficacy owing to decreased plasma concentrations of active M1 and M2 metabolites.

fexinidazole and itraconazole both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval.

fexinidazole will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Fexinidazole inhibits CYP3A4. Coadministration may increase risk for adverse effects of CYP3A4 substrates.
fluconazole
fluconazole and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
fluticasone intranasal
itraconazole will increase the level or effect of fluticasone intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase systemic corticosteroid adverse effects; monitor for signs/symptoms of high corticosteroid concentrations including Cushing type signs/symptoms.
fosamprenavir
itraconazole will increase the level or effect of fosamprenavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Do not exceed itraconazole dose to 200 mg/day in patients receiving fosamprenavir/ritonavir. In patients receiving fosamprenavir alone, dose reductions may be needed for patients receiving itraconazole doses greater than 400 mg/day.
fosaprepitant
itraconazole will increase the level or effect of fosaprepitant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
foscarnet
itraconazole and foscarnet both increase QTc interval. Avoid or Use Alternate Drug.
futibatinib
itraconazole will increase the level or effect of futibatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of futibatinib with drugs that are dual P-gp and strong CYP3A inhibitors may increase incidence/severity of futibatinib toxicities.
gilteritinib
itraconazole will increase the level or effect of gilteritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Consider alternatives to any strong CYP3A4 inhibitor when coadministered with gilteritinib. If such a combination cannot be avoided, closely monitor for gilteritinib-related adverse effects.

gilteritinib and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
glasdegib
itraconazole and glasdegib both increase QTc interval. Avoid or Use Alternate Drug.
hydroxychloroquine sulfate
itraconazole and hydroxychloroquine sulfate both increase QTc interval. Avoid or Use Alternate Drug.
hydroxyprogesterone caproate
itraconazole will increase the level or effect of hydroxyprogesterone caproate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
ibrutinib
itraconazole increases levels of ibrutinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid concomitant use of ibrutinib and strong CYP3A4 inhibitors. If a strong CYP3A4 inhibitor must be used short-term (eg, anti-infectives for =7 days), interrupt ibrutinib therapy until strong CYP3A4 inhibitor is discontinued.
ibuprofen/famotidine
ibuprofen/famotidine will decrease the level or effect of itraconazole by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Administer acid neutralizing medicines at least 2 hours before or 2 hours after the intake of itraconazole.
idelalisib
itraconazole will increase the level or effect of idelalisib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministered with strong CYP3A inhibitors, monitor for signs of idelalisib toxicity; follow recommendations for dosage modifications if adverse reactions occur

idelalisib will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Idelalisib is a strong CYP3A inhibitor; avoid coadministration with sensitive CYP3A substrates
iloperidone
itraconazole and iloperidone both increase QTc interval. Avoid or Use Alternate Drug.
imipramine
imipramine and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
indacaterol, inhaled
itraconazole and indacaterol, inhaled both increase QTc interval. Avoid or Use Alternate Drug.
inotuzumab
itraconazole and inotuzumab both increase QTc interval. Avoid or Use Alternate Drug.
isoflurane
isoflurane and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
ivosidenib
itraconazole will increase the level or effect of ivosidenib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of a strong CYP3A4 inhibitor is unavoidable, reduce ivosidenib dose to 250 mg qDay. If the strong inhibitor is discontinued, increase ivosidenib dose (after at least 5 half-lives of the strong CYP3A4 inhibitor) to 500 mg qDay. Monitor for increased risk of QTc interval prolongation.

ivosidenib will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Do not administer ivosidenib with itraconzole due to expected loss of antifungal efficacy.

itraconazole and ivosidenib both decrease QTc interval. Avoid or Use Alternate Drug.
ketamine
itraconazole will increase the level or effect of ketamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
ketoconazole
itraconazole will increase the level or effect of ketoconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

ketoconazole will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
lansoprazole
lansoprazole will decrease the level or effect of itraconazole by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
lapatinib
itraconazole will increase the level or effect of lapatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid concomitant use of strong CYP3A4 inhibitors with lapatinib. If an overlap in therapy cannot be avoided, consider reducing lapatinib dose to 500 mg/day during, and within 1 week of completing treatment with strong CYP3A4 inhibitor.
larotrectinib
itraconazole will increase the level or effect of larotrectinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of larotrectinib with strong CYP3A4 inhibitors is unavoidable, reduce larotrectinib dose by 50%. Resume prior larotrectinib dose once CYP3A4 inhibitor discontinued for 3-5 half-lives.
lefamulin
itraconazole will increase the level or effect of lefamulin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of lefamulin with strong CYP3A inhibitors.

lefamulin and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
lemborexant
itraconazole will increase the level or effect of lemborexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of lemborexant with moderate or strong CYP3A inhibitors.
lenvatinib
itraconazole and lenvatinib both increase QTc interval. Avoid or Use Alternate Drug.
levoketoconazole
levoketoconazole will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

itraconazole will increase the level or effect of levoketoconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

itraconazole and levoketoconazole both increase QTc interval. Avoid or Use Alternate Drug.
lofepramine
lofepramine and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
lofexidine
itraconazole and lofexidine both increase QTc interval. Avoid or Use Alternate Drug.
lopinavir
lopinavir will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

itraconazole and lopinavir both increase QTc interval. Avoid or Use Alternate Drug.
lorlatinib
itraconazole will increase the level or effect of lorlatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministering lorlatinib with strong CYP3A inhibitors. If unavoidable, reduce lorlatinib dose by 25 mg/day. If strong CYP3A inhibitor discontinued, increase to previous lorlatinib (dose after 3 plasma half-lives of strong CYP3A inhibitor). See monograph for further details.

lorlatinib will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
lumacaftor/ivacaftor
lumacaftor/ivacaftor will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
lurbinectedin
itraconazole will increase the level or effect of lurbinectedin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
macimorelin
itraconazole and macimorelin both increase QTc interval. Avoid or Use Alternate Drug.
macitentan
itraconazole will increase the level or effect of macitentan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministering macitentan with strong CYP3A4 inhibitors
maprotiline
maprotiline and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
mefloquine
mefloquine increases toxicity of itraconazole by QTc interval. Avoid or Use Alternate Drug. Mefloquine may enhance the QTc prolonging effect of high risk QTc prolonging agents.

itraconazole will increase the level or effect of mefloquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Potential for increased toxicity. Avoid coadministration during and for 15 weeks after discontinuing mefloquine.
midazolam intranasal
itraconazole will increase the level or effect of midazolam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of strong CYP3A4 inhibitors with midazolam intranasal causes higher midazolam systemic exposure, which may prolong sedation.
midostaurin
itraconazole will increase the level or effect of midostaurin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration with strong CYP3A4 inhibitors cannot be avoided, monitor midostaurin for increased risk of adverse reactions, especially during the first week of treatment.

itraconazole and midostaurin both increase QTc interval. Avoid or Use Alternate Drug.
mifepristone
mifepristone will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

itraconazole and mifepristone both increase QTc interval. Avoid or Use Alternate Drug.
mobocertinib
itraconazole will increase the level or effect of mobocertinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

itraconazole and mobocertinib both increase QTc interval. Avoid or Use Alternate Drug.
nefazodone
itraconazole will increase the level or effect of nefazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
neratinib
itraconazole will increase the level or effect of neratinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of neratinib with strong/moderate CYP3A4 inhibitors.
nevirapine
itraconazole will increase the level or effect of nevirapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
nilotinib
itraconazole will increase the level or effect of nilotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of a strong CYP3A4 inhibitor is unavoidable, reduce nilotinib to 300 mg qDay in patients with resistant or intolerant Ph+ CML or to 200 mg qDay in patients with newly diagnosed Ph+ CML-CP. If strong inhibitor is discontinued, allow a washout period before adjusting the nilotinib dose to the indicated dose.

itraconazole and nilotinib both increase QTc interval. Avoid or Use Alternate Drug.
nizatidine
nizatidine will decrease the level or effect of itraconazole by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
nortriptyline
nortriptyline and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
olaparib
itraconazole will increase the level or effect of olaparib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration with strong CYP3A inhibitors cannot be avoided, reduce olaparib dose to 150 mg (capsule) or 100 mg (tablet) PO BID. Do not substitute tablets with capsules.
omaveloxolone
itraconazole will increase the level or effect of omaveloxolone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If unavoidable, reduce omaveloxolone dose to 50 mg/day. Closely monitor and discontinue if adverse effects emerge.
ombitasvir/paritaprevir/ritonavir
itraconazole will increase the level or effect of ombitasvir/paritaprevir/ritonavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
ombitasvir/paritaprevir/ritonavir & dasabuvir (DSC)
itraconazole will increase the level or effect of ombitasvir/paritaprevir/ritonavir & dasabuvir (DSC) by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
omeprazole
omeprazole will decrease the level or effect of itraconazole by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
ondansetron
itraconazole and ondansetron both increase QTc interval. Avoid or Use Alternate Drug.
osimertinib
itraconazole and osimertinib both increase QTc interval. Avoid or Use Alternate Drug.
oxaliplatin
itraconazole and oxaliplatin both increase QTc interval. Avoid or Use Alternate Drug.
ozanimod
itraconazole and ozanimod both increase QTc interval. Avoid or Use Alternate Drug.
palbociclib
itraconazole will increase the level or effect of palbociclib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of palbociclib with strong CYP3A inhibitors. If unable to avoid, reduce palbociclib dose to 75 mg/day.
panobinostat
itraconazole and panobinostat both increase QTc interval. Avoid or Use Alternate Drug.
pantoprazole
pantoprazole will decrease the level or effect of itraconazole by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
pazopanib
itraconazole and pazopanib both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, reduce pazopanib dose to 400 mg PO qDay; closely monitor for QT prolongation
pemigatinib
itraconazole will increase the level or effect of pemigatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration with strong or moderate CYP3A4 inhibitors is unavoidable, reduce pemigatinib dose (refer to drug monograph dosage modifications). After discontinuing the CYP3A4 inhibitor for 3 elimination half-lives, may resume previous pemigatinib dose.
pentamidine
itraconazole and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.
perphenazine
perphenazine and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
pexidartinib
itraconazole will increase the level or effect of pexidartinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration with strong or moderate CYP3A4 inhibitors is unavoidable, reduce pexidartinib dose (refer to drug monograph dosage modifications). After discontinuing the CYP3A4 inhibitor for 3 elimination half-lives, may resume previous pexidartinib dose.
phenytoin
phenytoin decreases levels of itraconazole by increasing metabolism. Avoid or Use Alternate Drug.
pimavanserin
itraconazole will increase the level or effect of pimavanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Decrease dose to 10 mg/day if pimavanserin is coadministered with strong CYP3A4 inhibitors.

itraconazole and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.
pitolisant
itraconazole will increase the level or effect of pitolisant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

itraconazole and pitolisant both increase QTc interval. Avoid or Use Alternate Drug.
ponesimod
itraconazole and ponesimod both increase QTc interval. Avoid or Use Alternate Drug.
pralsetinib
itraconazole will increase the level or effect of pralsetinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
prochlorperazine
prochlorperazine and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
promazine
promazine and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
promethazine
promethazine and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
propafenone
itraconazole and propafenone both increase QTc interval. Avoid or Use Alternate Drug.
protriptyline
protriptyline and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
quetiapine
itraconazole and quetiapine both increase QTc interval. Avoid or Use Alternate Drug.
rabeprazole
rabeprazole will decrease the level or effect of itraconazole by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
red yeast rice
itraconazole will increase the level or effect of red yeast rice by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. May increase creatine kinase levels and increase risk of myopathy or rhabdomyolysis; red yeast rice contains monocolin K (reportedly identical to lovastatin)
regorafenib
itraconazole will increase the level or effect of regorafenib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors increase regorafenib levels and decrease exposure of the active metabolites M-2 and M-5. Not recommended during and 2 weeks after itraconazole treatment.
ribociclib
itraconazole will increase the level or effect of ribociclib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If a strong CYP3A inhibitor must be coadministered with ribociclib, reduce the ribociclib starting dose to 400 mg/day.

itraconazole and ribociclib both increase QTc interval. Avoid or Use Alternate Drug.
rifabutin
itraconazole will increase the level or effect of rifabutin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
rimegepant
itraconazole will increase the level or effect of rimegepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

itraconazole will increase the level or effect of rimegepant by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.
riociguat
itraconazole will increase the level or effect of riociguat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
ruxolitinib
itraconazole will increase the level or effect of ruxolitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Reduce ruxolitinib starting dose to 10 mg BID with platelet count 100 X 10^9/L or more and concurrent use of strong CYP3A4 inhibitors; avoid with platelet counts <100 X 10^9/L
ruxolitinib topical
itraconazole will increase the level or effect of ruxolitinib topical by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Reduce ruxolitinib starting dose to 10 mg BID with platelet count 100 X 10^9/L or more and concurrent use of strong CYP3A4 inhibitors; avoid with platelet counts <100 X 10^9/L
Saccharomyces boulardii
itraconazole decreases effects of Saccharomyces boulardii by unspecified interaction mechanism. Avoid or Use Alternate Drug. Systemic or oral antifungals may decrease activity of probiotic.
salmeterol
itraconazole will increase the level or effect of salmeterol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

itraconazole and salmeterol both increase QTc interval. Avoid or Use Alternate Drug.
saquinavir
saquinavir will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

itraconazole and saquinavir both increase QTc interval. Avoid or Use Alternate Drug.
selpercatinib
itraconazole will increase the level or effect of selpercatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

itraconazole and selpercatinib both increase QTc interval. Avoid or Use Alternate Drug.
selumetinib
itraconazole will increase the level or effect of selumetinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration with strong or moderate CYP3A4 inhibitors cannot be avoided, reduce selumetinib dosage (refer to selumetinib monograph for further information). After discontinuation of the strong or moderate CYP3A4 inhibitor for 3 elimination half-lives, resume selumetinib dose that was taken before initiating the inhibitor.
sevoflurane
sevoflurane and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
siponimod
itraconazole will increase the level or effect of siponimod by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of siponimod with a moderate or strong CYP3A4 inhibitor PLUS a moderate or strong CYP2C9 inhibitor is not recommended.

itraconazole and siponimod both increase QTc interval. Avoid or Use Alternate Drug.
sirolimus
itraconazole will increase the level or effect of sirolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Not recommended during and 2 weeks after itraconazole treatment.

itraconazole will increase the level or effect of sirolimus by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. Not recommended during and 2 weeks after itraconazole treatment.
sodium bicarbonate
sodium bicarbonate will decrease the level or effect of itraconazole by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
sodium citrate/citric acid
sodium citrate/citric acid will decrease the level or effect of itraconazole by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
solifenacin
itraconazole and solifenacin both increase QTc interval. Avoid or Use Alternate Drug.
sonidegib
itraconazole will increase the level or effect of sonidegib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sonidegib with strong CYP3A4 inhibitors.
sorafenib
itraconazole and sorafenib both increase QTc interval. Avoid or Use Alternate Drug.
sparsentan
itraconazole, sparsentan. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. If unavoidable, interrupt treatment with sparsentan. When resuming sparsentan, consider dose titration. .
stiripentol
itraconazole will increase the level or effect of stiripentol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
sunitinib
itraconazole and sunitinib both increase QTc interval. Avoid or Use Alternate Drug.
suvorexant
itraconazole increases levels of suvorexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Suvorexant not recommended with use of strong CYP3A4 inhibitors.
tacrolimus
itraconazole and tacrolimus both increase QTc interval. Avoid or Use Alternate Drug.
tadalafil
itraconazole will increase the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. For ED limit tadalafil to max of 2.5 mg/day (for daily use) or 10 mg dose every 72 hr (for use as needed). Avoid concurrent use of tadalafil for pulmonary HTN in patients taking strong CYP3A4 inhibitors.
talazoparib
itraconazole will increase the level or effect of talazoparib by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. If coadministration with certain P-gp inhibitors (ie, amiodarone, carvedilol, clarithromycin, itraconazole, verapamil) cannot be avoided, reduce talazoparib dose to 0.75 mg qDay. Once P-gp inhibitors are discontinued, increase talazoparib dose (after 3-5 half-lives of the inhibitor) to dose used prior to initiating the P-gp inhibitor(s).
tamsulosin
itraconazole increases levels of tamsulosin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Not recommended during and 2 weeks after itraconazole treatment. .
tazemetostat
itraconazole will increase the level or effect of tazemetostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of tazemetostat with strong CYP3A4 inhibitors.
temsirolimus
itraconazole will increase the level or effect of temsirolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
tepotinib
itraconazole will increase the level or effect of tepotinib by Other (see comment). Avoid or Use Alternate Drug. Interaction not studied clinically. Metabolism and data suggest drugs that are strong CYP3A4 and P-gp inhibitors may increase tepotinib (a P-gp and CYP3A4 substrate) effects and risk of toxicities.
tetrabenazine
tetrabenazine and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
thioridazine
thioridazine and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
tipranavir
tipranavir will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
tofacitinib
itraconazole increases levels of tofacitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Reduce tofacitinib dose to 5 mg qDay when coadministered with potent CYP3A4 inhibitors.
tolterodine
itraconazole will increase the level or effect of tolterodine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
topotecan
itraconazole will increase the level or effect of topotecan by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. Product labeling for PO topotecan recommends avoiding concomitant use of P-gp inhibitors; the interaction with IV topotecan may be less severe but is still likely of clinical significance
toremifene
itraconazole and toremifene both increase QTc interval. Avoid or Use Alternate Drug.
trabectedin
itraconazole will increase the level or effect of trabectedin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If strong CYP3A inhibitor must be used, short-term (eg, less than 14 days), administer strong CYP3A inhibitor 1 week after trabectedin infusion, and discontinue the day prior to next trabectedin infusion
trazodone
itraconazole will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

trazodone and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
triamcinolone acetonide injectable suspension
itraconazole will increase the level or effect of triamcinolone acetonide injectable suspension by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
trifluoperazine
trifluoperazine and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
trimipramine
trimipramine and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
tucatinib
tucatinib will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. If unavoidable, reduce CYP3A substrate dose according to product labeling.
vandetanib
itraconazole will increase the level or effect of vandetanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

itraconazole and vandetanib both increase QTc interval. Avoid or Use Alternate Drug.
vardenafil
itraconazole and vardenafil both increase QTc interval. Avoid or Use Alternate Drug.
vemurafenib
itraconazole increases levels of vemurafenib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

itraconazole and vemurafenib both increase QTc interval. Avoid or Use Alternate Drug.
verapamil
itraconazole will increase the level or effect of verapamil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Observe the patient for development of toxicity associated with verapamil (peripheral edema, dizziness, hypotension, flushing, headache). Consider reducing the dose of verapamil or withdrawing one of the agents.
vilazodone
itraconazole increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase vilazodone plasma levels by 50% - Reduce daily dose to 20 mg.
vorapaxar
itraconazole increases levels of vorapaxar by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
voriconazole
itraconazole will increase the level or effect of voriconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
voxelotor
voxelotor will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. Consider dose reduction of the sensitive CYP3A4 substrate(s) if unable to avoid.
ziprasidone
itraconazole and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.

Monitor Closely (300)

abemaciclib
itraconazole will increase the level or effect of abemaciclib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. In patients with starting doses of 150 or 200 mg BID, reduce abemaciclib dose to 100 mg BID when coadminister with strong CYP3A inhibitors. In patients who reduced dose to 100 mg BID due to adverse reactions, further reduce abemaciclib dose to 50 mg BID when coadministered with strong CYP3A inhibitors. If the strong CYP3A inhibitoris discontinued, increase abemaciclib dose (after 3-5 half-lives of the inhibitor) to the dose that was used before starting the inhibitor.
albuterol
albuterol and itraconazole both increase QTc interval. Use Caution/Monitor.
alfentanil
itraconazole will increase the level or effect of alfentanil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
alosetron
itraconazole will increase the level or effect of alosetron by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
aluminum hydroxide
aluminum hydroxide will decrease the level or effect of itraconazole by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer acid neutralizing medicines at least 2 hours before or 2 hours after itraconazole.
amitriptyline
itraconazole will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

itraconazole and amitriptyline both increase QTc interval. Use Caution/Monitor.
amlodipine
itraconazole will increase the level or effect of amlodipine by Other (see comment). Modify Therapy/Monitor Closely. CCBs elicit negative inotropic effects which may be additive to those of itraconazole; additionally, itraconazole can inhibit the metabolism of calcium channel blockers. Monitor for adverse reactions. Concomitant drug dose reduction may be necessary.
apalutamide
itraconazole will increase the level or effect of apalutamide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of apalutamide with strong CYP3A4 or CYP2C8 inhibitors does not require initial dosage modification; however, dose reduction may be needed based on tolerability.
apixaban
itraconazole will increase the level or effect of apixaban by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Apixaban is a both CYP3A4 and P-gp substrate. For patients receiving apixaban 5 or 10 mg BID, decrease apixaban dose by 50% when coadministered with drugs that are both P-gp and strong CYP3A4 inhibitors. For patients receiving apixaban 5 mg BID, avoid coadministration with combined P-gp and strong CYP3A4 inhibitors.
apomorphine
apomorphine and itraconazole both increase QTc interval. Use Caution/Monitor.
arformoterol
arformoterol and itraconazole both increase QTc interval. Use Caution/Monitor.
aripiprazole
itraconazole will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. For aripiprazole oral formulations other than the extended-release injectable: Reduce aripiprazole dose by 50% of the usual dose when initiating concomitant therapy with a strong CYP3A4 inhibitor, and further to 25% of the usual dose in patients who are also receiving strong CYP2D6 inhibitors (e.g., paroxetine, quinidine) or who are CYP2D6 poor metabolizers. Consider reducing apixaban dose to up to 75% when combining a strong CYP3A4 inhibitor with a less potent CYP2D6 inhibitor. For extended-release injectable aripiprazole: Please refer to prescribing information.
armodafinil
itraconazole will increase the level or effect of armodafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
arsenic trioxide
arsenic trioxide and itraconazole both increase QTc interval. Use Caution/Monitor.
artemether/lumefantrine
artemether/lumefantrine will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

itraconazole and artemether/lumefantrine both increase QTc interval. Use Caution/Monitor.
atazanavir
itraconazole will increase the level or effect of atazanavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
atevirdine
itraconazole increases levels of atevirdine by decreasing metabolism. Use Caution/Monitor.
atogepant
itraconazole will increase the level or effect of atogepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Recommended atogepant dosage is 10 mg PO qDay when coadministered with strong CYP3A4 inhibitors.
atomoxetine
atomoxetine and itraconazole both increase QTc interval. Use Caution/Monitor.
azithromycin
azithromycin and itraconazole both increase QTc interval. Use Caution/Monitor.
bazedoxifene/conjugated estrogens
itraconazole will increase the level or effect of bazedoxifene/conjugated estrogens by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
belzutifan
belzutifan will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. If unable to avoid coadministration of belzutifan with sensitive CYP3A4 substrates, consider increasing the sensitive CYP3A4 substrate dose in accordance with its prescribing information.
benzhydrocodone/acetaminophen
itraconazole will increase the level or effect of benzhydrocodone/acetaminophen by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Coadministration with strong CYP3A4 inhibitors may increase hydrocodone (benzhydrocodone is prodrug of hydrocodone) plasma concentrations and can result in potentially fatal respiratory depression.
berotralstat
itraconazole increases levels of berotralstat by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Reduced berotralstat dose to 110 mg/day when coadministered with P-gp inhibitors.
betrixaban
itraconazole increases levels of betrixaban by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Decrease betrixaban dose to 80 mg PO once, then 40 mg PO qDay if coadministered with a P-gp inhibitor.
bexarotene
itraconazole will increase the level or effect of bexarotene by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
bortezomib
itraconazole will increase the level or effect of bortezomib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
bosentan
itraconazole will increase the level or effect of bosentan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

bosentan will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
brentuximab vedotin
itraconazole increases levels of brentuximab vedotin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor patients for adverse reactions. .
brexpiprazole
itraconazole will increase the level or effect of brexpiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Administer half of the usual brexpiprazole dose when coadministered with strong CYP3A4 inhibitors. If also administered with a strong/moderate CYP2D6 inhibitor, administer a quarter of brexpiprazole dose.
buprenorphine subdermal implant
itraconazole will increase the level or effect of buprenorphine subdermal implant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor patients already on buprenorphine subdermal implant who require newly-initiated treatment with CYP3A4 inhibitors for signs and symptoms of overmedication. If the dose of the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, implant removal may be necessary and the patient should then be treated with a buprenorphine dosage form that permits dose adjustments. If a CYP3A4 inhibitor is discontinued in a patient who has been stabilized on buprenorphine, monitor the patient for withdrawal.
buprenorphine, long-acting injection
itraconazole will increase the level or effect of buprenorphine, long-acting injection by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Patients who transfer to buprenorphine long-acting injection from transmucosal buprenorphine coadministered with CYP3A4 inhibitors should be monitored to ensure buprenorphine plasma levels are adequate. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose occur and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, transition the patient back to a buprenorphine formulation that permits dose adjustments.
buspirone
itraconazole will increase the level or effect of buspirone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Limit buspirone dose 2.5 mg/da. Monitor for increased buspirone effects/toxicities when combined with strong CYP3A4 inhibitors.
busulfan
itraconazole increases levels of busulfan by decreasing hepatic clearance. Use Caution/Monitor.

itraconazole will increase the level or effect of busulfan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
calcifediol
itraconazole will increase the level or effect of calcifediol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Closely monitor when initiating or discontinuing a strong CYP3A4 inhibitor.
calcium carbonate
calcium carbonate will decrease the level or effect of itraconazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Administer acid neutralizing medicines at least 2 hours before or 2 hours after itraconazole.
cannabidiol
itraconazole will increase the level or effect of cannabidiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Consider reducing the cannabidiol dose when coadministered with a strong CYP3A4 inhibitor.
capmatinib
itraconazole will increase the level or effect of capmatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
cariprazine
itraconazole will increase the level or effect of cariprazine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Coadministration with strong CYP3A4 inhibitors requires cariprazine dose reduction. See Dosage Modification section in drug monograph.
cenobamate
cenobamate will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Increase dose of CYP3A4 substrate, as needed, when coadministered with cenobamate.
cevimeline
itraconazole will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
chlordiazepoxide
itraconazole will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
chlorpromazine
chlorpromazine and itraconazole both increase QTc interval. Use Caution/Monitor.
chlorpropamide
itraconazole will decrease the level or effect of chlorpropamide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
ciclesonide inhaled
itraconazole will increase the level or effect of ciclesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
cilostazol
itraconazole will increase the level or effect of cilostazol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Consider a dose reduction to 50 mg BID in patient who are concurrenlt receiving strong CYP3A4 inhibitors.
cimetidine
cimetidine will decrease the level or effect of itraconazole by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer acid neutralizing medicines at least 2 hours before or 2 hours after itraconazole. When taking with cimetidine, administer with non-diet cola to increase GI acidity.
cinacalcet
itraconazole will increase the level or effect of cinacalcet by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.
ciprofloxacin
itraconazole and ciprofloxacin both increase QTc interval. Use Caution/Monitor.
citalopram
itraconazole increases levels of citalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
clarithromycin
clarithromycin will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

clarithromycin and itraconazole both increase QTc interval. Use Caution/Monitor.
clevidipine
itraconazole will increase the level or effect of clevidipine by Other (see comment). Modify Therapy/Monitor Closely. CCBs elicit negative inotropic effects which may be additive to those of itraconazole; additionally, itraconazole can inhibit the metabolism of calcium channel blockers. Monitor for adverse reactions. Concomitant drug dose reduction may be necessary.
clomipramine
itraconazole and clomipramine both increase QTc interval. Use Caution/Monitor.
clonazepam
itraconazole will increase the level or effect of clonazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.
clorazepate
itraconazole will increase the level or effect of clorazepate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
cobicistat
cobicistat, itraconazole. Either increases levels of the other by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Specific dosage recommendations for itraconazole are not available when coadministered with cobicistat.
cortisone
itraconazole will increase the level or effect of cortisone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.
cyclosporine
itraconazole will increase the level or effect of cyclosporine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
dabigatran
itraconazole will increase the level or effect of dabigatran by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Atrial fibrillation: Avoid coadministering dabigatran with P-gp inhibitors if CrCl <30 mL/min. DVT/PE treatment: Avoid coadministering dabigatran with P-gp inhibitors if CrCl <50 mL/min
darolutamide
itraconazole will increase the level or effect of darolutamide by Other (see comment). Modify Therapy/Monitor Closely. Darolutamide is a P-gp and CYP3A4 substrate. Closely monitor for increased adverse reactions and modify dose of darolutamide as needed when coadministered with drugs that are both P-gp and strong or moderate CYP3A4 inhibitors.
darunavir
itraconazole, darunavir. Either increases effects of the other by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. When coadministration of itraconazole with darunavir/ritonavir is required, itraconazole should not exceed 200 mg/day.
daunorubicin
itraconazole will increase the level or effect of daunorubicin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
deferasirox
deferasirox will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
deflazacort
itraconazole will increase the level or effect of deflazacort by Other (see comment). Modify Therapy/Monitor Closely. Itraconazole is a strong P-gp and CYP3A4 inhibitor.Decrease deflazacort (P-gp and CYP3A4 substrate) dose to one-third of the recommended dose if coadministered with strong CYP3A4 and/or P-gp inhibitors.
degarelix
degarelix and itraconazole both increase QTc interval. Use Caution/Monitor.
desipramine
itraconazole and desipramine both increase QTc interval. Use Caution/Monitor.
deutetrabenazine
deutetrabenazine and itraconazole both increase QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation).
dexamethasone
itraconazole will increase the level or effect of dexamethasone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

dexamethasone will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
diazepam
itraconazole will increase the level or effect of diazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.
diazepam intranasal
itraconazole will increase the level or effect of diazepam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Strong or moderate CYP3A4 inhibitors may decrease rate of diazepam elimination, thereby increasing adverse reactions to diazepam.
didanosine
didanosine will decrease the level or effect of itraconazole by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor. Applies to didanosine chewable tablets and powder for oral solution; administer 2 hr before or several hours after didanosine oral solution or chewable tablet administration
dienogest/estradiol valerate
itraconazole will increase the level or effect of dienogest/estradiol valerate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor for potential adverse effects such as nausea, irregular uterine bleeding, breast tenderness and headache.
digoxin
itraconazole will increase the level or effect of digoxin by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Measure digoxin levels before initiating concomitant drugs. Monitor and consider reducing the digoxin dose by ~30-50% or modifying the dosing frequency.
diltiazem
diltiazem will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Coadministration of diltiazem and itraconazole may increase both drug levels, toxities, and additive negative inotropic effects.

itraconazole will increase the level or effect of diltiazem by Other (see comment). Modify Therapy/Monitor Closely. CCBs elicit negative inotropic effects which may be additive to those of itraconazole; additionally, itraconazole can inhibit the metabolism of calcium channel blockers. Monitor for adverse reactions. Concomitant drug dose reduction may be necessary.
dolasetron
dolasetron and itraconazole both increase QTc interval. Use Caution/Monitor.
donepezil
donepezil and itraconazole both increase QTc interval. Use Caution/Monitor.
doravirine
itraconazole will increase the level or effect of doravirine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of doravirine and CYP3A4 inhibitors may increase plasma concentrations and toxicities of doravirine.
doxepin
itraconazole and doxepin both increase QTc interval. Use Caution/Monitor.
doxepin cream
itraconazole will increase the level or effect of doxepin cream by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
doxorubicin liposomal
itraconazole will increase the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

itraconazole will increase the level or effect of doxorubicin liposomal by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
dronabinol
itraconazole will increase the level or effect of dronabinol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
dutasteride
itraconazole will increase the level or effect of dutasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
duvelisib
itraconazole will increase the level or effect of duvelisib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Coadministration with a strong CYP3A4 inhibitor increases duvelisib AUC, which may increase the risk of duvelisib toxicities. Reduce duvelisib dose to 15 mg BID when coadministered with a strong CYP3A4 inhibitor.

duvelisib will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce duvelisib dose to 15 mg BID when coadministered with a strong CYP3A4 inhibitor.
elagolix
itraconazole will increase the level or effect of elagolix by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Coadministration of elagolix 200 mg BID with strong CYP3A inhibitors for >1 month is not recommended. Limit elagolix dose to 150 mg qDay and CYP3A inhibitor duration of use to 6 months if coadministered.

elagolix decreases levels of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Elagolix is a weak-to-moderate CYP3A4 inducer. Monitor CYP3A substrates if coadministered. Consider increasing CYP3A substrate dose if needed.
eluxadoline
itraconazole increases levels of eluxadoline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. As a precautionary measure due to incomplete information on the metabolism of eluxadoline, use caution when coadministered with strong CYP3A4 inhibitors.
elvitegravir
itraconazole increases levels of elvitegravir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. When coadministered with elvitegravir, limit dose of itraconazole should not exceed 200 mg/day.
elvitegravir/cobicistat/emtricitabine/tenofovir DF
elvitegravir/cobicistat/emtricitabine/tenofovir DF, itraconazole. Either increases levels of the other by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Cobicistat and itraconazole are CYP3A4 inhibitors; do not exceed itraconazole dose of 200 mg/day.
enfortumab vedotin
itraconazole increases toxicity of enfortumab vedotin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Enfortumab vedotin is an antibody-drug conjugate that releases monomethylauristatin E (MMAE) via proteolytic cleavage. MMAE is primarily metabolized by CYP3A4 in vitro. Coadministration with strong CYP3A4 inhibitors may increase free MMAE exposure, which may increase the incidence or severity of toxicities.

itraconazole will increase the level or effect of enfortumab vedotin by Other (see comment). Use Caution/Monitor. Coadministration with dual P-gp and strong CYP3A4 inhibitors may increase unconjugated small molecule microtubule disrupting agent, monomethyl auristatin E (MMAE) exposure, which may increase the risk of enfortumab vedotin toxicities. Closely monitor for signs of toxicities.
erythromycin base
erythromycin base will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

erythromycin base will increase the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
erythromycin ethylsuccinate
erythromycin ethylsuccinate will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

erythromycin ethylsuccinate will increase the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
erythromycin lactobionate
erythromycin lactobionate will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

erythromycin lactobionate will increase the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
erythromycin stearate
erythromycin stearate will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

erythromycin stearate will increase the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
escitalopram
itraconazole will increase the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

itraconazole and escitalopram both increase QTc interval. Use Caution/Monitor.
estradiol
itraconazole will increase the level or effect of estradiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

itraconazole will increase the level or effect of estradiol by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
estradiol vaginal
itraconazole will increase the level or effect of estradiol vaginal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with CYP3A4 inhibitors may increase plasma concentrations of estrogens and toxicities.
estrogens conjugated synthetic
itraconazole will increase the level or effect of estrogens conjugated synthetic by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
estrogens esterified
itraconazole will increase the level or effect of estrogens esterified by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
estropipate
itraconazole will increase the level or effect of estropipate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
ethinylestradiol
itraconazole will increase the level or effect of ethinylestradiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. CYP3A4 inhibitors such as itraconazole may increase plasma hormone levels.
ethosuximide
itraconazole will increase the level or effect of ethosuximide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
etonogestrel
itraconazole will increase the level or effect of etonogestrel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
etoposide
itraconazole will increase the level or effect of etoposide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
etravirine
itraconazole will increase the level or effect of etravirine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Dose adjustments for itraconazole, ketoconazole or posaconazole may be necessary depending on the other coadministered drugs.
fedratinib
fedratinib will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP3A4 substrates as necessary.
finasteride
itraconazole will increase the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
fingolimod
fingolimod and itraconazole both increase QTc interval. Use Caution/Monitor.
flecainide
flecainide and itraconazole both increase QTc interval. Modify Therapy/Monitor Closely.
fludrocortisone
itraconazole will increase the level or effect of fludrocortisone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
flunisolide inhaled
itraconazole will increase the level or effect of flunisolide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
fluoxetine
itraconazole and fluoxetine both increase QTc interval. Use Caution/Monitor.
fluphenazine
itraconazole and fluphenazine both increase QTc interval. Use Caution/Monitor.
flurazepam
itraconazole will increase the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
fluticasone furoate
itraconazole will increase the level or effect of fluticasone furoate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Strong CYP3A4 inhibitors may increase fluticasone systemic exposure
fluticasone inhaled
itraconazole will increase the level or effect of fluticasone inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Strong CYP3A4 inhibitors may increase fluticasone systemic exposure
fluvoxamine
itraconazole and fluvoxamine both increase QTc interval. Use Caution/Monitor.
formoterol
itraconazole and formoterol both increase QTc interval. Use Caution/Monitor.
fostamatinib
itraconazole will increase the level or effect of fostamatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Strong CYP3A4 inhibitors may increase exposure to R406 (fostamatinib major active metabolite). Monitor for toxicities that may require fostamatinib dose reduction.
fostemsavir
itraconazole and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.
gefitinib
itraconazole increases levels of gefitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Coadministration of strong CYP3A4 inhibitors may increase risk for gefitinib adverse effects.
gemifloxacin
gemifloxacin and itraconazole both increase QTc interval. Use Caution/Monitor.
gemtuzumab
itraconazole and gemtuzumab both increase QTc interval. Use Caution/Monitor.
glasdegib
itraconazole will increase the level or effect of glasdegib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Consider alternate therapies that are not strong CYP3A inhibitors or monitor for increased risk of adverse effects, including QTc interval prolongation.
glecaprevir/pibrentasvir
itraconazole will increase the level or effect of glecaprevir/pibrentasvir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

itraconazole will increase the level or effect of glecaprevir/pibrentasvir by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
goserelin
itraconazole and goserelin both increase QTc interval. Use Caution/Monitor.
granisetron
granisetron and itraconazole both increase QTc interval. Use Caution/Monitor.
guanfacine
itraconazole will increase the level or effect of guanfacine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. For extended-release (ER) guanfacine, if coadministered, decrease the guanfacine dosage to half of the recommended dose. Specific recommendations for immediate-release (IR) guanfacine are not available.
haloperidol
haloperidol and itraconazole both increase QTc interval. Modify Therapy/Monitor Closely.

itraconazole will increase the level or effect of haloperidol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
histrelin
itraconazole and histrelin both increase QTc interval. Use Caution/Monitor.
hydroxyzine
hydroxyzine and itraconazole both increase QTc interval. Use Caution/Monitor.

itraconazole and hydroxyzine both increase QTc interval. Use Caution/Monitor.
ibutilide
ibutilide and itraconazole both increase QTc interval. Use Caution/Monitor.
ifosfamide
itraconazole will decrease the level or effect of ifosfamide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of CYP3A4 inhibitors may decrease the metabolism of ifosfamide to its active alkylating metabolites and decrease the efficacy of ifosfamide.
iloperidone
itraconazole will increase the level or effect of iloperidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce iloperidone dose by 50% when administered with a strong CYP3A4 inhibitor.
imatinib
itraconazole will increase the level or effect of imatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
indinavir
itraconazole will increase the level or effect of indinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce indinavir dose to 600 mg q8hr is recommended when coadministered itraconazole.
isoniazid
isoniazid decreases levels of itraconazole by unspecified interaction mechanism. Use Caution/Monitor.
isradipine
itraconazole will increase the level or effect of isradipine by Other (see comment). Modify Therapy/Monitor Closely. Calcium channel blockers (CCBs) may potentiate negative inotropic effects of itraconazole; additionally, itraconazole can inhibit the metabolism of CCB. Monitor for adverse reactions and consider dose reduction of CCBs.

itraconazole and isradipine both increase QTc interval. Use Caution/Monitor.
istradefylline
itraconazole will increase the level or effect of istradefylline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Do not exceed istradefylline 20 mg/day if coadministered with strong CYP3A4 inhibitors.

istradefylline will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. This effect was not observed with istradefylline 20 mg/day. Consider dose reduction of sensitive CYP3A4 substrates.
ivacaftor
itraconazole will increase the level or effect of ivacaftor by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce ivacaftor dose if coadministered with strong CYP3A4 inhibitors. See specific ivacaftor-containing product for precise dosage modification.
ivermectin
itraconazole will increase the level or effect of ivermectin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
ketoconazole
ketoconazole will increase the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
lacosamide
itraconazole increases levels of lacosamide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Consider decreasing lacosamide dose when coadministered with strong CYP3A4 inhibitors.
lansoprazole
itraconazole will increase the level or effect of lansoprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Separate proton pump inhibitors at least 2 hr before or 2 hr after itraconazole. Use of Sporanox oral solution (instead of the capsule) or administration of itraconazole with an acidic beverage (eg, cola) may minimize the significance of this interaction. Closely monitor for reduced itraconazole efficacy if combined.
lapatinib
itraconazole and lapatinib both increase QTc interval. Modify Therapy/Monitor Closely. If concurrent use unavoidable, decrease the lapatinib dose to 500 mg PO once daily. Increase lapatinib dose to indicated dose if itraconazole discontinued
lenacapavir
lenacapavir will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lencapavir may increase CYP3A4 substrates initiated within 9 months after last SC dose of lenacapavir, which may increase potential risk of adverse reactions of CYP3A4 substrates.
leuprolide
itraconazole and leuprolide both increase QTc interval. Use Caution/Monitor.
levamlodipine
itraconazole will increase the level or effect of levamlodipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Coadministration with moderate and strong CYP3A inhibitors results in increased systemic exposure to amlodipine and may require dose reduction. Monitor for symptoms of hypotension and edema when amlodipine is coadministered with CYP3A inhibitors to determine the need for dose adjustment.
levoketoconazole
levoketoconazole will increase the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
levomilnacipran
itraconazole will increase the level or effect of levomilnacipran by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Do not exceed 80 mg/day of levomilnacipran when coadministered with strong CYP3A4 inhibitors
levonorgestrel oral/ethinylestradiol/ferrous bisglycinate
itraconazole will increase the level or effect of levonorgestrel oral/ethinylestradiol/ferrous bisglycinate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with CYP3A4 inhibitors may increase the plasma hormone concentrations. Use of a nonhormonal contraceptive is recommended.
linagliptin
itraconazole will increase the level or effect of linagliptin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
lithium
itraconazole and lithium both increase QTc interval. Use Caution/Monitor.
loperamide
itraconazole and loperamide both increase QTc interval. Use Caution/Monitor.
lopinavir
itraconazole will increase the level or effect of lopinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Limit adult maximum itraconazole dose to 200 mg/day in patients receiving lopinavir/ritonavir.
loratadine
itraconazole will increase the level or effect of loratadine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

loratadine will increase the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
losartan
itraconazole decreases effects of losartan by decreasing metabolism. Use Caution/Monitor. May inhibit the conversion of losartan to its active metabolite E-3174. Importance of interaction not established; monitor individual therapeutic response to determine losartan dosage.
lumacaftor/ivacaftor
itraconazole increases levels of lumacaftor/ivacaftor by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Strong CYP3A inhibitors do not impact lumacaftor exposure, but increased ivacaftor exposure by 4.3-fold. Due to the induction effect of lumacaftor on CYP3A, at steady-state the net exposure of ivacaftor is not expected to exceed that when given in the absence of lumacaftor at a dose of 150 mg q12hr (the approved dose of ivacaftor monotherapy). Therefore, no dose adjustment is necessary when CYP3A inhibitors are initiated in patients currently taking lumacaftor/ivacaftor. However, when initiating lumacaftor/ivacaftor in patients taking strong CYP3A inhibitors, reduce the dose to 1 tablet daily (lumacaftor 200 mg/ivacaftor 125 mg total daily dose) for the first week of treatment to allow for the steady-state induction effect of lumacaftor. Following this period, continue with the recommended daily dose. No dose adjustment is required for moderate or weak CYP3A4 inhibitors.
lumateperone
itraconazole will increase the level or effect of lumateperone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce lumateperone dose to 10.5 mg/day if coadministered with strong CYP3A4 inhibitors.
lumefantrine
itraconazole will increase the level or effect of lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.

itraconazole and lumefantrine both increase QTc interval. Modify Therapy/Monitor Closely.
maraviroc
itraconazole will increase the level or effect of maraviroc by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Decrease maraviroc dose to 150 mg BID when coadministered with strong CYP3A4 inhibitors. Maraviroc is contraindicated in patients with severe renal impairment (CrCl <30 mL/min) receiving a strong CYP3A4 inhibitor.

itraconazole will increase the level or effect of maraviroc by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely.
marijuana
itraconazole will increase the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
medroxyprogesterone
itraconazole will increase the level or effect of medroxyprogesterone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
mestranol
itraconazole will increase the level or effect of mestranol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
methylprednisolone
itraconazole will increase the level or effect of methylprednisolone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.
mifepristone
itraconazole, mifepristone. Either increases levels of the other by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Do not exceed mifepristone 300 mg/day for Cushing syndrome when coadministered with strong CYP3A4 inhibitors. Monitor for increased concentrations/toxic effects, during and 2 weeks following treatment with mifepristone.
mipomersen
mipomersen, itraconazole. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Both drugs have potential to increase hepatic enzymes; monitor LFTs.
mirtazapine
itraconazole will increase the level or effect of mirtazapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

itraconazole and mirtazapine both increase QTc interval. Use Caution/Monitor.
mirvetuximab soravtansine
itraconazole will increase the level or effect of mirvetuximab soravtansine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with strong CYP3A4 inhibitors may increase unconjugated DM4 (a CYP3A4 substrate and the cytotoxic component of the antibody drug conjugate for mirvetuximab soravtansine) exposure, which may increase the risk of adverse reactions.
mitotane
mitotane decreases levels of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments.
modafinil
itraconazole will increase the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
mometasone inhaled
itraconazole will increase the level or effect of mometasone inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Increases risk for systemic corticosteroid side effects
mometasone, intranasal
itraconazole will increase the level or effect of mometasone, intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
montelukast
itraconazole will increase the level or effect of montelukast by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
naldemedine
itraconazole increases levels of naldemedine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor naldemedine for potential adverse effects if coadministered with strong or moderate CYP3A4 inhibitors.

itraconazole increases levels of naldemedine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Monitor naldemedine for potential adverse effects if coadministered with P-gp inhibitors.
nefazodone
nefazodone will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

nefazodone will increase the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
nelfinavir
itraconazole will increase the level or effect of nelfinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.

itraconazole will increase the level or effect of nelfinavir by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely.
netupitant/palonosetron
itraconazole will increase the level or effect of netupitant/palonosetron by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Netupitant is mainly metabolized by CYP3A4; no dosage adjustment is required
nicardipine
itraconazole will increase the level or effect of nicardipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.

nicardipine will increase the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

itraconazole will increase the level or effect of nicardipine by Other (see comment). Modify Therapy/Monitor Closely. CCBs elicit negative inotropic effects which may be additive to those of itraconazole; additionally, itraconazole can inhibit the metabolism of calcium channel blockers. Monitor for adverse reactions. Concomitant drug dose reduction may be necessary.
nifedipine
itraconazole will increase the level or effect of nifedipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Consider initiating nifedipine at the lowest dose available if given concomitantly with this medication

nifedipine will decrease the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

itraconazole will increase the level or effect of nifedipine by Other (see comment). Modify Therapy/Monitor Closely. CCBs elicit negative inotropic effects which may be additive to those of itraconazole; additionally, itraconazole can inhibit the metabolism of calcium channel blockers. Monitor for adverse reactions. Concomitant drug dose reduction may be necessary.
nimodipine
itraconazole will increase the level or effect of nimodipine by Other (see comment). Modify Therapy/Monitor Closely. CCBs elicit negative inotropic effects which may be additive to those of itraconazole; additionally, itraconazole can inhibit the metabolism of calcium channel blockers. Monitor for adverse reactions. Concomitant drug dose reduction may be necessary.
nintedanib
itraconazole increases levels of nintedanib by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. If nintedanib adverse effects occur, management may require interruption, dose reduction, or discontinuation of therapy .
nirmatrelvir
nirmatrelvir will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Limit itraconazole adult dose to 200 mg/day if coadministered with ritonavir.
nirmatrelvir/ritonavir
nirmatrelvir/ritonavir will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Limit itraconazole adult dose to 200 mg/day if coadministered with ritonavir.
nitrendipine
itraconazole will increase the level or effect of nitrendipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
nortriptyline
itraconazole and nortriptyline both increase QTc interval. Use Caution/Monitor.
octreotide
itraconazole and octreotide both increase QTc interval. Use Caution/Monitor.
ofloxacin
itraconazole and ofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.
olanzapine
itraconazole and olanzapine both increase QTc interval. Use Caution/Monitor. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances
oliceridine
itraconazole will increase the level or effect of oliceridine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. If concomitant use is necessary, may require less frequent oliceridine dosing. Closely monitor for respiratory depression and sedation and titrate subsequent doses accordingly. If inhibitor is discontinued, consider increase oliceridine dosage until stable drug effects are achieved. Monitor for signs of opioid withdrawal.
ondansetron
itraconazole will increase the level or effect of ondansetron by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. P-gp inhibitors may decrease clearance of ondansetron. No dosage adjustment for ondansetron is recommended
osilodrostat
itraconazole will increase the level or effect of osilodrostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce dose of osilodrostat, a CYP3A4 substrate, by half when coadministered with a strong CYP3A4 inhibitor.

osilodrostat and itraconazole both increase QTc interval. Use Caution/Monitor.
osimertinib
itraconazole will increase the level or effect of osimertinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.
ospemifene
itraconazole increases levels of ospemifene by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
oxybutynin
itraconazole will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
oxycodone
itraconazole increases levels of oxycodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Oxycodone dose reduction may be warranted when coadministered with strong CYP3A4 inhibitors.
paclitaxel
itraconazole will increase the level or effect of paclitaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
paclitaxel protein bound
itraconazole will increase the level or effect of paclitaxel protein bound by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
paliperidone
itraconazole and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely.

itraconazole will increase the level or effect of paliperidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
panobinostat
itraconazole increases levels of panobinostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce panobinostat starting dose to 10 mg if coadministered with strong CYP3A4 inhibitors.
pantoprazole
itraconazole will increase the level or effect of pantoprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. For patients using the Sporanox brand of itraconazole (capsules or solution), administer proton pump inhibitors at least 2 hr before or 2 hr after itraconazole. Use of Sporanox oral solution or administration of itraconazole with an acidic beverage (eg, cola) may minimize the significance of this interaction.
parecoxib
itraconazole will increase the level or effect of parecoxib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
paricalcitol
itraconazole will increase the level or effect of paricalcitol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
paroxetine
itraconazole and paroxetine both increase QTc interval. Modify Therapy/Monitor Closely.
pasireotide
itraconazole and pasireotide both increase QTc interval. Use Caution/Monitor.
perampanel
itraconazole will increase the level or effect of perampanel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
phenobarbital
phenobarbital will decrease the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
phenytoin
phenytoin will decrease the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Antifungal failure may occur due to clinically significant decreases in itraconazole serum concentrations when given with phenytoin. Increased itraconazole dosage may be needed.
polatuzumab vedotin
itraconazole will increase the level or effect of polatuzumab vedotin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Polatuzumab undergoes catabolism to small peptides, amino acids, monomethyl auristatin E (MMAE), and unconjugated MMAE-related catabolites. MMAE is a CYP3A4 substrate. Coadministration of polatuzumab vedotin with a strong CYP3A4 inhibitor may increase unconjugated MMAE AUC, which may increase polatuzumab vedotin toxicities.
ponatinib
itraconazole increases levels of ponatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Decrease ponatinib starting dose to 30 mg qDay if concomitantly used with strong CYP3A4 inhibitors.
posaconazole
itraconazole will increase the level or effect of posaconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

itraconazole and posaconazole both increase QTc interval. Use Caution/Monitor.
praziquantel
itraconazole will increase the level or effect of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
prednisolone
itraconazole will increase the level or effect of prednisolone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
prednisone
itraconazole will increase the level or effect of prednisone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
primaquine
itraconazole will increase the level or effect of primaquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

itraconazole and primaquine both increase QTc interval. Use Caution/Monitor.
procainamide
itraconazole and procainamide both increase QTc interval. Use Caution/Monitor.
progesterone intravaginal gel
itraconazole will increase the level or effect of progesterone intravaginal gel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
progesterone micronized
itraconazole will increase the level or effect of progesterone micronized by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
progesterone, natural
itraconazole will increase the level or effect of progesterone, natural by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
propafenone
itraconazole will increase the level or effect of propafenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Closely monitor for evidence of propafenone toxicity when used together with a strong CYP3A4 inhibitor. Avoid concurrent use of a CYP2D6 inhibitor in patients receiving proprafenone and a CYP3A4 inhibitor.
quazepam
itraconazole will increase the level or effect of quazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
quercetin
quercetin will decrease the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
quetiapine
itraconazole will increase the level or effect of quetiapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor for adverse reactions. Concomitant drug dose reduction may be necessary.
quinine
itraconazole will increase the level or effect of quinine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

itraconazole and quinine both increase QTc interval. Use Caution/Monitor.
rabeprazole
itraconazole will increase the level or effect of rabeprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. For patients using the Sporanox brand of itraconazole (capsules or solution), administer proton pump inhibitors at least 2 hr before or 2 hr after itraconazole. Use of Sporanox oral solution or administration of itraconazole with an acidic beverage (eg, cola) may minimize the significance of this interaction.
ramelteon
itraconazole will increase the level or effect of ramelteon by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
repaglinide
itraconazole will increase the level or effect of repaglinide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
ribociclib
ribociclib will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.
rifabutin
rifabutin will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

rifabutin decreases levels of itraconazole by increasing metabolism. Use Caution/Monitor.

itraconazole increases levels of rifabutin by decreasing metabolism. Modify Therapy/Monitor Closely.
rifampin
rifampin will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

rifampin will decrease the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
rifaximin
itraconazole increases levels of rifaximin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
rilpivirine
itraconazole increases levels of rilpivirine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. No rilpivirine dose adjustment is required. Clinically monitor for breakthrough fungal infections when azole antifungals are co-administered with rilpivirine.

itraconazole and rilpivirine both increase QTc interval. Use Caution/Monitor.
riociguat
itraconazole will increase the level or effect of riociguat by decreasing metabolism. Modify Therapy/Monitor Closely. Coadministration of riociguat (substrate of CYP isoenzymes 1A1, 2C8, 3A, 2J2) with strong CYP inhibitors may require a decreased initial dose of 0.5 mg PO TID; monitor for signs of hypotension and reduce dose if needed

itraconazole will increase the level or effect of riociguat by Other (see comment). Modify Therapy/Monitor Closely. Coadministration of riociguat (an ABCG2 [BCRP] substrate) with strong ABCG2 inhibitors may require a decreased initial dose of 0.5 mg PO TID; monitor for signs of hypotension and reduce dose if needed
ripretinib
itraconazole will increase the level or effect of ripretinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with a strong CYP3A inhibitor will increase systemic exposure to ripretinib and its active metabolite (DP-5439), which may increase risk of adverse reactions.
risperidone
itraconazole will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

itraconazole and risperidone both increase QTc interval. Use Caution/Monitor.
ritonavir
ritonavir will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Limit itraconazole dose to 200 mg/day in patients receiving ritonavir.
rivaroxaban
itraconazole increases levels of rivaroxaban by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Avoid concomitant use of rivaroxaban and combined Pgp and strong CYP3A4 inhibitors. Combination may lead to significant increases in rivaroxaban levels and increase bleeding risk.
roflumilast
itraconazole will increase the level or effect of roflumilast by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
romidepsin
itraconazole will increase the level or effect of romidepsin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor for toxicity related to increased romidepsin exposure and follow the dose modifications for toxicity when romidepsin is initially coadministered with strong CYP3A4 inhibitor.

itraconazole and romidepsin both increase QTc interval. Modify Therapy/Monitor Closely.
rucaparib
rucaparib will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP3A4 substrates, if clinically indicated.
saquinavir
itraconazole will increase the level or effect of saquinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Limit itraconazole dose to 200 mg/day in patients receiving saquinavir/ritonavir.

itraconazole will increase the level or effect of saquinavir by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Limit itraconazole dose to 200 mg/day in patients receiving saquinavir/ritonavir.
saxagliptin
itraconazole will increase the level or effect of saxagliptin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Limit saxagliptin dose to 2.5 mg/day when coadministered with strong CYP3A4 inhibitors
sertraline
itraconazole and sertraline both increase QTc interval. Use Caution/Monitor.
sildenafil
itraconazole will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Not recommended during and 2 weeks after itraconazole treatment when sildenafil is used for pulmonary arterial hypertension.
simvastatin
simvastatin will increase the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
sodium bicarbonate
sodium bicarbonate decreases levels of itraconazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
sodium citrate/citric acid
sodium citrate/citric acid decreases levels of itraconazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
sodium zirconium cyclosilicate
sodium zirconium cyclosilicate will decrease the level or effect of itraconazole by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Check specific recommendations for drugs that exhibit pH-dependent solubility that may affect their systemic exposure and efficacy. In general, administer drugs at least 2 hr before or after sodium zirconium cyclosilicate.
sofosbuvir/velpatasvir
itraconazole will increase the level or effect of sofosbuvir/velpatasvir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
sotalol
itraconazole and sotalol both increase QTc interval. Modify Therapy/Monitor Closely.
St John's Wort
St John's Wort will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

St John's Wort will decrease the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
stiripentol
stiripentol, itraconazole. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP3A4 inhibitor and inducer. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. CYP3A4 substrates may require dosage adjustment.
sufentanil
itraconazole will increase the level or effect of sufentanil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
sufentanil SL
itraconazole will increase the level or effect of sufentanil SL by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of sufentanil SL with any CYP3A4 inhibitor may increase sufentanil plasma concentration, and, thereby increase or prolonged adverse effects, including potentially fatal respiratory depression.
sulfamethoxazole
sulfamethoxazole and itraconazole both increase QTc interval. Modify Therapy/Monitor Closely.
tacrolimus ointment
itraconazole will increase the level or effect of tacrolimus ointment by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
tamoxifen
itraconazole will increase the level or effect of tamoxifen by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. CYP3A4 inhibition decreases metabolism of tamoxifen to N-desmethyl tamoxifen (active metabolite with similar biologic activity)
tasimelteon
itraconazole will increase the level or effect of tasimelteon by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
tazemetostat
tazemetostat will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
tecovirimat
tecovirimat will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Tecovirimat is a weak CYP3A4 inducer. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered.
telavancin
itraconazole and telavancin both increase QTc interval. Use Caution/Monitor.
teniposide
itraconazole will increase the level or effect of teniposide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
terbinafine
itraconazole will increase the level or effect of terbinafine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
tezacaftor
itraconazole will increase the level or effect of tezacaftor by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adjust tezacaftor dosage regimen if coadministered with a strong CYP3A inhibitor.
theophylline
itraconazole will increase the level or effect of theophylline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.
tipranavir
itraconazole will increase the level or effect of tipranavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Limit itraconazole adult maximum dose to 200 mg/day in patients treated with tipranavir.
tisotumab vedotin
itraconazole increases levels of tisotumab vedotin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Tisotumab vedotin?s active metabolite (MMAE) is a CYP3A4 substrate. Coadministration with strong CYP3A4 inhibitors may increase unconjugated MMAE systemic exposure and increase risk of adverse effects.
tobramycin inhaled
tobramycin inhaled and itraconazole both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Avoid concurrent or sequential use to decrease risk for ototoxicity
tolvaptan
tolvaptan will increase the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
toremifene
itraconazole increases levels of toremifene by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Metabolism of toremifene may be inhibited by drugs known to inhibit CYP3A4 hepatic enzymes.
tramadol
itraconazole will increase the level or effect of tramadol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
trazodone
trazodone will decrease the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
triclabendazole
itraconazole and triclabendazole both increase QTc interval. Use Caution/Monitor.
trimethoprim
itraconazole and trimethoprim both increase QTc interval. Modify Therapy/Monitor Closely.
trimipramine
itraconazole will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
triptorelin
itraconazole and triptorelin both increase QTc interval. Use Caution/Monitor.
tropisetron
itraconazole and tropisetron both increase QTc interval. Modify Therapy/Monitor Closely.
ulipristal
itraconazole will increase the level or effect of ulipristal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
umeclidinium bromide/vilanterol inhaled
itraconazole will increase the level or effect of umeclidinium bromide/vilanterol inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Vilanterol is a CYP3A4 substrate; coadministration with potent CYP3A4 inhibitors may increase systemic exposure

itraconazole and umeclidinium bromide/vilanterol inhaled both decrease QTc interval. Use Caution/Monitor.
upadacitinib
itraconazole will increase the level or effect of upadacitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Caution if upadacitinib is coadministered with strong CYP3A4 inhibitors.
valbenazine
itraconazole will increase the level or effect of valbenazine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce valbenazine dose to 40 mg once daily when coadministered with a strong CYP3A4 inhibitor.

valbenazine and itraconazole both increase QTc interval. Use Caution/Monitor.
vardenafil
itraconazole will increase the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. If coadministered with itraconazole 400 mg/day, limit vardenafil dose to 2.5 mg/24 hr. If coadministered with itraconazole 200 mg/day, limit vardenafil dose to 5 mg/24 hr.
velpatasvir
itraconazole will increase the level or effect of velpatasvir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
vemurafenib
itraconazole increases levels of vemurafenib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
venlafaxine
itraconazole and venlafaxine both increase QTc interval. Modify Therapy/Monitor Closely.

itraconazole will increase the level or effect of venlafaxine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
verapamil
verapamil will increase the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

itraconazole will increase the level or effect of verapamil by Other (see comment). Modify Therapy/Monitor Closely. CCBs elicit negative inotropic effects which may be additive to those of itraconazole; additionally, itraconazole can inhibit the metabolism of calcium channel blockers. Monitor for adverse reactions. Concomitant drug dose reduction may be necessary.
vilanterol/fluticasone furoate inhaled
itraconazole will increase the level or effect of vilanterol/fluticasone furoate inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Fluticasone furoate and vilanterol are both CYP3A4 substrates; coadministration with potent CYP3A4 inhibitors may increase systemic exposure

itraconazole and vilanterol/fluticasone furoate inhaled both increase QTc interval. Use Caution/Monitor.
vinblastine
itraconazole will increase the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

itraconazole will increase the level or effect of vinblastine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
vincristine
itraconazole will increase the level or effect of vincristine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

itraconazole will increase the level or effect of vincristine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
vincristine liposomal
itraconazole will increase the level or effect of vincristine liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

itraconazole will increase the level or effect of vincristine liposomal by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
vinorelbine
itraconazole will increase the level or effect of vinorelbine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
voclosporin
voclosporin, itraconazole. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
vonoprazan
vonoprazan will decrease the level or effect of itraconazole by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Closely monitor for reduced itraconazole efficacy if combined. Itraconazole capsules only: Separate administration by at least 1 hr before or 2 hr after ketoconazole.
voriconazole
itraconazole and voriconazole both increase QTc interval. Modify Therapy/Monitor Closely.
vorinostat
itraconazole and vorinostat both increase QTc interval. Use Caution/Monitor.
voxilaprevir
itraconazole will increase the level or effect of voxilaprevir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
warfarin
itraconazole will increase the level or effect of warfarin by Other (see comment). Use Caution/Monitor. Warfarin's less potent R-enantiomer is metabolized in part by CYP3A4 (and also CYP1A2 and CYP2C19). Monitor INR more frequently if coadministered with inhibitors of these isoenzymes and adjust warfarin dose if needed.
zaleplon
itraconazole will increase the level or effect of zaleplon by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
zanubrutinib
itraconazole will increase the level or effect of zanubrutinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce zanubrutinib (a CYP3A4 substrate) to 80 mg PO BID when coadministered with a moderate CYP3A4 inhibitor. Interrupt dose as recommended for adverse reactions. After discontinuing the CYP3A4 inhibitor, resume previous zanubrutinib dose.
ziprasidone
itraconazole will increase the level or effect of ziprasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
zolpidem
itraconazole will increase the level or effect of zolpidem by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
zonisamide
itraconazole will increase the level or effect of zonisamide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

Minor (49)

acetazolamide
acetazolamide will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
alvimopan
itraconazole will increase the level or effect of alvimopan by P-glycoprotein (MDR1) efflux transporter. Minor/Significance Unknown.
ambrisentan
itraconazole will increase the level or effect of ambrisentan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
amitriptyline
itraconazole will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
anastrozole
anastrozole will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
caffeine
itraconazole increases levels of caffeine by decreasing metabolism. Minor/Significance Unknown.
clomipramine
itraconazole will increase the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
cyclophosphamide
cyclophosphamide will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
DHEA, herbal
DHEA, herbal will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
eslicarbazepine acetate
eslicarbazepine acetate will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
esomeprazole
itraconazole will increase the level or effect of esomeprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
fexofenadine
itraconazole will increase the level or effect of fexofenadine by P-glycoprotein (MDR1) efflux transporter. Minor/Significance Unknown.
fluconazole
fluconazole will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
flucytosine
flucytosine increases effects of itraconazole by pharmacodynamic synergism. Minor/Significance Unknown.
fosaprepitant
fosaprepitant will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
ganaxolone
itraconazole, ganaxolone. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. Changes in ganaxolone exposures when coadministered with strong, moderate, or weak CYP3A4 inhibitors are not expected to be clinically significant.
griseofulvin
griseofulvin will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
hydrocortisone
hydrocortisone will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
indacaterol, inhaled
itraconazole increases levels of indacaterol, inhaled by Other (see comment). Minor/Significance Unknown. Comment: Data suggests that systemic clearance is influenced by modulation of both P-gp and CYP3A4 activities. No dose adjustment is warranted at the 75 mcg dose.
lapatinib
lapatinib will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
levofloxacin
itraconazole and levofloxacin both increase QTc interval. Minor/Significance Unknown.
loperamide
itraconazole will increase the level or effect of loperamide by Other (see comment). Minor/Significance Unknown. Monitor ECG when itraconazole is coadministered with loperamide (dose >16mg/day).
lumefantrine
lumefantrine will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
marijuana
marijuana will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
methylprednisolone
methylprednisolone will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
metronidazole
metronidazole will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
miconazole vaginal
miconazole vaginal will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
moxifloxacin
itraconazole and moxifloxacin both increase QTc interval. Minor/Significance Unknown.
nafcillin
nafcillin will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
nelfinavir
nelfinavir will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
nevirapine
nevirapine will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
nifedipine
nifedipine will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
nilotinib
nilotinib will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
oxcarbazepine
oxcarbazepine will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
pentobarbital
pentobarbital will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

pentobarbital decreases levels of itraconazole by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
phenobarbital
phenobarbital will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

phenobarbital decreases levels of itraconazole by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
phenytoin
phenytoin will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
pomalidomide
itraconazole increases levels of pomalidomide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

itraconazole increases levels of pomalidomide by P-glycoprotein (MDR1) efflux transporter. Minor/Significance Unknown.
posaconazole
posaconazole will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
prednisone
prednisone will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
primidone
primidone will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

primidone decreases levels of itraconazole by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
quinupristin/dalfopristin
quinupristin/dalfopristin will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
rifapentine
rifapentine will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
rufinamide
rufinamide will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
secobarbital
secobarbital will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

secobarbital decreases levels of itraconazole by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
topiramate
topiramate will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
verapamil
verapamil will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
voriconazole
voriconazole will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
zafirlukast
zafirlukast will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

abametapir
Serious - Use Alternative (1)abametapir will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates. If not feasible, avoid use of abametapir.
abemaciclib
Monitor Closely (1)itraconazole will increase the level or effect of abemaciclib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. In patients with starting doses of 150 or 200 mg BID, reduce abemaciclib dose to 100 mg BID when coadminister with strong CYP3A inhibitors. In patients who reduced dose to 100 mg BID due to adverse reactions, further reduce abemaciclib dose to 50 mg BID when coadministered with strong CYP3A inhibitors. If the strong CYP3A inhibitoris discontinued, increase abemaciclib dose (after 3-5 half-lives of the inhibitor) to the dose that was used before starting the inhibitor.
acalabrutinib
Serious - Use Alternative (1)itraconazole will increase the level or effect of acalabrutinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of acalabrutinib with strong CYP3A inhibitors. If a strong CYP3A inhibitor must be used short-term (eg, up to 7 days), temporarily interrupt treatment with acalabrutinib.
acetazolamide
Minor (1)acetazolamide will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
adagrasib
Serious - Use Alternative (1)itraconazole will increase the level or effect of adagrasib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of adagrasib, a CYP3A4 substrate, with strong CYP3A4 inhibitors until adagrasib concentrations have reached steady-state (after ~8 days). If steady state is not reached, concomitant use of strong CYP3A4 inhibitors will increase adagrasib concentrations and risk of its toxicities
ado-trastuzumab emtansine
Serious - Use Alternative (1)itraconazole increases levels of ado-trastuzumab emtansine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Consider an alternate medication with no or minimal potential to inhibit CYP3A4. If concomitant use of strong CYP3A4 inhibitors is unavoidable, consider delaying ado-trastuzumab until the strong CYP3A4 inhibitors have cleared from the circulation (~3 elimination half-lives of the inhibitors) when possible. If a strong CYP3A4 inhibitor is coadministered and ado-trastuzumab cannot be delayed, closely monitor for adverse reactions.
afatinib
Serious - Use Alternative (1)itraconazole increases levels of afatinib by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. Reduce afatinib daily dose by 10 mg if not tolerated when coadministered with P-gp inhibitors.
albuterol
Monitor Closely (1)albuterol and itraconazole both increase QTc interval. Use Caution/Monitor.
alfentanil
Monitor Closely (1)itraconazole will increase the level or effect of alfentanil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
alfuzosin
Contraindicated (2)itraconazole increases levels of alfuzosin by decreasing metabolism. Contraindicated.

alfuzosin and itraconazole both increase QTc interval. Contraindicated.
aliskiren
Serious - Use Alternative (1)itraconazole will increase the level or effect of aliskiren by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. Consider an alternative with no or minimal potential to inhibit CYP3A4. If concomitant use of strong CYP3A4 inhibitors is unavoidable, closely monitor for respiratory depression and sedation, and consider decreasing alfentanil dose necessary.
almotriptan
Serious - Use Alternative (1)itraconazole will increase the level or effect of almotriptan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Start almotriptan dose at 6.25 mg when coadministered with potent CYP3A4 inhibitors. Do not exceed 12.5 mg/day. Avoid concomitant use of almotriptan and potent CYP3A4 inhibitors in patients with renal or hepatic impairment.
alosetron
Monitor Closely (1)itraconazole will increase the level or effect of alosetron by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
alprazolam
Serious - Use Alternative (1)itraconazole increases levels of alprazolam by decreasing metabolism. Avoid or Use Alternate Drug.
aluminum hydroxide
Monitor Closely (1)aluminum hydroxide will decrease the level or effect of itraconazole by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer acid neutralizing medicines at least 2 hours before or 2 hours after itraconazole.
alvimopan
Minor (1)itraconazole will increase the level or effect of alvimopan by P-glycoprotein (MDR1) efflux transporter. Minor/Significance Unknown.
ambrisentan
Minor (1)itraconazole will increase the level or effect of ambrisentan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
amiodarone
Serious - Use Alternative (2)itraconazole will increase the level or effect of amiodarone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

amiodarone and itraconazole both increase QTc interval. Avoid or Use Alternate Drug. Coadministration of amiodarone and a QT prolonging agent may result in additive effects on the QT interval and increase risk of torsades de pointes.
amisulpride
Serious - Use Alternative (1)amisulpride and itraconazole both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.
amitriptyline
Monitor Closely (2)itraconazole will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

itraconazole and amitriptyline both increase QTc interval. Use Caution/Monitor.Minor (1)itraconazole will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
amlodipine
Monitor Closely (1)itraconazole will increase the level or effect of amlodipine by Other (see comment). Modify Therapy/Monitor Closely. CCBs elicit negative inotropic effects which may be additive to those of itraconazole; additionally, itraconazole can inhibit the metabolism of calcium channel blockers. Monitor for adverse reactions. Concomitant drug dose reduction may be necessary.
anagrelide
Serious - Use Alternative (1)itraconazole and anagrelide both increase QTc interval. Avoid or Use Alternate Drug.
anastrozole
Minor (1)anastrozole will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
apalutamide
Monitor Closely (1)itraconazole will increase the level or effect of apalutamide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of apalutamide with strong CYP3A4 or CYP2C8 inhibitors does not require initial dosage modification; however, dose reduction may be needed based on tolerability.Serious - Use Alternative (1)apalutamide will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid concurrent use 2 weeks before and during itraconazole treatment. Evaluate for loss of therapeutic effect if medication must be coadministered.
apixaban
Monitor Closely (1)itraconazole will increase the level or effect of apixaban by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Apixaban is a both CYP3A4 and P-gp substrate. For patients receiving apixaban 5 or 10 mg BID, decrease apixaban dose by 50% when coadministered with drugs that are both P-gp and strong CYP3A4 inhibitors. For patients receiving apixaban 5 mg BID, avoid coadministration with combined P-gp and strong CYP3A4 inhibitors.
apomorphine
Monitor Closely (1)apomorphine and itraconazole both increase QTc interval. Use Caution/Monitor.
aprepitant
Serious - Use Alternative (1)itraconazole will increase the level or effect of aprepitant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
arformoterol
Monitor Closely (1)arformoterol and itraconazole both increase QTc interval. Use Caution/Monitor.
aripiprazole
Monitor Closely (1)itraconazole will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. For aripiprazole oral formulations other than the extended-release injectable: Reduce aripiprazole dose by 50% of the usual dose when initiating concomitant therapy with a strong CYP3A4 inhibitor, and further to 25% of the usual dose in patients who are also receiving strong CYP2D6 inhibitors (e.g., paroxetine, quinidine) or who are CYP2D6 poor metabolizers. Consider reducing apixaban dose to up to 75% when combining a strong CYP3A4 inhibitor with a less potent CYP2D6 inhibitor. For extended-release injectable aripiprazole: Please refer to prescribing information.Serious - Use Alternative (1)aripiprazole and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
armodafinil
Monitor Closely (1)itraconazole will increase the level or effect of armodafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
arsenic trioxide
Monitor Closely (1)arsenic trioxide and itraconazole both increase QTc interval. Use Caution/Monitor.
artemether
Serious - Use Alternative (1)artemether and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
artemether/lumefantrine
Monitor Closely (2)artemether/lumefantrine will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

itraconazole and artemether/lumefantrine both increase QTc interval. Use Caution/Monitor.Serious - Use Alternative (1)artemether/lumefantrine and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
asenapine
Serious - Use Alternative (1)itraconazole and asenapine both increase QTc interval. Avoid or Use Alternate Drug.
asenapine transdermal
Serious - Use Alternative (1)asenapine transdermal and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
atazanavir
Monitor Closely (1)itraconazole will increase the level or effect of atazanavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
atevirdine
Monitor Closely (1)itraconazole increases levels of atevirdine by decreasing metabolism. Use Caution/Monitor.
atogepant
Monitor Closely (1)itraconazole will increase the level or effect of atogepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Recommended atogepant dosage is 10 mg PO qDay when coadministered with strong CYP3A4 inhibitors.
atomoxetine
Monitor Closely (1)atomoxetine and itraconazole both increase QTc interval. Use Caution/Monitor.
atorvastatin
Serious - Use Alternative (1)itraconazole will increase the level or effect of atorvastatin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Limit atorvastatin dose to 20 mg/day
avanafil
Contraindicated (1)itraconazole will increase the level or effect of avanafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration with strong CYP3A4 is contraindicated during and 2 weeks after itraconazole.
avapritinib
Serious - Use Alternative (1)itraconazole will increase the level or effect of avapritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of avapritinib with strong CYP3A4 inhibitors.
axitinib
Serious - Use Alternative (1)itraconazole increases levels of axitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If unable to avoid coadministration with strong CYP3A4 inhibitors, reduce axitinib dose by 50%.
azithromycin
Monitor Closely (1)azithromycin and itraconazole both increase QTc interval. Use Caution/Monitor.
bazedoxifene/conjugated estrogens
Monitor Closely (1)itraconazole will increase the level or effect of bazedoxifene/conjugated estrogens by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.Serious - Use Alternative (1)itraconazole will increase the level or effect of bazedoxifene/conjugated estrogens by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
bedaquiline
Serious - Use Alternative (2)itraconazole will increase the level or effect of bedaquiline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of bedaquiline with strong CYP3A4 inhibitors for >14 consecutive days, unless the benefit of treatment outweighs the risk

bedaquiline and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
belzutifan
Monitor Closely (1)belzutifan will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. If unable to avoid coadministration of belzutifan with sensitive CYP3A4 substrates, consider increasing the sensitive CYP3A4 substrate dose in accordance with its prescribing information.
benzhydrocodone/acetaminophen
Monitor Closely (1)itraconazole will increase the level or effect of benzhydrocodone/acetaminophen by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Coadministration with strong CYP3A4 inhibitors may increase hydrocodone (benzhydrocodone is prodrug of hydrocodone) plasma concentrations and can result in potentially fatal respiratory depression.
berotralstat
Monitor Closely (1)itraconazole increases levels of berotralstat by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Reduced berotralstat dose to 110 mg/day when coadministered with P-gp inhibitors.
betrixaban
Monitor Closely (1)itraconazole increases levels of betrixaban by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Decrease betrixaban dose to 80 mg PO once, then 40 mg PO qDay if coadministered with a P-gp inhibitor.
bexarotene
Monitor Closely (1)itraconazole will increase the level or effect of bexarotene by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
bortezomib
Monitor Closely (1)itraconazole will increase the level or effect of bortezomib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
bosentan
Monitor Closely (2)bosentan will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

itraconazole will increase the level or effect of bosentan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
bosutinib
Serious - Use Alternative (3)itraconazole increases levels of bosutinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors increases bosutinib plasma concentration ~5-fold.

itraconazole increases levels of bosutinib by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.

itraconazole and bosutinib both increase QTc interval. Avoid or Use Alternate Drug.
brentuximab vedotin
Monitor Closely (1)itraconazole increases levels of brentuximab vedotin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor patients for adverse reactions. .
brexpiprazole
Monitor Closely (1)itraconazole will increase the level or effect of brexpiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Administer half of the usual brexpiprazole dose when coadministered with strong CYP3A4 inhibitors. If also administered with a strong/moderate CYP2D6 inhibitor, administer a quarter of brexpiprazole dose.
brigatinib
Serious - Use Alternative (1)itraconazole will increase the level or effect of brigatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If concomitant use of a strong CYP3A inhibitor cannot be avoided, reduce the brigatinib once daily dose by about 50% (ie, from 180 mg to 90 mg, or from 90 mg to 60 mg). After discontinuation of a strong CYP3A inhibitor, resume the brigatinib dose that was tolerated prior to initiating the strong CYP3A inhibitor.
bromocriptine
Serious - Use Alternative (1)itraconazole will increase the level or effect of bromocriptine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
budesonide
Serious - Use Alternative (1)itraconazole will increase the level or effect of budesonide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration is necessary, closely monitor for signs and symptoms of corticosteroid excess.
buprenorphine
Serious - Use Alternative (2)itraconazole will increase the level or effect of buprenorphine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

itraconazole and buprenorphine both increase QTc interval. Avoid or Use Alternate Drug.
buprenorphine buccal
Serious - Use Alternative (1)buprenorphine buccal and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
buprenorphine subdermal implant
Monitor Closely (1)itraconazole will increase the level or effect of buprenorphine subdermal implant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor patients already on buprenorphine subdermal implant who require newly-initiated treatment with CYP3A4 inhibitors for signs and symptoms of overmedication. If the dose of the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, implant removal may be necessary and the patient should then be treated with a buprenorphine dosage form that permits dose adjustments. If a CYP3A4 inhibitor is discontinued in a patient who has been stabilized on buprenorphine, monitor the patient for withdrawal.Serious - Use Alternative (1)buprenorphine subdermal implant and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
buprenorphine transdermal
Serious - Use Alternative (2)itraconazole will increase the level or effect of buprenorphine transdermal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

buprenorphine transdermal and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
buprenorphine, long-acting injection
Monitor Closely (1)itraconazole will increase the level or effect of buprenorphine, long-acting injection by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Patients who transfer to buprenorphine long-acting injection from transmucosal buprenorphine coadministered with CYP3A4 inhibitors should be monitored to ensure buprenorphine plasma levels are adequate. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose occur and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, transition the patient back to a buprenorphine formulation that permits dose adjustments.Serious - Use Alternative (1)buprenorphine, long-acting injection and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
buspirone
Monitor Closely (1)itraconazole will increase the level or effect of buspirone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Limit buspirone dose 2.5 mg/da. Monitor for increased buspirone effects/toxicities when combined with strong CYP3A4 inhibitors.
busulfan
Monitor Closely (2)itraconazole will increase the level or effect of busulfan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

itraconazole increases levels of busulfan by decreasing hepatic clearance. Use Caution/Monitor.
cabazitaxel
Serious - Use Alternative (1)itraconazole will increase the level or effect of cabazitaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of cabazitaxel with strong CYP3A4 inhibitors. If patients require coadministration of a strong CYP3A inhibitor, consider a 25% cabazitaxel dose reduction.
cabozantinib
Serious - Use Alternative (1)itraconazole will increase the level or effect of cabozantinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of cabozantinib with strong CYP3A4 inhibitors. If a strong CYP3A4 inhibitor is required, decrease cabozantinib dose by 40 mg/day (Cometriq) or by 20 mg/day (Cabometyx). Resume previous dose 2-3 days after strong CYP3A4 inhibitor discontinued.
caffeine
Minor (1)itraconazole increases levels of caffeine by decreasing metabolism. Minor/Significance Unknown.
calcifediol
Monitor Closely (1)itraconazole will increase the level or effect of calcifediol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Closely monitor when initiating or discontinuing a strong CYP3A4 inhibitor.
calcitriol
Serious - Use Alternative (1)itraconazole will increase the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
calcium carbonate
Monitor Closely (1)calcium carbonate will decrease the level or effect of itraconazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Administer acid neutralizing medicines at least 2 hours before or 2 hours after itraconazole.
cannabidiol
Monitor Closely (1)itraconazole will increase the level or effect of cannabidiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Consider reducing the cannabidiol dose when coadministered with a strong CYP3A4 inhibitor.
capmatinib
Monitor Closely (1)itraconazole will increase the level or effect of capmatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
carbamazepine
Serious - Use Alternative (2)itraconazole will increase the level or effect of carbamazepine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Not recommended 2 weeks before, during, and 2 weeks after itraconazole.

carbamazepine will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Not recommended 2 weeks before, during, and 2 weeks after itraconazole.
cariprazine
Monitor Closely (1)itraconazole will increase the level or effect of cariprazine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Coadministration with strong CYP3A4 inhibitors requires cariprazine dose reduction. See Dosage Modification section in drug monograph.
cenobamate
Monitor Closely (1)cenobamate will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Increase dose of CYP3A4 substrate, as needed, when coadministered with cenobamate.
ceritinib
Serious - Use Alternative (3)itraconazole increases levels of ceritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid if possible; if concomitant use is unavoidable, reduce ceritinib dose by ~33%; after discontinuation of strong CYP3A inhibitor, resume at previous dose.

ceritinib and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.

ceritinib will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
cevimeline
Monitor Closely (1)itraconazole will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
chlordiazepoxide
Monitor Closely (1)itraconazole will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
chloroquine
Serious - Use Alternative (2)itraconazole will increase the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

chloroquine and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
chlorpromazine
Monitor Closely (1)chlorpromazine and itraconazole both increase QTc interval. Use Caution/Monitor.
chlorpropamide
Monitor Closely (1)itraconazole will decrease the level or effect of chlorpropamide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
ciclesonide inhaled
Monitor Closely (1)itraconazole will increase the level or effect of ciclesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
cilostazol
Monitor Closely (1)itraconazole will increase the level or effect of cilostazol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Consider a dose reduction to 50 mg BID in patient who are concurrenlt receiving strong CYP3A4 inhibitors.
cimetidine
Monitor Closely (1)cimetidine will decrease the level or effect of itraconazole by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer acid neutralizing medicines at least 2 hours before or 2 hours after itraconazole. When taking with cimetidine, administer with non-diet cola to increase GI acidity.
cinacalcet
Monitor Closely (1)itraconazole will increase the level or effect of cinacalcet by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.
ciprofloxacin
Monitor Closely (1)itraconazole and ciprofloxacin both increase QTc interval. Use Caution/Monitor.
citalopram
Monitor Closely (1)itraconazole increases levels of citalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)citalopram and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
clarithromycin
Monitor Closely (2)clarithromycin and itraconazole both increase QTc interval. Use Caution/Monitor.

clarithromycin will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)itraconazole will increase the level or effect of clarithromycin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
clevidipine
Monitor Closely (1)itraconazole will increase the level or effect of clevidipine by Other (see comment). Modify Therapy/Monitor Closely. CCBs elicit negative inotropic effects which may be additive to those of itraconazole; additionally, itraconazole can inhibit the metabolism of calcium channel blockers. Monitor for adverse reactions. Concomitant drug dose reduction may be necessary.
clomipramine
Monitor Closely (1)itraconazole and clomipramine both increase QTc interval. Use Caution/Monitor.Minor (1)itraconazole will increase the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
clonazepam
Monitor Closely (1)itraconazole will increase the level or effect of clonazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.
clorazepate
Monitor Closely (1)itraconazole will increase the level or effect of clorazepate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
clozapine
Serious - Use Alternative (2)itraconazole will increase the level or effect of clozapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

clozapine and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
cobicistat
Monitor Closely (1)cobicistat, itraconazole. Either increases levels of the other by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Specific dosage recommendations for itraconazole are not available when coadministered with cobicistat.Serious - Use Alternative (1)itraconazole will increase the level or effect of cobicistat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
cobimetinib
Serious - Use Alternative (1)itraconazole will increase the level or effect of cobimetinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration with strong CYP3A4 inhibitors with (increases cobimetinib systemic exposure by 6.7-fold).
colchicine
Serious - Use Alternative (2)itraconazole will increase the level or effect of colchicine by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. Avoid use of colchicine with P-gp inhibitors. If coadministration is necessary, decrease colchicine dose or frequency as recommended in prescribing information. Use of any colchicine product in conjunction with P-gp inhibitors is contraindicated in patients with renal or hepatic impairment.

itraconazole will increase the level or effect of colchicine by Other (see comment). Avoid or Use Alternate Drug. Colchicine is a P-gp and CYP3A4 substrate. Avoid use with drugs that are both P-gp and strong CYP3A4 inhibitors. If coadministration is necessary, decrease colchicine dose or frequency as recommended in prescribing information. Use of any colchicine product in conjunction with strong CYP3A4 inhibitors is contraindicated in patients with renal or hepatic impairment.
conivaptan
Contraindicated (1)conivaptan will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Not recommended during, and 2 weeks after itraconazole.
conjugated estrogens
Serious - Use Alternative (1)itraconazole will increase the level or effect of conjugated estrogens by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
conjugated estrogens, vaginal
Serious - Use Alternative (1)itraconazole will increase the level or effect of conjugated estrogens, vaginal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
copanlisib
Serious - Use Alternative (1)itraconazole will increase the level or effect of copanlisib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If concomitant use with strong CYP3A inhibitors cannot be avoided, reduce copanlisib dose to 45 mg.
cortisone
Monitor Closely (1)itraconazole will increase the level or effect of cortisone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.
crizotinib
Serious - Use Alternative (2)itraconazole increases levels of crizotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If combination cannot be avoided, decrease crizotinib dose to 250 mg daily. Monitor for increased crizotinib toxicities, including QTc interval prolongation and ventricular arrhythmias. .

crizotinib and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
cyclophosphamide
Minor (1)cyclophosphamide will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
cyclosporine
Monitor Closely (1)itraconazole will increase the level or effect of cyclosporine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
dabigatran
Monitor Closely (1)itraconazole will increase the level or effect of dabigatran by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Atrial fibrillation: Avoid coadministering dabigatran with P-gp inhibitors if CrCl <30 mL/min. DVT/PE treatment: Avoid coadministering dabigatran with P-gp inhibitors if CrCl <50 mL/min
dabrafenib
Serious - Use Alternative (2)itraconazole will increase the level or effect of dabrafenib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Not recommended during and 2 weeks after itraconazole.

itraconazole and dabrafenib both increase QTc interval. Avoid or Use Alternate Drug.
daridorexant
Serious - Use Alternative (1)itraconazole will increase the level or effect of daridorexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
darifenacin
Serious - Use Alternative (1)itraconazole will increase the level or effect of darifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Not recommended during and 2 weeks after itraconazole.
darolutamide
Monitor Closely (1)itraconazole will increase the level or effect of darolutamide by Other (see comment). Modify Therapy/Monitor Closely. Darolutamide is a P-gp and CYP3A4 substrate. Closely monitor for increased adverse reactions and modify dose of darolutamide as needed when coadministered with drugs that are both P-gp and strong or moderate CYP3A4 inhibitors.
darunavir
Monitor Closely (1)itraconazole, darunavir. Either increases effects of the other by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. When coadministration of itraconazole with darunavir/ritonavir is required, itraconazole should not exceed 200 mg/day.
dasatinib
Serious - Use Alternative (2)itraconazole will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Not recommended during and 2 weeks after itraconazole.

itraconazole and dasatinib both increase QTc interval. Avoid or Use Alternate Drug.
daunorubicin
Monitor Closely (1)itraconazole will increase the level or effect of daunorubicin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
deferasirox
Monitor Closely (1)deferasirox will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
deflazacort
Monitor Closely (1)itraconazole will increase the level or effect of deflazacort by Other (see comment). Modify Therapy/Monitor Closely. Itraconazole is a strong P-gp and CYP3A4 inhibitor.Decrease deflazacort (P-gp and CYP3A4 substrate) dose to one-third of the recommended dose if coadministered with strong CYP3A4 and/or P-gp inhibitors.
degarelix
Monitor Closely (1)degarelix and itraconazole both increase QTc interval. Use Caution/Monitor.
desflurane
Serious - Use Alternative (1)desflurane and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
desipramine
Monitor Closely (1)itraconazole and desipramine both increase QTc interval. Use Caution/Monitor.
deutetrabenazine
Monitor Closely (1)deutetrabenazine and itraconazole both increase QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation).
dexamethasone
Monitor Closely (2)itraconazole will increase the level or effect of dexamethasone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

dexamethasone will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
dexlansoprazole
Serious - Use Alternative (1)dexlansoprazole will decrease the level or effect of itraconazole by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
DHEA, herbal
Minor (1)DHEA, herbal will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
diazepam
Monitor Closely (1)itraconazole will increase the level or effect of diazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.
diazepam intranasal
Monitor Closely (1)itraconazole will increase the level or effect of diazepam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Strong or moderate CYP3A4 inhibitors may decrease rate of diazepam elimination, thereby increasing adverse reactions to diazepam.
didanosine
Monitor Closely (1)didanosine will decrease the level or effect of itraconazole by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor. Applies to didanosine chewable tablets and powder for oral solution; administer 2 hr before or several hours after didanosine oral solution or chewable tablet administration
dienogest/estradiol valerate
Monitor Closely (1)itraconazole will increase the level or effect of dienogest/estradiol valerate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor for potential adverse effects such as nausea, irregular uterine bleeding, breast tenderness and headache.
digoxin
Monitor Closely (1)itraconazole will increase the level or effect of digoxin by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Measure digoxin levels before initiating concomitant drugs. Monitor and consider reducing the digoxin dose by ~30-50% or modifying the dosing frequency.
dihydroergotamine
Contraindicated (1)itraconazole will increase the level or effect of dihydroergotamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Increased risk of ergotism leading to cerebral ischemia and/or ischemia of the extremities
dihydroergotamine intranasal
Contraindicated (1)itraconazole will increase the level or effect of dihydroergotamine intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Increased risk of ergotism leading to cerebral ischemia and/or ischemia of the extremities
diltiazem
Monitor Closely (2)diltiazem will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Coadministration of diltiazem and itraconazole may increase both drug levels, toxities, and additive negative inotropic effects.

itraconazole will increase the level or effect of diltiazem by Other (see comment). Modify Therapy/Monitor Closely. CCBs elicit negative inotropic effects which may be additive to those of itraconazole; additionally, itraconazole can inhibit the metabolism of calcium channel blockers. Monitor for adverse reactions. Concomitant drug dose reduction may be necessary.
disopyramide
Contraindicated (2)itraconazole will increase the level or effect of disopyramide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

disopyramide and itraconazole both increase QTc interval. Contraindicated.
docetaxel
Serious - Use Alternative (1)itraconazole will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration is unavoidable, consider a 50% docetaxel dose reduction and monitor for increased docetaxel toxicities.
dofetilide
Contraindicated (2)dofetilide and itraconazole both increase QTc interval. Contraindicated.

itraconazole will increase the level or effect of dofetilide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Both drugs will increase QT interval
dolasetron
Monitor Closely (1)dolasetron and itraconazole both increase QTc interval. Use Caution/Monitor.
donepezil
Monitor Closely (1)donepezil and itraconazole both increase QTc interval. Use Caution/Monitor.
doravirine
Monitor Closely (1)itraconazole will increase the level or effect of doravirine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of doravirine and CYP3A4 inhibitors may increase plasma concentrations and toxicities of doravirine.
doxepin
Monitor Closely (1)itraconazole and doxepin both increase QTc interval. Use Caution/Monitor.
doxepin cream
Monitor Closely (1)itraconazole will increase the level or effect of doxepin cream by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
doxorubicin
Serious - Use Alternative (1)itraconazole will increase the level or effect of doxorubicin by Other (see comment). Avoid or Use Alternate Drug. Doxorubicin is a CYP3A4 and P-gp substrate. Avoid use in combination with CYP3A4 and P-gp inhibitors due to the potential for increased doxorubicin systemic exposure and effects.
doxorubicin liposomal
Monitor Closely (2)itraconazole will increase the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

itraconazole will increase the level or effect of doxorubicin liposomal by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
dronabinol
Monitor Closely (1)itraconazole will increase the level or effect of dronabinol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
dronedarone
Contraindicated (2)itraconazole will increase the level or effect of dronedarone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Contraindicated during and 2 weeks after itraconazole treatment.

itraconazole and dronedarone both increase QTc interval. Contraindicated.
droperidol
Serious - Use Alternative (1)itraconazole and droperidol both increase QTc interval. Avoid or Use Alternate Drug.
dutasteride
Monitor Closely (1)itraconazole will increase the level or effect of dutasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
duvelisib
Monitor Closely (2)itraconazole will increase the level or effect of duvelisib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Coadministration with a strong CYP3A4 inhibitor increases duvelisib AUC, which may increase the risk of duvelisib toxicities. Reduce duvelisib dose to 15 mg BID when coadministered with a strong CYP3A4 inhibitor.

duvelisib will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce duvelisib dose to 15 mg BID when coadministered with a strong CYP3A4 inhibitor.
edoxaban
Serious - Use Alternative (1)itraconazole will increase the level or effect of edoxaban by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. Dose adjustment may be required with strong P-gp inhibitors. DVT/PE treatment: Decrease dose to 30 mg PO once daily. NVAF: No dose reduction recommended
efavirenz
Serious - Use Alternative (3)itraconazole will increase the level or effect of efavirenz by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Not recommended 2 weeks before and during itraconazole.

efavirenz will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Not recommended 2 weeks before and during itraconazole.

efavirenz and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
elacestrant
Serious - Use Alternative (1)itraconazole will increase the level or effect of elacestrant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
elagolix
Monitor Closely (2)itraconazole will increase the level or effect of elagolix by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Coadministration of elagolix 200 mg BID with strong CYP3A inhibitors for >1 month is not recommended. Limit elagolix dose to 150 mg qDay and CYP3A inhibitor duration of use to 6 months if coadministered.

elagolix decreases levels of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Elagolix is a weak-to-moderate CYP3A4 inducer. Monitor CYP3A substrates if coadministered. Consider increasing CYP3A substrate dose if needed.
elbasvir/grazoprevir
Serious - Use Alternative (1)itraconazole will increase the level or effect of elbasvir/grazoprevir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
eletriptan
Serious - Use Alternative (1)itraconazole increases levels of eletriptan by decreasing metabolism. Contraindicated. Use of eletriptan within at least 72 hr of treatment with a strong CYP3A4 inhibitor is contraindicated.
eliglustat
Contraindicated (2)itraconazole will increase the level or effect of eliglustat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Strong CYP3A4 inhibitors are contraindicated with eliglustat poor or intermediate metabolizers; reduce eliglustat dose from 84 mg BID to 84 mg once daily in extensive metabolizers; eliglustat is contraindiated if strong or moderate CYP2D6 inhibitors are given concomitantly with strong or moderate CYP3A inhibitors

itraconazole and eliglustat both increase QTc interval. Contraindicated.
eluxadoline
Monitor Closely (1)itraconazole increases levels of eluxadoline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. As a precautionary measure due to incomplete information on the metabolism of eluxadoline, use caution when coadministered with strong CYP3A4 inhibitors.
elvitegravir
Monitor Closely (1)itraconazole increases levels of elvitegravir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. When coadministered with elvitegravir, limit dose of itraconazole should not exceed 200 mg/day.
elvitegravir/cobicistat/emtricitabine/tenofovir DF
Monitor Closely (1)elvitegravir/cobicistat/emtricitabine/tenofovir DF, itraconazole. Either increases levels of the other by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Cobicistat and itraconazole are CYP3A4 inhibitors; do not exceed itraconazole dose of 200 mg/day.Serious - Use Alternative (1)itraconazole will increase the level or effect of elvitegravir/cobicistat/emtricitabine/tenofovir DF by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
encorafenib
Serious - Use Alternative (2)itraconazole will increase the level or effect of encorafenib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If concomitant use of a strong CYP3A4 inhibitor is unavoidable, reduce encorafenib dose to one-third of the dose (eg, reduce from 450 mg/day to 150 mg/day). After discontinuing the inhibitor for 3-5 elimination half-lives, resume previous encorafenib dose.

encorafenib and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
enfortumab vedotin
Monitor Closely (2)itraconazole increases toxicity of enfortumab vedotin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Enfortumab vedotin is an antibody-drug conjugate that releases monomethylauristatin E (MMAE) via proteolytic cleavage. MMAE is primarily metabolized by CYP3A4 in vitro. Coadministration with strong CYP3A4 inhibitors may increase free MMAE exposure, which may increase the incidence or severity of toxicities.

itraconazole will increase the level or effect of enfortumab vedotin by Other (see comment). Use Caution/Monitor. Coadministration with dual P-gp and strong CYP3A4 inhibitors may increase unconjugated small molecule microtubule disrupting agent, monomethyl auristatin E (MMAE) exposure, which may increase the risk of enfortumab vedotin toxicities. Closely monitor for signs of toxicities.
entrectinib
Serious - Use Alternative (2)itraconazole will increase the level or effect of entrectinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of strong CYP3A4 inhibitors with entrectinib, a CYP3A4 substrate. If coadministration unavoidable, reduce entrectinib dose to 100 mg/day for patients aged 12 y or older with BSA >1.50m2. Resume previous entrectinib dose after discontinuing strong CYP3A inhibitor for 3-5 elimination half-lives.

entrectinib and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
enzalutamide
Serious - Use Alternative (2)itraconazole will increase the level or effect of enzalutamide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

enzalutamide will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
eplerenone
Contraindicated (1)itraconazole will increase the level or effect of eplerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. May increase the risk of hyperkalemia and hypotension
erdafitinib
Serious - Use Alternative (1)itraconazole will increase the level or effect of erdafitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If unable to avoid coadministration with strong CYP3A4 inhibitors, monitor closely for adverse reactions and consider decreasing dose accordingly. If strong CYP3A4 inhibitor is discontinued, consider increasing erdafitinib dose in the absence of any drug-related toxicities.
ergoloid mesylates
Contraindicated (1)itraconazole will increase the level or effect of ergoloid mesylates by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
ergotamine
Contraindicated (1)itraconazole will increase the level or effect of ergotamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Increased risk of ergotism leading to cerebral ischemia and/or ischemia of the extremities
eribulin
Serious - Use Alternative (1)eribulin and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
erlotinib
Serious - Use Alternative (1)itraconazole will increase the level or effect of erlotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. When combination must be used, closely monitor for severe adverse reactions (eg, severe diarrhea, severe skin reactions). If severe adverse reactions do occur, reduce erlotinib dose (in 50 mg decrements).
erythromycin base
Monitor Closely (2)erythromycin base will increase the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

erythromycin base will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (2)itraconazole will increase the level or effect of erythromycin base by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

itraconazole and erythromycin base both increase QTc interval. Avoid or Use Alternate Drug.
erythromycin ethylsuccinate
Monitor Closely (2)erythromycin ethylsuccinate will increase the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

erythromycin ethylsuccinate will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (2)itraconazole will increase the level or effect of erythromycin ethylsuccinate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

itraconazole and erythromycin ethylsuccinate both increase QTc interval. Avoid or Use Alternate Drug.
erythromycin lactobionate
Monitor Closely (2)erythromycin lactobionate will increase the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

erythromycin lactobionate will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (2)itraconazole will increase the level or effect of erythromycin lactobionate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

itraconazole and erythromycin lactobionate both increase QTc interval. Avoid or Use Alternate Drug.
erythromycin stearate
Monitor Closely (2)erythromycin stearate will increase the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

erythromycin stearate will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (2)itraconazole will increase the level or effect of erythromycin stearate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

itraconazole and erythromycin stearate both increase QTc interval. Avoid or Use Alternate Drug.
escitalopram
Monitor Closely (2)itraconazole will increase the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

itraconazole and escitalopram both increase QTc interval. Use Caution/Monitor.
eslicarbazepine acetate
Minor (1)eslicarbazepine acetate will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
esomeprazole
Serious - Use Alternative (1)esomeprazole will decrease the level or effect of itraconazole by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.Minor (1)itraconazole will increase the level or effect of esomeprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
estazolam
Contraindicated (1)itraconazole will increase the level or effect of estazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
estradiol
Monitor Closely (2)itraconazole will increase the level or effect of estradiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

itraconazole will increase the level or effect of estradiol by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
estradiol vaginal
Monitor Closely (1)itraconazole will increase the level or effect of estradiol vaginal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with CYP3A4 inhibitors may increase plasma concentrations of estrogens and toxicities.
estrogens conjugated synthetic
Monitor Closely (1)itraconazole will increase the level or effect of estrogens conjugated synthetic by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
estrogens esterified
Monitor Closely (1)itraconazole will increase the level or effect of estrogens esterified by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
estropipate
Monitor Closely (1)itraconazole will increase the level or effect of estropipate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
eszopiclone
Serious - Use Alternative (1)itraconazole will increase the level or effect of eszopiclone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
ethinylestradiol
Monitor Closely (1)itraconazole will increase the level or effect of ethinylestradiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. CYP3A4 inhibitors such as itraconazole may increase plasma hormone levels.
ethosuximide
Monitor Closely (1)itraconazole will increase the level or effect of ethosuximide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
etonogestrel
Monitor Closely (1)itraconazole will increase the level or effect of etonogestrel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
etoposide
Monitor Closely (1)itraconazole will increase the level or effect of etoposide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
etravirine
Monitor Closely (1)itraconazole will increase the level or effect of etravirine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Dose adjustments for itraconazole, ketoconazole or posaconazole may be necessary depending on the other coadministered drugs.
everolimus
Serious - Use Alternative (2)itraconazole will increase the level or effect of everolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Not recommended during and 2 weeks after itraconazole.

itraconazole will increase the level or effect of everolimus by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. Not recommended during and 2 weeks after itraconazole.
famotidine
Serious - Use Alternative (1)famotidine will decrease the level or effect of itraconazole by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
fedratinib
Monitor Closely (1)fedratinib will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP3A4 substrates as necessary.Serious - Use Alternative (1)itraconazole will increase the level or effect of fedratinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If unable to avoid fedratinib coadministration with strong CYP3A4 inhibitors, decrease fedratinib dose to 200 mg/day. If CYP3A4 inhibitor discontinued, increase fedratinib dose to 300 mg/day for 2 weeks, and then 400 mg/day thereafter as tolerated.
felbamate
Serious - Use Alternative (1)itraconazole will increase the level or effect of felbamate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
felodipine
Contraindicated (2)felodipine will increase the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Contraindicated.

itraconazole will increase the level or effect of felodipine by Other (see comment). Contraindicated. CCBs elicit negative inotropic effects which may be additive to those of itraconazole; additionally, itraconazole can inhibit the metabolism of calcium channel blockers. Coadministration is contraindicated during and 2 weeks after itraconazole treatment.
fentanyl
Serious - Use Alternative (1)itraconazole will increase the level or effect of fentanyl by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Not recommended during and 2 weeks after itraconazole. If coadministration with fentanyl is necessary, closely monitor for respiratory depression and sedation and consider fentanyl dose adjustments until stable drug effects are achieved.
fentanyl intranasal
Serious - Use Alternative (1)itraconazole will increase the level or effect of fentanyl intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Not recommended during and 2 weeks after itraconazole. If coadministration with fentanyl is necessary, closely monitor for respiratory depression and sedation and consider fentanyl dose adjustments until stable drug effects are achieved.
fentanyl transdermal
Serious - Use Alternative (1)itraconazole will increase the level or effect of fentanyl transdermal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Not recommended during and 2 weeks after itraconazole. If coadministration with fentanyl is necessary, closely monitor for respiratory depression and sedation and consider fentanyl dose adjustments until stable drug effects are achieved.
fentanyl transmucosal
Serious - Use Alternative (1)itraconazole will increase the level or effect of fentanyl transmucosal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Not recommended during and 2 weeks after itraconazole. If coadministration with fentanyl is necessary, closely monitor for respiratory depression and sedation and consider fentanyl dose adjustments until stable drug effects are achieved.
fesoterodine
Contraindicated (1)itraconazole will increase the level or effect of fesoterodine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration in patients with renal or hepatic impairment may result in increased fesoterodine levels and increased risk for potentially fatal adverse events.
fexinidazole
Serious - Use Alternative (3)itraconazole will decrease the level or effect of fexinidazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If unable to avoid coadministration, monitor fexinidazole for decreased efficacy owing to decreased plasma concentrations of active M1 and M2 metabolites.

fexinidazole and itraconazole both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval.

fexinidazole will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Fexinidazole inhibits CYP3A4. Coadministration may increase risk for adverse effects of CYP3A4 substrates.
fexofenadine
Minor (1)itraconazole will increase the level or effect of fexofenadine by P-glycoprotein (MDR1) efflux transporter. Minor/Significance Unknown.
finasteride
Monitor Closely (1)itraconazole will increase the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
finerenone
Contraindicated (1)itraconazole will increase the level or effect of finerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
fingolimod
Monitor Closely (1)fingolimod and itraconazole both increase QTc interval. Use Caution/Monitor.
flecainide
Monitor Closely (1)flecainide and itraconazole both increase QTc interval. Modify Therapy/Monitor Closely.
flibanserin
Contraindicated (1)itraconazole will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of flibanserin with moderate or strong CYP3A4 inhibitors is contraindicated. Severe hypotension or syncope can occur.
fluconazole
Serious - Use Alternative (1)fluconazole and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.Minor (1)fluconazole will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
flucytosine
Minor (1)flucytosine increases effects of itraconazole by pharmacodynamic synergism. Minor/Significance Unknown.
fludrocortisone
Monitor Closely (1)itraconazole will increase the level or effect of fludrocortisone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
flunisolide inhaled
Monitor Closely (1)itraconazole will increase the level or effect of flunisolide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
fluoxetine
Monitor Closely (1)itraconazole and fluoxetine both increase QTc interval. Use Caution/Monitor.
fluphenazine
Monitor Closely (1)itraconazole and fluphenazine both increase QTc interval. Use Caution/Monitor.
flurazepam
Monitor Closely (1)itraconazole will increase the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
fluticasone furoate
Monitor Closely (1)itraconazole will increase the level or effect of fluticasone furoate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Strong CYP3A4 inhibitors may increase fluticasone systemic exposure
fluticasone inhaled
Monitor Closely (1)itraconazole will increase the level or effect of fluticasone inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Strong CYP3A4 inhibitors may increase fluticasone systemic exposure
fluticasone intranasal
Serious - Use Alternative (1)itraconazole will increase the level or effect of fluticasone intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase systemic corticosteroid adverse effects; monitor for signs/symptoms of high corticosteroid concentrations including Cushing type signs/symptoms.
fluvoxamine
Monitor Closely (1)itraconazole and fluvoxamine both increase QTc interval. Use Caution/Monitor.
formoterol
Monitor Closely (1)itraconazole and formoterol both increase QTc interval. Use Caution/Monitor.
fosamprenavir
Serious - Use Alternative (1)itraconazole will increase the level or effect of fosamprenavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Do not exceed itraconazole dose to 200 mg/day in patients receiving fosamprenavir/ritonavir. In patients receiving fosamprenavir alone, dose reductions may be needed for patients receiving itraconazole doses greater than 400 mg/day.
fosaprepitant
Serious - Use Alternative (1)itraconazole will increase the level or effect of fosaprepitant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.Minor (1)fosaprepitant will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
foscarnet
Serious - Use Alternative (1)itraconazole and foscarnet both increase QTc interval. Avoid or Use Alternate Drug.
fostamatinib
Monitor Closely (1)itraconazole will increase the level or effect of fostamatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Strong CYP3A4 inhibitors may increase exposure to R406 (fostamatinib major active metabolite). Monitor for toxicities that may require fostamatinib dose reduction.
fostemsavir
Monitor Closely (1)itraconazole and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.
futibatinib
Serious - Use Alternative (1)itraconazole will increase the level or effect of futibatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of futibatinib with drugs that are dual P-gp and strong CYP3A inhibitors may increase incidence/severity of futibatinib toxicities.
ganaxolone
Minor (1)itraconazole, ganaxolone. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. Changes in ganaxolone exposures when coadministered with strong, moderate, or weak CYP3A4 inhibitors are not expected to be clinically significant.
gefitinib
Monitor Closely (1)itraconazole increases levels of gefitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Coadministration of strong CYP3A4 inhibitors may increase risk for gefitinib adverse effects.
gemifloxacin
Monitor Closely (1)gemifloxacin and itraconazole both increase QTc interval. Use Caution/Monitor.
gemtuzumab
Monitor Closely (1)itraconazole and gemtuzumab both increase QTc interval. Use Caution/Monitor.
gilteritinib
Serious - Use Alternative (2)itraconazole will increase the level or effect of gilteritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Consider alternatives to any strong CYP3A4 inhibitor when coadministered with gilteritinib. If such a combination cannot be avoided, closely monitor for gilteritinib-related adverse effects.

gilteritinib and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
glasdegib
Monitor Closely (1)itraconazole will increase the level or effect of glasdegib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Consider alternate therapies that are not strong CYP3A inhibitors or monitor for increased risk of adverse effects, including QTc interval prolongation.Serious - Use Alternative (1)itraconazole and glasdegib both increase QTc interval. Avoid or Use Alternate Drug.
glecaprevir/pibrentasvir
Monitor Closely (2)itraconazole will increase the level or effect of glecaprevir/pibrentasvir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

itraconazole will increase the level or effect of glecaprevir/pibrentasvir by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
goserelin
Monitor Closely (1)itraconazole and goserelin both increase QTc interval. Use Caution/Monitor.
granisetron
Monitor Closely (1)granisetron and itraconazole both increase QTc interval. Use Caution/Monitor.
griseofulvin
Minor (1)griseofulvin will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
guanfacine
Monitor Closely (1)itraconazole will increase the level or effect of guanfacine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. For extended-release (ER) guanfacine, if coadministered, decrease the guanfacine dosage to half of the recommended dose. Specific recommendations for immediate-release (IR) guanfacine are not available.
haloperidol
Monitor Closely (2)itraconazole will increase the level or effect of haloperidol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

haloperidol and itraconazole both increase QTc interval. Modify Therapy/Monitor Closely.
histrelin
Monitor Closely (1)itraconazole and histrelin both increase QTc interval. Use Caution/Monitor.
hydrocortisone
Minor (1)hydrocortisone will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
hydroxychloroquine sulfate
Serious - Use Alternative (1)itraconazole and hydroxychloroquine sulfate both increase QTc interval. Avoid or Use Alternate Drug.
hydroxyprogesterone caproate
Serious - Use Alternative (1)itraconazole will increase the level or effect of hydroxyprogesterone caproate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
hydroxyzine
Monitor Closely (2)hydroxyzine and itraconazole both increase QTc interval. Use Caution/Monitor.

itraconazole and hydroxyzine both increase QTc interval. Use Caution/Monitor.
ibrutinib
Serious - Use Alternative (1)itraconazole increases levels of ibrutinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid concomitant use of ibrutinib and strong CYP3A4 inhibitors. If a strong CYP3A4 inhibitor must be used short-term (eg, anti-infectives for =7 days), interrupt ibrutinib therapy until strong CYP3A4 inhibitor is discontinued.
ibuprofen/famotidine
Serious - Use Alternative (1)ibuprofen/famotidine will decrease the level or effect of itraconazole by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Administer acid neutralizing medicines at least 2 hours before or 2 hours after the intake of itraconazole.
ibutilide
Monitor Closely (1)ibutilide and itraconazole both increase QTc interval. Use Caution/Monitor.
idelalisib
Serious - Use Alternative (2)itraconazole will increase the level or effect of idelalisib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministered with strong CYP3A inhibitors, monitor for signs of idelalisib toxicity; follow recommendations for dosage modifications if adverse reactions occur

idelalisib will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Idelalisib is a strong CYP3A inhibitor; avoid coadministration with sensitive CYP3A substrates
ifosfamide
Monitor Closely (1)itraconazole will decrease the level or effect of ifosfamide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of CYP3A4 inhibitors may decrease the metabolism of ifosfamide to its active alkylating metabolites and decrease the efficacy of ifosfamide.
iloperidone
Monitor Closely (1)itraconazole will increase the level or effect of iloperidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce iloperidone dose by 50% when administered with a strong CYP3A4 inhibitor.Serious - Use Alternative (1)itraconazole and iloperidone both increase QTc interval. Avoid or Use Alternate Drug.
imatinib
Monitor Closely (1)itraconazole will increase the level or effect of imatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
imipramine
Serious - Use Alternative (1)imipramine and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
indacaterol, inhaled
Serious - Use Alternative (1)itraconazole and indacaterol, inhaled both increase QTc interval. Avoid or Use Alternate Drug.Minor (1)itraconazole increases levels of indacaterol, inhaled by Other (see comment). Minor/Significance Unknown. Comment: Data suggests that systemic clearance is influenced by modulation of both P-gp and CYP3A4 activities. No dose adjustment is warranted at the 75 mcg dose.
indapamide
Contraindicated (1)indapamide and itraconazole both increase QTc interval. Contraindicated.
indinavir
Monitor Closely (1)itraconazole will increase the level or effect of indinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce indinavir dose to 600 mg q8hr is recommended when coadministered itraconazole.
inotuzumab
Serious - Use Alternative (1)itraconazole and inotuzumab both increase QTc interval. Avoid or Use Alternate Drug.
irinotecan
Contraindicated (1)itraconazole will increase the level or effect of irinotecan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Strong CYP3A4 Inhibitors may increase the serum concentration of SN-38 (active metabolite for irinotecan products). Contraindicated during and 2 weeks after itraconazole treatment.
irinotecan liposomal
Contraindicated (1)itraconazole will increase the level or effect of irinotecan liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Contraindicated during and 2 weeks after itraconazole treatment. Strong CYP3A4 Inhibitors may increase the serum concentration of SN-38 (active metabolite for irinotecan products).
isavuconazonium sulfate
Contraindicated (1)itraconazole will increase the level or effect of isavuconazonium sulfate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
isoflurane
Serious - Use Alternative (1)isoflurane and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
isoniazid
Monitor Closely (1)isoniazid decreases levels of itraconazole by unspecified interaction mechanism. Use Caution/Monitor.
isradipine
Monitor Closely (2)itraconazole and isradipine both increase QTc interval. Use Caution/Monitor.

itraconazole will increase the level or effect of isradipine by Other (see comment). Modify Therapy/Monitor Closely. Calcium channel blockers (CCBs) may potentiate negative inotropic effects of itraconazole; additionally, itraconazole can inhibit the metabolism of CCB. Monitor for adverse reactions and consider dose reduction of CCBs.
istradefylline
Monitor Closely (2)istradefylline will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. This effect was not observed with istradefylline 20 mg/day. Consider dose reduction of sensitive CYP3A4 substrates.

itraconazole will increase the level or effect of istradefylline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Do not exceed istradefylline 20 mg/day if coadministered with strong CYP3A4 inhibitors.
ivabradine
Contraindicated (1)itraconazole will increase the level or effect of ivabradine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of ivabradine with itraconazole is contraindicated during and 2 weeks after of itraconazole treatment.
ivacaftor
Monitor Closely (1)itraconazole will increase the level or effect of ivacaftor by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce ivacaftor dose if coadministered with strong CYP3A4 inhibitors. See specific ivacaftor-containing product for precise dosage modification.
ivermectin
Monitor Closely (1)itraconazole will increase the level or effect of ivermectin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
ivosidenib
Serious - Use Alternative (3)itraconazole will increase the level or effect of ivosidenib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of a strong CYP3A4 inhibitor is unavoidable, reduce ivosidenib dose to 250 mg qDay. If the strong inhibitor is discontinued, increase ivosidenib dose (after at least 5 half-lives of the strong CYP3A4 inhibitor) to 500 mg qDay. Monitor for increased risk of QTc interval prolongation.

ivosidenib will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Do not administer ivosidenib with itraconzole due to expected loss of antifungal efficacy.

itraconazole and ivosidenib both decrease QTc interval. Avoid or Use Alternate Drug.
ketamine
Serious - Use Alternative (1)itraconazole will increase the level or effect of ketamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
ketoconazole
Monitor Closely (1)ketoconazole will increase the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.Serious - Use Alternative (2)ketoconazole will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

itraconazole will increase the level or effect of ketoconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
lacosamide
Monitor Closely (1)itraconazole increases levels of lacosamide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Consider decreasing lacosamide dose when coadministered with strong CYP3A4 inhibitors.
lansoprazole
Monitor Closely (1)itraconazole will increase the level or effect of lansoprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Separate proton pump inhibitors at least 2 hr before or 2 hr after itraconazole. Use of Sporanox oral solution (instead of the capsule) or administration of itraconazole with an acidic beverage (eg, cola) may minimize the significance of this interaction. Closely monitor for reduced itraconazole efficacy if combined. Serious - Use Alternative (1)lansoprazole will decrease the level or effect of itraconazole by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
lapatinib
Monitor Closely (1)itraconazole and lapatinib both increase QTc interval. Modify Therapy/Monitor Closely. If concurrent use unavoidable, decrease the lapatinib dose to 500 mg PO once daily. Increase lapatinib dose to indicated dose if itraconazole discontinuedSerious - Use Alternative (1)itraconazole will increase the level or effect of lapatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid concomitant use of strong CYP3A4 inhibitors with lapatinib. If an overlap in therapy cannot be avoided, consider reducing lapatinib dose to 500 mg/day during, and within 1 week of completing treatment with strong CYP3A4 inhibitor.Minor (1)lapatinib will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
larotrectinib
Serious - Use Alternative (1)itraconazole will increase the level or effect of larotrectinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of larotrectinib with strong CYP3A4 inhibitors is unavoidable, reduce larotrectinib dose by 50%. Resume prior larotrectinib dose once CYP3A4 inhibitor discontinued for 3-5 half-lives.
lefamulin
Serious - Use Alternative (2)itraconazole will increase the level or effect of lefamulin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of lefamulin with strong CYP3A inhibitors.

lefamulin and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
lemborexant
Serious - Use Alternative (1)itraconazole will increase the level or effect of lemborexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of lemborexant with moderate or strong CYP3A inhibitors.
lenacapavir
Monitor Closely (1)lenacapavir will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lencapavir may increase CYP3A4 substrates initiated within 9 months after last SC dose of lenacapavir, which may increase potential risk of adverse reactions of CYP3A4 substrates.
lenvatinib
Serious - Use Alternative (1)itraconazole and lenvatinib both increase QTc interval. Avoid or Use Alternate Drug.
leuprolide
Monitor Closely (1)itraconazole and leuprolide both increase QTc interval. Use Caution/Monitor.
levamlodipine
Monitor Closely (1)itraconazole will increase the level or effect of levamlodipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Coadministration with moderate and strong CYP3A inhibitors results in increased systemic exposure to amlodipine and may require dose reduction. Monitor for symptoms of hypotension and edema when amlodipine is coadministered with CYP3A inhibitors to determine the need for dose adjustment.
levofloxacin
Minor (1)itraconazole and levofloxacin both increase QTc interval. Minor/Significance Unknown.
levoketoconazole
Monitor Closely (1)levoketoconazole will increase the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.Serious - Use Alternative (3)levoketoconazole will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

itraconazole and levoketoconazole both increase QTc interval. Avoid or Use Alternate Drug.

itraconazole will increase the level or effect of levoketoconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
levomilnacipran
Monitor Closely (1)itraconazole will increase the level or effect of levomilnacipran by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Do not exceed 80 mg/day of levomilnacipran when coadministered with strong CYP3A4 inhibitors
levonorgestrel oral/ethinylestradiol/ferrous bisglycinate
Monitor Closely (1)itraconazole will increase the level or effect of levonorgestrel oral/ethinylestradiol/ferrous bisglycinate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with CYP3A4 inhibitors may increase the plasma hormone concentrations. Use of a nonhormonal contraceptive is recommended.
linagliptin
Monitor Closely (1)itraconazole will increase the level or effect of linagliptin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
lithium
Monitor Closely (1)itraconazole and lithium both increase QTc interval. Use Caution/Monitor.
lofepramine
Serious - Use Alternative (1)lofepramine and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
lofexidine
Serious - Use Alternative (1)itraconazole and lofexidine both increase QTc interval. Avoid or Use Alternate Drug.
lomitapide
Contraindicated (1)itraconazole increases levels of lomitapide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of lomitapide with itraconazole is contraindicated during and 2 weeks after of itraconazole treatment.
lonafarnib
Contraindicated (1)itraconazole will increase the level or effect of lonafarnib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Lonafarnib is a sensitive CYP3A4 substrate. Coadministration with strong or moderate CYP3A4 inhibitors is contraindicated.
loperamide
Monitor Closely (1)itraconazole and loperamide both increase QTc interval. Use Caution/Monitor.Minor (1)itraconazole will increase the level or effect of loperamide by Other (see comment). Minor/Significance Unknown. Monitor ECG when itraconazole is coadministered with loperamide (dose >16mg/day).
lopinavir
Monitor Closely (1)itraconazole will increase the level or effect of lopinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Limit adult maximum itraconazole dose to 200 mg/day in patients receiving lopinavir/ritonavir.Serious - Use Alternative (2)lopinavir will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

itraconazole and lopinavir both increase QTc interval. Avoid or Use Alternate Drug.
loratadine
Monitor Closely (2)itraconazole will increase the level or effect of loratadine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

loratadine will increase the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
lorlatinib
Serious - Use Alternative (2)lorlatinib will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

itraconazole will increase the level or effect of lorlatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministering lorlatinib with strong CYP3A inhibitors. If unavoidable, reduce lorlatinib dose by 25 mg/day. If strong CYP3A inhibitor discontinued, increase to previous lorlatinib (dose after 3 plasma half-lives of strong CYP3A inhibitor). See monograph for further details.
losartan
Monitor Closely (1)itraconazole decreases effects of losartan by decreasing metabolism. Use Caution/Monitor. May inhibit the conversion of losartan to its active metabolite E-3174. Importance of interaction not established; monitor individual therapeutic response to determine losartan dosage.
lovastatin
Contraindicated (1)itraconazole will increase the level or effect of lovastatin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of lovastatin with itraconazole is contraindicated during and 2 weeks after of itraconazole treatment.
lumacaftor/ivacaftor
Monitor Closely (1)itraconazole increases levels of lumacaftor/ivacaftor by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Strong CYP3A inhibitors do not impact lumacaftor exposure, but increased ivacaftor exposure by 4.3-fold. Due to the induction effect of lumacaftor on CYP3A, at steady-state the net exposure of ivacaftor is not expected to exceed that when given in the absence of lumacaftor at a dose of 150 mg q12hr (the approved dose of ivacaftor monotherapy). Therefore, no dose adjustment is necessary when CYP3A inhibitors are initiated in patients currently taking lumacaftor/ivacaftor. However, when initiating lumacaftor/ivacaftor in patients taking strong CYP3A inhibitors, reduce the dose to 1 tablet daily (lumacaftor 200 mg/ivacaftor 125 mg total daily dose) for the first week of treatment to allow for the steady-state induction effect of lumacaftor. Following this period, continue with the recommended daily dose. No dose adjustment is required for moderate or weak CYP3A4 inhibitors.Serious - Use Alternative (1)lumacaftor/ivacaftor will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
lumateperone
Monitor Closely (1)itraconazole will increase the level or effect of lumateperone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce lumateperone dose to 10.5 mg/day if coadministered with strong CYP3A4 inhibitors.
lumefantrine
Monitor Closely (2)itraconazole will increase the level or effect of lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.

itraconazole and lumefantrine both increase QTc interval. Modify Therapy/Monitor Closely.Minor (1)lumefantrine will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
lurasidone
Contraindicated (1)itraconazole will increase the level or effect of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of lurasidone and strong CYP3A4 inhibitors is contraindicated.
lurbinectedin
Serious - Use Alternative (1)itraconazole will increase the level or effect of lurbinectedin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
macimorelin
Serious - Use Alternative (1)itraconazole and macimorelin both increase QTc interval. Avoid or Use Alternate Drug.
macitentan
Serious - Use Alternative (1)itraconazole will increase the level or effect of macitentan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministering macitentan with strong CYP3A4 inhibitors
maprotiline
Serious - Use Alternative (1)maprotiline and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
maraviroc
Monitor Closely (2)itraconazole will increase the level or effect of maraviroc by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Decrease maraviroc dose to 150 mg BID when coadministered with strong CYP3A4 inhibitors. Maraviroc is contraindicated in patients with severe renal impairment (CrCl <30 mL/min) receiving a strong CYP3A4 inhibitor.

itraconazole will increase the level or effect of maraviroc by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely.
marijuana
Monitor Closely (1)itraconazole will increase the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Minor (1)marijuana will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
mavacamten
Contraindicated (1)itraconazole will increase the level or effect of mavacamten by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Strong CYP3A4 inhibitors may increase mavacamten systemic exposure, resulting in heart failure due to systolic dysfunction.
medroxyprogesterone
Monitor Closely (1)itraconazole will increase the level or effect of medroxyprogesterone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
mefloquine
Serious - Use Alternative (2)mefloquine increases toxicity of itraconazole by QTc interval. Avoid or Use Alternate Drug. Mefloquine may enhance the QTc prolonging effect of high risk QTc prolonging agents.

itraconazole will increase the level or effect of mefloquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Potential for increased toxicity. Avoid coadministration during and for 15 weeks after discontinuing mefloquine.
mestranol
Monitor Closely (1)itraconazole will increase the level or effect of mestranol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
methadone
Contraindicated (1)itraconazole will increase the level or effect of methadone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. QT interval prolongation and serious arrhythmia (torsades de pointes) have occurred in patients using methadone concomitantly with oral itraconazole and/or other CYP3A4 inhibitors.
methylergonovine
Contraindicated (1)itraconazole increases effects of methylergonovine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Increased risk of ergotism leading to cerebral ischemia and/or ischemia of the extremities.
methylprednisolone
Monitor Closely (1)itraconazole will increase the level or effect of methylprednisolone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.Minor (1)methylprednisolone will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
metronidazole
Minor (1)metronidazole will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
miconazole vaginal
Minor (1)miconazole vaginal will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
midazolam
Contraindicated (1)itraconazole will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of oral midazolam and itraconazole is contraindicated during and 2 weeks after itraconazole treatment. Use IV midazolam with great caution in patients receiving itraconazole, consider reduced initial doses whenever possible and closely monitor.
midazolam intranasal
Serious - Use Alternative (1)itraconazole will increase the level or effect of midazolam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of strong CYP3A4 inhibitors with midazolam intranasal causes higher midazolam systemic exposure, which may prolong sedation.
midostaurin
Serious - Use Alternative (2)itraconazole will increase the level or effect of midostaurin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration with strong CYP3A4 inhibitors cannot be avoided, monitor midostaurin for increased risk of adverse reactions, especially during the first week of treatment.

itraconazole and midostaurin both increase QTc interval. Avoid or Use Alternate Drug.
mifepristone
Monitor Closely (1)itraconazole, mifepristone. Either increases levels of the other by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Do not exceed mifepristone 300 mg/day for Cushing syndrome when coadministered with strong CYP3A4 inhibitors. Monitor for increased concentrations/toxic effects, during and 2 weeks following treatment with mifepristone.Serious - Use Alternative (2)mifepristone will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

itraconazole and mifepristone both increase QTc interval. Avoid or Use Alternate Drug.
mipomersen
Monitor Closely (1)mipomersen, itraconazole. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Both drugs have potential to increase hepatic enzymes; monitor LFTs.
mirtazapine
Monitor Closely (2)itraconazole will increase the level or effect of mirtazapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

itraconazole and mirtazapine both increase QTc interval. Use Caution/Monitor.
mirvetuximab soravtansine
Monitor Closely (1)itraconazole will increase the level or effect of mirvetuximab soravtansine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with strong CYP3A4 inhibitors may increase unconjugated DM4 (a CYP3A4 substrate and the cytotoxic component of the antibody drug conjugate for mirvetuximab soravtansine) exposure, which may increase the risk of adverse reactions.
mitotane
Monitor Closely (1)mitotane decreases levels of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments.
mobocertinib
Serious - Use Alternative (2)itraconazole will increase the level or effect of mobocertinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

itraconazole and mobocertinib both increase QTc interval. Avoid or Use Alternate Drug.
modafinil
Monitor Closely (1)itraconazole will increase the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
mometasone inhaled
Monitor Closely (1)itraconazole will increase the level or effect of mometasone inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Increases risk for systemic corticosteroid side effects
mometasone, intranasal
Monitor Closely (1)itraconazole will increase the level or effect of mometasone, intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
montelukast
Monitor Closely (1)itraconazole will increase the level or effect of montelukast by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
moxifloxacin
Minor (1)itraconazole and moxifloxacin both increase QTc interval. Minor/Significance Unknown.
nafcillin
Minor (1)nafcillin will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
naldemedine
Monitor Closely (2)itraconazole increases levels of naldemedine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor naldemedine for potential adverse effects if coadministered with strong or moderate CYP3A4 inhibitors.

itraconazole increases levels of naldemedine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Monitor naldemedine for potential adverse effects if coadministered with P-gp inhibitors.
naloxegol
Contraindicated (1)itraconazole will increase the level or effect of naloxegol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of naloxegol with strong CYP3A4 inhibitors can significantly increase naloxegol systemic exposure which may precipitate opioid withdrawal symptoms
nefazodone
Monitor Closely (2)nefazodone will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

nefazodone will increase the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.Serious - Use Alternative (1)itraconazole will increase the level or effect of nefazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
nelfinavir
Monitor Closely (2)itraconazole will increase the level or effect of nelfinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.

itraconazole will increase the level or effect of nelfinavir by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely.Minor (1)nelfinavir will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
neratinib
Serious - Use Alternative (1)itraconazole will increase the level or effect of neratinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of neratinib with strong/moderate CYP3A4 inhibitors.
netupitant/palonosetron
Monitor Closely (1)itraconazole will increase the level or effect of netupitant/palonosetron by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Netupitant is mainly metabolized by CYP3A4; no dosage adjustment is required
nevirapine
Serious - Use Alternative (1)itraconazole will increase the level or effect of nevirapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.Minor (1)nevirapine will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
nicardipine
Monitor Closely (3)nicardipine will increase the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

itraconazole will increase the level or effect of nicardipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.

itraconazole will increase the level or effect of nicardipine by Other (see comment). Modify Therapy/Monitor Closely. CCBs elicit negative inotropic effects which may be additive to those of itraconazole; additionally, itraconazole can inhibit the metabolism of calcium channel blockers. Monitor for adverse reactions. Concomitant drug dose reduction may be necessary.
nifedipine
Monitor Closely (3)nifedipine will decrease the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

itraconazole will increase the level or effect of nifedipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Consider initiating nifedipine at the lowest dose available if given concomitantly with this medication

itraconazole will increase the level or effect of nifedipine by Other (see comment). Modify Therapy/Monitor Closely. CCBs elicit negative inotropic effects which may be additive to those of itraconazole; additionally, itraconazole can inhibit the metabolism of calcium channel blockers. Monitor for adverse reactions. Concomitant drug dose reduction may be necessary. Minor (1)nifedipine will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
nilotinib
Serious - Use Alternative (2)itraconazole and nilotinib both increase QTc interval. Avoid or Use Alternate Drug.

itraconazole will increase the level or effect of nilotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of a strong CYP3A4 inhibitor is unavoidable, reduce nilotinib to 300 mg qDay in patients with resistant or intolerant Ph+ CML or to 200 mg qDay in patients with newly diagnosed Ph+ CML-CP. If strong inhibitor is discontinued, allow a washout period before adjusting the nilotinib dose to the indicated dose. Minor (1)nilotinib will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
nimodipine
Monitor Closely (1)itraconazole will increase the level or effect of nimodipine by Other (see comment). Modify Therapy/Monitor Closely. CCBs elicit negative inotropic effects which may be additive to those of itraconazole; additionally, itraconazole can inhibit the metabolism of calcium channel blockers. Monitor for adverse reactions. Concomitant drug dose reduction may be necessary.
nintedanib
Monitor Closely (1)itraconazole increases levels of nintedanib by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. If nintedanib adverse effects occur, management may require interruption, dose reduction, or discontinuation of therapy .
nirmatrelvir
Monitor Closely (1)nirmatrelvir will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Limit itraconazole adult dose to 200 mg/day if coadministered with ritonavir.
nirmatrelvir/ritonavir
Monitor Closely (1)nirmatrelvir/ritonavir will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Limit itraconazole adult dose to 200 mg/day if coadministered with ritonavir.
nisoldipine
Contraindicated (1)itraconazole will increase the level or effect of nisoldipine by Other (see comment). Contraindicated. CCBs elicit negative inotropic effects which may be additive to those of itraconazole; additionally, itraconazole can inhibit the metabolism of calcium channel blockers. Coadministration is contraindicated during and 2 weeks after itraconazole treatment.
nitrendipine
Monitor Closely (1)itraconazole will increase the level or effect of nitrendipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
nizatidine
Serious - Use Alternative (1)nizatidine will decrease the level or effect of itraconazole by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
nortriptyline
Monitor Closely (1)itraconazole and nortriptyline both increase QTc interval. Use Caution/Monitor.Serious - Use Alternative (1)nortriptyline and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
octreotide
Monitor Closely (1)itraconazole and octreotide both increase QTc interval. Use Caution/Monitor.
ofloxacin
Monitor Closely (1)itraconazole and ofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.
olanzapine
Monitor Closely (1)itraconazole and olanzapine both increase QTc interval. Use Caution/Monitor. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances
olaparib
Serious - Use Alternative (1)itraconazole will increase the level or effect of olaparib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration with strong CYP3A inhibitors cannot be avoided, reduce olaparib dose to 150 mg (capsule) or 100 mg (tablet) PO BID. Do not substitute tablets with capsules.
oliceridine
Monitor Closely (1)itraconazole will increase the level or effect of oliceridine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. If concomitant use is necessary, may require less frequent oliceridine dosing. Closely monitor for respiratory depression and sedation and titrate subsequent doses accordingly. If inhibitor is discontinued, consider increase oliceridine dosage until stable drug effects are achieved. Monitor for signs of opioid withdrawal.
omaveloxolone
Serious - Use Alternative (1)itraconazole will increase the level or effect of omaveloxolone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If unavoidable, reduce omaveloxolone dose to 50 mg/day. Closely monitor and discontinue if adverse effects emerge.
ombitasvir/paritaprevir/ritonavir
Serious - Use Alternative (1)itraconazole will increase the level or effect of ombitasvir/paritaprevir/ritonavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
ombitasvir/paritaprevir/ritonavir & dasabuvir (DSC)
Serious - Use Alternative (1)itraconazole will increase the level or effect of ombitasvir/paritaprevir/ritonavir & dasabuvir (DSC) by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
omeprazole
Serious - Use Alternative (1)omeprazole will decrease the level or effect of itraconazole by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
ondansetron
Monitor Closely (1)itraconazole will increase the level or effect of ondansetron by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. P-gp inhibitors may decrease clearance of ondansetron. No dosage adjustment for ondansetron is recommendedSerious - Use Alternative (1)itraconazole and ondansetron both increase QTc interval. Avoid or Use Alternate Drug.
osilodrostat
Monitor Closely (2)osilodrostat and itraconazole both increase QTc interval. Use Caution/Monitor.

itraconazole will increase the level or effect of osilodrostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce dose of osilodrostat, a CYP3A4 substrate, by half when coadministered with a strong CYP3A4 inhibitor.
osimertinib
Monitor Closely (1)itraconazole will increase the level or effect of osimertinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)itraconazole and osimertinib both increase QTc interval. Avoid or Use Alternate Drug.
ospemifene
Monitor Closely (1)itraconazole increases levels of ospemifene by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
oxaliplatin
Serious - Use Alternative (1)itraconazole and oxaliplatin both increase QTc interval. Avoid or Use Alternate Drug.
oxcarbazepine
Minor (1)oxcarbazepine will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
oxybutynin
Monitor Closely (1)itraconazole will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
oxycodone
Monitor Closely (1)itraconazole increases levels of oxycodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Oxycodone dose reduction may be warranted when coadministered with strong CYP3A4 inhibitors.
ozanimod
Serious - Use Alternative (1)itraconazole and ozanimod both increase QTc interval. Avoid or Use Alternate Drug.
paclitaxel
Monitor Closely (1)itraconazole will increase the level or effect of paclitaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
paclitaxel protein bound
Monitor Closely (1)itraconazole will increase the level or effect of paclitaxel protein bound by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
pacritinib
Contraindicated (1)itraconazole will increase the level or effect of pacritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
palbociclib
Serious - Use Alternative (1)itraconazole will increase the level or effect of palbociclib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of palbociclib with strong CYP3A inhibitors. If unable to avoid, reduce palbociclib dose to 75 mg/day.
paliperidone
Monitor Closely (2)itraconazole will increase the level or effect of paliperidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

itraconazole and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely.
panobinostat
Monitor Closely (1)itraconazole increases levels of panobinostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce panobinostat starting dose to 10 mg if coadministered with strong CYP3A4 inhibitors.Serious - Use Alternative (1)itraconazole and panobinostat both increase QTc interval. Avoid or Use Alternate Drug.
pantoprazole
Monitor Closely (1)itraconazole will increase the level or effect of pantoprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. For patients using the Sporanox brand of itraconazole (capsules or solution), administer proton pump inhibitors at least 2 hr before or 2 hr after itraconazole. Use of Sporanox oral solution or administration of itraconazole with an acidic beverage (eg, cola) may minimize the significance of this interaction. Serious - Use Alternative (1)pantoprazole will decrease the level or effect of itraconazole by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
parecoxib
Monitor Closely (1)itraconazole will increase the level or effect of parecoxib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
paricalcitol
Monitor Closely (1)itraconazole will increase the level or effect of paricalcitol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
paroxetine
Monitor Closely (1)itraconazole and paroxetine both increase QTc interval. Modify Therapy/Monitor Closely.
pasireotide
Monitor Closely (1)itraconazole and pasireotide both increase QTc interval. Use Caution/Monitor.
pazopanib
Serious - Use Alternative (1)itraconazole and pazopanib both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, reduce pazopanib dose to 400 mg PO qDay; closely monitor for QT prolongation
pemigatinib
Serious - Use Alternative (1)itraconazole will increase the level or effect of pemigatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration with strong or moderate CYP3A4 inhibitors is unavoidable, reduce pemigatinib dose (refer to drug monograph dosage modifications). After discontinuing the CYP3A4 inhibitor for 3 elimination half-lives, may resume previous pemigatinib dose.
pentamidine
Serious - Use Alternative (1)itraconazole and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.
pentobarbital
Minor (2)pentobarbital will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

pentobarbital decreases levels of itraconazole by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
perampanel
Monitor Closely (1)itraconazole will increase the level or effect of perampanel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
perphenazine
Serious - Use Alternative (1)perphenazine and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
pexidartinib
Serious - Use Alternative (1)itraconazole will increase the level or effect of pexidartinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration with strong or moderate CYP3A4 inhibitors is unavoidable, reduce pexidartinib dose (refer to drug monograph dosage modifications). After discontinuing the CYP3A4 inhibitor for 3 elimination half-lives, may resume previous pexidartinib dose.
phenobarbital
Monitor Closely (1)phenobarbital will decrease the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.Minor (2)phenobarbital will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

phenobarbital decreases levels of itraconazole by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
phenytoin
Monitor Closely (1)phenytoin will decrease the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Antifungal failure may occur due to clinically significant decreases in itraconazole serum concentrations when given with phenytoin. Increased itraconazole dosage may be needed.Serious - Use Alternative (1)phenytoin decreases levels of itraconazole by increasing metabolism. Avoid or Use Alternate Drug.Minor (1)phenytoin will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
pimavanserin
Serious - Use Alternative (2)itraconazole will increase the level or effect of pimavanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Decrease dose to 10 mg/day if pimavanserin is coadministered with strong CYP3A4 inhibitors.

itraconazole and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.
pimozide
Contraindicated (1)itraconazole will increase the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Both drugs will increase QT interval. Coadministration of pimozide and itraconazole is contraindicated during and 2 weeks after itraconazole treatment.
pitolisant
Serious - Use Alternative (2)itraconazole will increase the level or effect of pitolisant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

itraconazole and pitolisant both increase QTc interval. Avoid or Use Alternate Drug.
polatuzumab vedotin
Monitor Closely (1)itraconazole will increase the level or effect of polatuzumab vedotin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Polatuzumab undergoes catabolism to small peptides, amino acids, monomethyl auristatin E (MMAE), and unconjugated MMAE-related catabolites. MMAE is a CYP3A4 substrate. Coadministration of polatuzumab vedotin with a strong CYP3A4 inhibitor may increase unconjugated MMAE AUC, which may increase polatuzumab vedotin toxicities.
pomalidomide
Minor (2)itraconazole increases levels of pomalidomide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

itraconazole increases levels of pomalidomide by P-glycoprotein (MDR1) efflux transporter. Minor/Significance Unknown.
ponatinib
Monitor Closely (1)itraconazole increases levels of ponatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Decrease ponatinib starting dose to 30 mg qDay if concomitantly used with strong CYP3A4 inhibitors.
ponesimod
Serious - Use Alternative (1)itraconazole and ponesimod both increase QTc interval. Avoid or Use Alternate Drug.
posaconazole
Monitor Closely (2)itraconazole will increase the level or effect of posaconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

itraconazole and posaconazole both increase QTc interval. Use Caution/Monitor.Minor (1)posaconazole will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
pralsetinib
Serious - Use Alternative (1)itraconazole will increase the level or effect of pralsetinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
praziquantel
Monitor Closely (1)itraconazole will increase the level or effect of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
prednisolone
Monitor Closely (1)itraconazole will increase the level or effect of prednisolone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
prednisone
Monitor Closely (1)itraconazole will increase the level or effect of prednisone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Minor (1)prednisone will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
primaquine
Monitor Closely (2)itraconazole will increase the level or effect of primaquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

itraconazole and primaquine both increase QTc interval. Use Caution/Monitor.
primidone
Minor (2)primidone will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

primidone decreases levels of itraconazole by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
procainamide
Monitor Closely (1)itraconazole and procainamide both increase QTc interval. Use Caution/Monitor.
prochlorperazine
Serious - Use Alternative (1)prochlorperazine and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
progesterone intravaginal gel
Monitor Closely (1)itraconazole will increase the level or effect of progesterone intravaginal gel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
progesterone micronized
Monitor Closely (1)itraconazole will increase the level or effect of progesterone micronized by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
progesterone, natural
Monitor Closely (1)itraconazole will increase the level or effect of progesterone, natural by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
promazine
Serious - Use Alternative (1)promazine and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
promethazine
Serious - Use Alternative (1)promethazine and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
propafenone
Monitor Closely (1)itraconazole will increase the level or effect of propafenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Closely monitor for evidence of propafenone toxicity when used together with a strong CYP3A4 inhibitor. Avoid concurrent use of a CYP2D6 inhibitor in patients receiving proprafenone and a CYP3A4 inhibitor.Serious - Use Alternative (1)itraconazole and propafenone both increase QTc interval. Avoid or Use Alternate Drug.
protriptyline
Serious - Use Alternative (1)protriptyline and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
quazepam
Monitor Closely (1)itraconazole will increase the level or effect of quazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
quercetin
Monitor Closely (1)quercetin will decrease the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
quetiapine
Monitor Closely (1)itraconazole will increase the level or effect of quetiapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor for adverse reactions. Concomitant drug dose reduction may be necessary.Serious - Use Alternative (1)itraconazole and quetiapine both increase QTc interval. Avoid or Use Alternate Drug.
quinidine
Contraindicated (3)itraconazole will increase the level or effect of quinidine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Both drugs will increase QT interval. Coadministration of quinidine and itraconazole is contraindicated during and 2 weeks after itraconazole treatment.

quinidine will increase the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Contraindicated. Both drugs will increase QT interval

quinidine and itraconazole both increase QTc interval. Contraindicated.
quinine
Monitor Closely (2)itraconazole will increase the level or effect of quinine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

itraconazole and quinine both increase QTc interval. Use Caution/Monitor.
quinupristin/dalfopristin
Minor (1)quinupristin/dalfopristin will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
rabeprazole
Monitor Closely (1)itraconazole will increase the level or effect of rabeprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. For patients using the Sporanox brand of itraconazole (capsules or solution), administer proton pump inhibitors at least 2 hr before or 2 hr after itraconazole. Use of Sporanox oral solution or administration of itraconazole with an acidic beverage (eg, cola) may minimize the significance of this interaction.Serious - Use Alternative (1)rabeprazole will decrease the level or effect of itraconazole by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
ramelteon
Monitor Closely (1)itraconazole will increase the level or effect of ramelteon by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
ranolazine
Contraindicated (2)itraconazole will increase the level or effect of ranolazine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. May increase risk of cardiovascular events, including prolonged QTc. Coadministration of ranolazine and itraconazole is contraindicated during and 2 weeks after itraconazole treatment.

ranolazine will increase the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Contraindicated.
red yeast rice
Serious - Use Alternative (1)itraconazole will increase the level or effect of red yeast rice by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. May increase creatine kinase levels and increase risk of myopathy or rhabdomyolysis; red yeast rice contains monocolin K (reportedly identical to lovastatin)
regorafenib
Serious - Use Alternative (1)itraconazole will increase the level or effect of regorafenib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors increase regorafenib levels and decrease exposure of the active metabolites M-2 and M-5. Not recommended during and 2 weeks after itraconazole treatment.
repaglinide
Monitor Closely (1)itraconazole will increase the level or effect of repaglinide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
ribociclib
Monitor Closely (1)ribociclib will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.Serious - Use Alternative (2)itraconazole will increase the level or effect of ribociclib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If a strong CYP3A inhibitor must be coadministered with ribociclib, reduce the ribociclib starting dose to 400 mg/day.

itraconazole and ribociclib both increase QTc interval. Avoid or Use Alternate Drug.
rifabutin
Monitor Closely (3)rifabutin decreases levels of itraconazole by increasing metabolism. Use Caution/Monitor.

itraconazole increases levels of rifabutin by decreasing metabolism. Modify Therapy/Monitor Closely.

rifabutin will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)itraconazole will increase the level or effect of rifabutin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
rifampin
Monitor Closely (2)rifampin will decrease the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

rifampin will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
rifapentine
Minor (1)rifapentine will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
rifaximin
Monitor Closely (1)itraconazole increases levels of rifaximin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
rilpivirine
Monitor Closely (2)itraconazole increases levels of rilpivirine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. No rilpivirine dose adjustment is required. Clinically monitor for breakthrough fungal infections when azole antifungals are co-administered with rilpivirine.

itraconazole and rilpivirine both increase QTc interval. Use Caution/Monitor.
rimegepant
Serious - Use Alternative (2)itraconazole will increase the level or effect of rimegepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

itraconazole will increase the level or effect of rimegepant by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.
riociguat
Monitor Closely (2)itraconazole will increase the level or effect of riociguat by decreasing metabolism. Modify Therapy/Monitor Closely. Coadministration of riociguat (substrate of CYP isoenzymes 1A1, 2C8, 3A, 2J2) with strong CYP inhibitors may require a decreased initial dose of 0.5 mg PO TID; monitor for signs of hypotension and reduce dose if needed

itraconazole will increase the level or effect of riociguat by Other (see comment). Modify Therapy/Monitor Closely. Coadministration of riociguat (an ABCG2 [BCRP] substrate) with strong ABCG2 inhibitors may require a decreased initial dose of 0.5 mg PO TID; monitor for signs of hypotension and reduce dose if neededSerious - Use Alternative (1)itraconazole will increase the level or effect of riociguat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
ripretinib
Monitor Closely (1)itraconazole will increase the level or effect of ripretinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with a strong CYP3A inhibitor will increase systemic exposure to ripretinib and its active metabolite (DP-5439), which may increase risk of adverse reactions.
risperidone
Monitor Closely (2)itraconazole will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

itraconazole and risperidone both increase QTc interval. Use Caution/Monitor.
ritonavir
Monitor Closely (1)ritonavir will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Limit itraconazole dose to 200 mg/day in patients receiving ritonavir.
rivaroxaban
Monitor Closely (1)itraconazole increases levels of rivaroxaban by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Avoid concomitant use of rivaroxaban and combined Pgp and strong CYP3A4 inhibitors. Combination may lead to significant increases in rivaroxaban levels and increase bleeding risk.
roflumilast
Monitor Closely (1)itraconazole will increase the level or effect of roflumilast by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
romidepsin
Monitor Closely (2)itraconazole will increase the level or effect of romidepsin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor for toxicity related to increased romidepsin exposure and follow the dose modifications for toxicity when romidepsin is initially coadministered with strong CYP3A4 inhibitor.

itraconazole and romidepsin both increase QTc interval. Modify Therapy/Monitor Closely.
rucaparib
Monitor Closely (1)rucaparib will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP3A4 substrates, if clinically indicated.
rufinamide
Minor (1)rufinamide will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
ruxolitinib
Serious - Use Alternative (1)itraconazole will increase the level or effect of ruxolitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Reduce ruxolitinib starting dose to 10 mg BID with platelet count 100 X 10^9/L or more and concurrent use of strong CYP3A4 inhibitors; avoid with platelet counts <100 X 10^9/L
ruxolitinib topical
Serious - Use Alternative (1)itraconazole will increase the level or effect of ruxolitinib topical by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Reduce ruxolitinib starting dose to 10 mg BID with platelet count 100 X 10^9/L or more and concurrent use of strong CYP3A4 inhibitors; avoid with platelet counts <100 X 10^9/L
Saccharomyces boulardii
Serious - Use Alternative (1)itraconazole decreases effects of Saccharomyces boulardii by unspecified interaction mechanism. Avoid or Use Alternate Drug. Systemic or oral antifungals may decrease activity of probiotic.
salmeterol
Serious - Use Alternative (2)itraconazole will increase the level or effect of salmeterol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

itraconazole and salmeterol both increase QTc interval. Avoid or Use Alternate Drug.
saquinavir
Monitor Closely (2)itraconazole will increase the level or effect of saquinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Limit itraconazole dose to 200 mg/day in patients receiving saquinavir/ritonavir.

itraconazole will increase the level or effect of saquinavir by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Limit itraconazole dose to 200 mg/day in patients receiving saquinavir/ritonavir.Serious - Use Alternative (2)saquinavir will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

itraconazole and saquinavir both increase QTc interval. Avoid or Use Alternate Drug.
saxagliptin
Monitor Closely (1)itraconazole will increase the level or effect of saxagliptin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Limit saxagliptin dose to 2.5 mg/day when coadministered with strong CYP3A4 inhibitors
secobarbital
Minor (2)secobarbital will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

secobarbital decreases levels of itraconazole by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
selpercatinib
Serious - Use Alternative (2)itraconazole will increase the level or effect of selpercatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

itraconazole and selpercatinib both increase QTc interval. Avoid or Use Alternate Drug.
selumetinib
Serious - Use Alternative (1)itraconazole will increase the level or effect of selumetinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration with strong or moderate CYP3A4 inhibitors cannot be avoided, reduce selumetinib dosage (refer to selumetinib monograph for further information). After discontinuation of the strong or moderate CYP3A4 inhibitor for 3 elimination half-lives, resume selumetinib dose that was taken before initiating the inhibitor.
sertraline
Monitor Closely (1)itraconazole and sertraline both increase QTc interval. Use Caution/Monitor.
sevoflurane
Serious - Use Alternative (1)sevoflurane and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
sildenafil
Monitor Closely (1)itraconazole will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Not recommended during and 2 weeks after itraconazole treatment when sildenafil is used for pulmonary arterial hypertension.
silodosin
Contraindicated (2)itraconazole will increase the level or effect of silodosin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Not recommended during and 2 weeks after itraconazole treatment.

itraconazole will increase the level or effect of silodosin by P-glycoprotein (MDR1) efflux transporter. Contraindicated. Not recommended during and 2 weeks after itraconazole treatment.
simvastatin
Contraindicated (1)itraconazole will increase the level or effect of simvastatin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Contraindicated during and 2 weeks after itraconazole treatment. Increased risk for rhabdomyolysis with drugs that increase simvastatin systemic exposure.Monitor Closely (1)simvastatin will increase the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
siponimod
Serious - Use Alternative (2)itraconazole will increase the level or effect of siponimod by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of siponimod with a moderate or strong CYP3A4 inhibitor PLUS a moderate or strong CYP2C9 inhibitor is not recommended.

itraconazole and siponimod both increase QTc interval. Avoid or Use Alternate Drug.
sirolimus
Serious - Use Alternative (2)itraconazole will increase the level or effect of sirolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Not recommended during and 2 weeks after itraconazole treatment.

itraconazole will increase the level or effect of sirolimus by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. Not recommended during and 2 weeks after itraconazole treatment.
sodium bicarbonate
Monitor Closely (1)sodium bicarbonate decreases levels of itraconazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.Serious - Use Alternative (1)sodium bicarbonate will decrease the level or effect of itraconazole by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
sodium citrate/citric acid
Monitor Closely (1)sodium citrate/citric acid decreases levels of itraconazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.Serious - Use Alternative (1)sodium citrate/citric acid will decrease the level or effect of itraconazole by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
sodium zirconium cyclosilicate
Monitor Closely (1)sodium zirconium cyclosilicate will decrease the level or effect of itraconazole by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Check specific recommendations for drugs that exhibit pH-dependent solubility that may affect their systemic exposure and efficacy. In general, administer drugs at least 2 hr before or after sodium zirconium cyclosilicate.
sofosbuvir/velpatasvir
Monitor Closely (1)itraconazole will increase the level or effect of sofosbuvir/velpatasvir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
solifenacin
Contraindicated (1)itraconazole will increase the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration in patients with renal or hepatic impairment may result in increased solifenacin levels and increased risk for potentially fatal adverse events.Serious - Use Alternative (1)itraconazole and solifenacin both increase QTc interval. Avoid or Use Alternate Drug.
sonidegib
Serious - Use Alternative (1)itraconazole will increase the level or effect of sonidegib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sonidegib with strong CYP3A4 inhibitors.
sorafenib
Serious - Use Alternative (1)itraconazole and sorafenib both increase QTc interval. Avoid or Use Alternate Drug.
sotalol
Monitor Closely (1)itraconazole and sotalol both increase QTc interval. Modify Therapy/Monitor Closely.
sparsentan
Serious - Use Alternative (1)itraconazole, sparsentan. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. If unavoidable, interrupt treatment with sparsentan. When resuming sparsentan, consider dose titration. .
St John's Wort
Monitor Closely (2)St John's Wort will decrease the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

St John's Wort will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
stiripentol
Monitor Closely (1)stiripentol, itraconazole. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP3A4 inhibitor and inducer. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. CYP3A4 substrates may require dosage adjustment.Serious - Use Alternative (1)itraconazole will increase the level or effect of stiripentol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
sufentanil
Monitor Closely (1)itraconazole will increase the level or effect of sufentanil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
sufentanil SL
Monitor Closely (1)itraconazole will increase the level or effect of sufentanil SL by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of sufentanil SL with any CYP3A4 inhibitor may increase sufentanil plasma concentration, and, thereby increase or prolonged adverse effects, including potentially fatal respiratory depression.
sulfamethoxazole
Monitor Closely (1)sulfamethoxazole and itraconazole both increase QTc interval. Modify Therapy/Monitor Closely.
sunitinib
Serious - Use Alternative (1)itraconazole and sunitinib both increase QTc interval. Avoid or Use Alternate Drug.
suvorexant
Serious - Use Alternative (1)itraconazole increases levels of suvorexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Suvorexant not recommended with use of strong CYP3A4 inhibitors.
tacrolimus
Serious - Use Alternative (1)itraconazole and tacrolimus both increase QTc interval. Avoid or Use Alternate Drug.
tacrolimus ointment
Monitor Closely (1)itraconazole will increase the level or effect of tacrolimus ointment by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
tadalafil
Serious - Use Alternative (1)itraconazole will increase the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. For ED limit tadalafil to max of 2.5 mg/day (for daily use) or 10 mg dose every 72 hr (for use as needed). Avoid concurrent use of tadalafil for pulmonary HTN in patients taking strong CYP3A4 inhibitors.
talazoparib
Serious - Use Alternative (1)itraconazole will increase the level or effect of talazoparib by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. If coadministration with certain P-gp inhibitors (ie, amiodarone, carvedilol, clarithromycin, itraconazole, verapamil) cannot be avoided, reduce talazoparib dose to 0.75 mg qDay. Once P-gp inhibitors are discontinued, increase talazoparib dose (after 3-5 half-lives of the inhibitor) to dose used prior to initiating the P-gp inhibitor(s).
tamoxifen
Monitor Closely (1)itraconazole will increase the level or effect of tamoxifen by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. CYP3A4 inhibition decreases metabolism of tamoxifen to N-desmethyl tamoxifen (active metabolite with similar biologic activity)
tamsulosin
Serious - Use Alternative (1)itraconazole increases levels of tamsulosin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Not recommended during and 2 weeks after itraconazole treatment. .
tasimelteon
Monitor Closely (1)itraconazole will increase the level or effect of tasimelteon by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
tazemetostat
Monitor Closely (1)tazemetostat will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)itraconazole will increase the level or effect of tazemetostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of tazemetostat with strong CYP3A4 inhibitors.
tecovirimat
Monitor Closely (1)tecovirimat will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Tecovirimat is a weak CYP3A4 inducer. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered.
telavancin
Monitor Closely (1)itraconazole and telavancin both increase QTc interval. Use Caution/Monitor.
temsirolimus
Serious - Use Alternative (1)itraconazole will increase the level or effect of temsirolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
teniposide
Monitor Closely (1)itraconazole will increase the level or effect of teniposide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
tepotinib
Serious - Use Alternative (1)itraconazole will increase the level or effect of tepotinib by Other (see comment). Avoid or Use Alternate Drug. Interaction not studied clinically. Metabolism and data suggest drugs that are strong CYP3A4 and P-gp inhibitors may increase tepotinib (a P-gp and CYP3A4 substrate) effects and risk of toxicities.
terbinafine
Monitor Closely (1)itraconazole will increase the level or effect of terbinafine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
tetrabenazine
Serious - Use Alternative (1)tetrabenazine and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
tezacaftor
Monitor Closely (1)itraconazole will increase the level or effect of tezacaftor by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adjust tezacaftor dosage regimen if coadministered with a strong CYP3A inhibitor.
theophylline
Monitor Closely (1)itraconazole will increase the level or effect of theophylline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.
thioridazine
Serious - Use Alternative (1)thioridazine and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
ticagrelor
Contraindicated (1)itraconazole increases levels of ticagrelor by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Contraindicated during and 2 weeks after itraconazole treatment.
tipranavir
Monitor Closely (1)itraconazole will increase the level or effect of tipranavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Limit itraconazole adult maximum dose to 200 mg/day in patients treated with tipranavir.Serious - Use Alternative (1)tipranavir will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
tisotumab vedotin
Monitor Closely (1)itraconazole increases levels of tisotumab vedotin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Tisotumab vedotin?s active metabolite (MMAE) is a CYP3A4 substrate. Coadministration with strong CYP3A4 inhibitors may increase unconjugated MMAE systemic exposure and increase risk of adverse effects.
tobramycin inhaled
Monitor Closely (1)tobramycin inhaled and itraconazole both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Avoid concurrent or sequential use to decrease risk for ototoxicity
tofacitinib
Serious - Use Alternative (1)itraconazole increases levels of tofacitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Reduce tofacitinib dose to 5 mg qDay when coadministered with potent CYP3A4 inhibitors.
tolterodine
Serious - Use Alternative (1)itraconazole will increase the level or effect of tolterodine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
tolvaptan
Contraindicated (1)itraconazole will increase the level or effect of tolvaptan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Larger doses of strong CYP3A4 inhibitors may produce larger increases in tolvaptan exposure. Concomitant use of tolvaptan with strong CYP3A4 inhibitors is contraindicated.Monitor Closely (1)tolvaptan will increase the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
topiramate
Minor (1)topiramate will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
topotecan
Serious - Use Alternative (1)itraconazole will increase the level or effect of topotecan by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. Product labeling for PO topotecan recommends avoiding concomitant use of P-gp inhibitors; the interaction with IV topotecan may be less severe but is still likely of clinical significance
toremifene
Monitor Closely (1)itraconazole increases levels of toremifene by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Metabolism of toremifene may be inhibited by drugs known to inhibit CYP3A4 hepatic enzymes.Serious - Use Alternative (1)itraconazole and toremifene both increase QTc interval. Avoid or Use Alternate Drug.
trabectedin
Serious - Use Alternative (1)itraconazole will increase the level or effect of trabectedin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If strong CYP3A inhibitor must be used, short-term (eg, less than 14 days), administer strong CYP3A inhibitor 1 week after trabectedin infusion, and discontinue the day prior to next trabectedin infusion
tramadol
Monitor Closely (1)itraconazole will increase the level or effect of tramadol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
trazodone
Monitor Closely (1)trazodone will decrease the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.Serious - Use Alternative (2)trazodone and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.

itraconazole will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
triamcinolone acetonide injectable suspension
Serious - Use Alternative (1)itraconazole will increase the level or effect of triamcinolone acetonide injectable suspension by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
triazolam
Contraindicated (2)itraconazole will increase the level or effect of triazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Both drugs will increase QT interval

itraconazole increases levels of triazolam by decreasing metabolism. Contraindicated.
triclabendazole
Monitor Closely (1)itraconazole and triclabendazole both increase QTc interval. Use Caution/Monitor.
trifluoperazine
Serious - Use Alternative (1)trifluoperazine and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
trimethoprim
Monitor Closely (1)itraconazole and trimethoprim both increase QTc interval. Modify Therapy/Monitor Closely.
trimipramine
Monitor Closely (1)itraconazole will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)trimipramine and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
triptorelin
Monitor Closely (1)itraconazole and triptorelin both increase QTc interval. Use Caution/Monitor.
tropisetron
Monitor Closely (1)itraconazole and tropisetron both increase QTc interval. Modify Therapy/Monitor Closely.
tucatinib
Serious - Use Alternative (1)tucatinib will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. If unavoidable, reduce CYP3A substrate dose according to product labeling.
ubrogepant
Contraindicated (1)itraconazole will increase the level or effect of ubrogepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
ulipristal
Monitor Closely (1)itraconazole will increase the level or effect of ulipristal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
umeclidinium bromide/vilanterol inhaled
Monitor Closely (2)itraconazole will increase the level or effect of umeclidinium bromide/vilanterol inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Vilanterol is a CYP3A4 substrate; coadministration with potent CYP3A4 inhibitors may increase systemic exposure

itraconazole and umeclidinium bromide/vilanterol inhaled both decrease QTc interval. Use Caution/Monitor.
upadacitinib
Monitor Closely (1)itraconazole will increase the level or effect of upadacitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Caution if upadacitinib is coadministered with strong CYP3A4 inhibitors.
valbenazine
Monitor Closely (2)itraconazole will increase the level or effect of valbenazine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce valbenazine dose to 40 mg once daily when coadministered with a strong CYP3A4 inhibitor.

valbenazine and itraconazole both increase QTc interval. Use Caution/Monitor.
vandetanib
Serious - Use Alternative (2)itraconazole will increase the level or effect of vandetanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

itraconazole and vandetanib both increase QTc interval. Avoid or Use Alternate Drug.
vardenafil
Monitor Closely (1)itraconazole will increase the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. If coadministered with itraconazole 400 mg/day, limit vardenafil dose to 2.5 mg/24 hr. If coadministered with itraconazole 200 mg/day, limit vardenafil dose to 5 mg/24 hr.Serious - Use Alternative (1)itraconazole and vardenafil both increase QTc interval. Avoid or Use Alternate Drug.
velpatasvir
Monitor Closely (1)itraconazole will increase the level or effect of velpatasvir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
vemurafenib
Monitor Closely (1)itraconazole increases levels of vemurafenib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.Serious - Use Alternative (2)itraconazole increases levels of vemurafenib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

itraconazole and vemurafenib both increase QTc interval. Avoid or Use Alternate Drug.
venetoclax
Contraindicated (1)itraconazole will increase the level or effect of venetoclax by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Use of strong CYP3A4 inhibitors is contraindicated with venetoclax during the initial ramp-up dosing phase. If a strong CYP3A inhibitor must be used after the ramp-up phase, reduce the venetoclax dose by at least 75%.
venlafaxine
Monitor Closely (2)itraconazole will increase the level or effect of venlafaxine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

itraconazole and venlafaxine both increase QTc interval. Modify Therapy/Monitor Closely.
verapamil
Monitor Closely (2)verapamil will increase the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

itraconazole will increase the level or effect of verapamil by Other (see comment). Modify Therapy/Monitor Closely. CCBs elicit negative inotropic effects which may be additive to those of itraconazole; additionally, itraconazole can inhibit the metabolism of calcium channel blockers. Monitor for adverse reactions. Concomitant drug dose reduction may be necessary. Serious - Use Alternative (1)itraconazole will increase the level or effect of verapamil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Observe the patient for development of toxicity associated with verapamil (peripheral edema, dizziness, hypotension, flushing, headache). Consider reducing the dose of verapamil or withdrawing one of the agents.Minor (1)verapamil will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
vilanterol/fluticasone furoate inhaled
Monitor Closely (2)itraconazole will increase the level or effect of vilanterol/fluticasone furoate inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Fluticasone furoate and vilanterol are both CYP3A4 substrates; coadministration with potent CYP3A4 inhibitors may increase systemic exposure

itraconazole and vilanterol/fluticasone furoate inhaled both increase QTc interval. Use Caution/Monitor.
vilazodone
Serious - Use Alternative (1)itraconazole increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase vilazodone plasma levels by 50% - Reduce daily dose to 20 mg.
vinblastine
Monitor Closely (2)itraconazole will increase the level or effect of vinblastine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

itraconazole will increase the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
vincristine
Monitor Closely (2)itraconazole will increase the level or effect of vincristine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

itraconazole will increase the level or effect of vincristine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
vincristine liposomal
Monitor Closely (2)itraconazole will increase the level or effect of vincristine liposomal by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

itraconazole will increase the level or effect of vincristine liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
vinorelbine
Monitor Closely (1)itraconazole will increase the level or effect of vinorelbine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
voclosporin
Contraindicated (2)itraconazole will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

itraconazole and voclosporin both increase QTc interval. Contraindicated.Monitor Closely (1)voclosporin, itraconazole. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
vonoprazan
Monitor Closely (1)vonoprazan will decrease the level or effect of itraconazole by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Closely monitor for reduced itraconazole efficacy if combined. Itraconazole capsules only: Separate administration by at least 1 hr before or 2 hr after ketoconazole.
vorapaxar
Serious - Use Alternative (1)itraconazole increases levels of vorapaxar by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
voriconazole
Monitor Closely (1)itraconazole and voriconazole both increase QTc interval. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)itraconazole will increase the level or effect of voriconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.Minor (1)voriconazole will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
vorinostat
Monitor Closely (1)itraconazole and vorinostat both increase QTc interval. Use Caution/Monitor.
voxelotor
Serious - Use Alternative (1)voxelotor will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. Consider dose reduction of the sensitive CYP3A4 substrate(s) if unable to avoid.
voxilaprevir
Monitor Closely (1)itraconazole will increase the level or effect of voxilaprevir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
warfarin
Monitor Closely (1)itraconazole will increase the level or effect of warfarin by Other (see comment). Use Caution/Monitor. Warfarin's less potent R-enantiomer is metabolized in part by CYP3A4 (and also CYP1A2 and CYP2C19). Monitor INR more frequently if coadministered with inhibitors of these isoenzymes and adjust warfarin dose if needed.
zafirlukast
Minor (1)zafirlukast will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
zaleplon
Monitor Closely (1)itraconazole will increase the level or effect of zaleplon by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
zanubrutinib
Monitor Closely (1)itraconazole will increase the level or effect of zanubrutinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce zanubrutinib (a CYP3A4 substrate) to 80 mg PO BID when coadministered with a moderate CYP3A4 inhibitor. Interrupt dose as recommended for adverse reactions. After discontinuing the CYP3A4 inhibitor, resume previous zanubrutinib dose.
ziprasidone
Monitor Closely (1)itraconazole will increase the level or effect of ziprasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)itraconazole and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.
zolpidem
Monitor Closely (1)itraconazole will increase the level or effect of zolpidem by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
zonisamide
Monitor Closely (1)itraconazole will increase the level or effect of zonisamide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

>10%

Systemic fungal infections

Nausea (11%)

1-10% (Systemic fungal infections)

Rash (9%)

Vomiting (5%)

Edema (4%)

Headache (4%)

Abnormal liver function test results (3%)

Diarrhea (3%)

Fever (3%)

Fatigue (3%)

Hypertension (3%)

Pruritus (3%)

Abdominal pain (2%)

Dizziness (2%)

Hypertriglyceridemia (2%)

Hypokalemia (2%)

Albuminuria (1%)

Anorexia (1%)

Decreased libido (1%)

Somnolence (1%)

Anorexia (1%)

Impotence (1%)

1-10% (Toenail infections)

Headache (10%)

Rhinitis (9%)

Upper respiratory tract infection (8%)

Sinusitis, injury (7%)

Diarrhea (4%)

Dyspepsia (4%)

Flatulence (4%)

Abdominal pain (4%)

Dizziness (4%)

Rash (4%)

Elevated liver enzymes (4%)

Gastrointestinal disorders (4%)

Rash (3%)

Cystitis (3%)

Urinary tract infection (3%)

Liver function abnormality (3%)

Myalgia (3%)

Nausea (3%)

Hypertension (2%)

Appetite increased (2%)

Constipation (2%)

Gastritis, gastroenteritis (2%)

Pharyngitis (2%)

Abnormal dreaming (2%)

Orthostatic hypertension (1%)

Headache (1%)

Malaise (1%)

Myalgia (1%)

Vasculitis (1%)

Vertigo (1%)

Frequency Not Defined

Hepatobiliary disorders: Hyperbilirubinemia

Cardiac disorders: Cardiac failure, left ventricular failure, tachycardia

General disorders and administration site conditions: Face edema, chest pain, chills

Hepatobiliary disorders: Hepatic failure, jaundice

Investigations: ALT increased, AST increased, blood alkaline phosphatase increased, blood lactate dehydrogenase increased, blood urea increased, gamma glutamyltransferase increased, urine analysis abnormal

Metabolism and nutrition disorders: Hyperglycemia, hyperkalemia, hypomagnesemia

Psychiatric disorders: Confusional state

Renal and urinary disorders: Renal impairment

Respiratory, thoracic and mediastinal disorders: Dysphonia, cough

Skin and subcutaneous tissue disorders: Hyperhidrosis

Vascular disorders: Hypotension

Postmarketing Reports

Blood and lymphatic system disorders: Leukopenia, neutropenia, thrombocytopenia

Immune system disorders: Anaphylaxis; anaphylactic, anaphylactoid and allergic reactions; serum sickness; angioneurotic edema

Nervous System Disorders: Peripheral neuropathy, paresthesia, hypoesthesia, tremor

Eye Disorders: Visual disturbances, including vision blurred and diplopia

Ear and labyrinth disorders: Transient or permanent hearing loss

Respiratory, thoracic and mediastinal disorders: Pulmonary edema, dyspnea

Gastrointestinal disorders: Pancreatitis, dysgeusia

Hepatobiliary disorders: Serious hepatotoxicity (including some cases of fatal acute liver failure), hepatitis

Skin and subcutaneous tissue disorders: Toxic epidermal necrolysis, Stevens-Johnson syndrome, acute generalized exanthematous pustulosis, erythema multiforme, exfoliative dermatitis, leukocytoclastic vasculitis, alopecia, photosensitivity, urticaria

Musculoskeletal and connective tissue disorders: Arthralgia

Renal and urinary disorders: Urinary incontinence, pollakiuria

Reproductive system and breast disorders: Erectile dysfunction

General disorders and administration site conditions: Peripheral edema

Investigations: Blood creatine phosphokinase increased

Black Box Warnings

Congestive heart failure

Can cause or exacerbate congestive heart failure (CHF)
When itraconazole IV was administered to healthy human volunteers and dogs, negative inotropic effects were seen
Do not use for the treatment of onychomycosis in patients with ventricular dysfunction (eg, history of CHF)
If signs or symptoms of CHF occur during administration, reassess benefit and risk of continuing treatment

Contraindicated drug interactions

Itraconazole is potent CYP4503A4 inhibitor
Coadministration of the following drugs are contraindicated with itraconazole: methadone, disopyramide, dofetilide, dronedarone, quinidine, isavuconazole, ergot alkaloids (eg, dihydroergotamine, ergonovine, ergotamine, methylergonovine), irinotecan, ivabradine, lurasidone, oral midazolam, pimozide, triazolam, felodipine, nisoldipine, ranolazine, eplerenone, cisapride, naloxegol, lomitapide, lovastatin, simvastatin, avanafil, ticagrelor
In patients with varying degrees of renal or hepatic impairment, coadministration of itraconazole with colchicine, fesoterodine, and solifenacin are contraindicated
Coadministration with eliglustat is contraindicated in subjects that are poor or intermediate metabolizers of CYP2D6 and in subjects taking strong or moderate CYP2D6 inhibitors
Elevated plasma concentrations of some of these drugs and may increase or prolong both the pharmacologic effects and/or adverse reactions to these drugs (eg, increased plasma concentrations of some of these drugs can lead to QT prolongation and ventricular tachyarrhythmias including occurrences of torsades de pointes)
Coadministration with venetoclax is contraindicated in patients with chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) during the dose initiation and ramp-up phase of venetoclax

Contraindications

Hypersensitivity

Contraindicated with certain CYP3A4 substrate drugs (see Black Box Warnings)

Coadministration with colchicine, fesoterodine, and solifenacin in patients with varying degrees of renal or hepatic impairment

Coadministration with eliglustat in patients who are poor or intermediated CYP2D6 metabolizers, or if coadministered with strong or moderate CYP2D6 inhibitors

Increased plasma concentrations resulting from coadministration with itraconazole of some of the aforementioned drugs can lead to QT prolongation and ventricular tachyarrhythmias

Treatment of onychomycosis in women who are pregnant or plan to become pregnant

Coadministration with venetoclax in patients with chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) during dose initiation and ramp-up phase of venetoclax

Cautions

Cases of serious hepatotoxicity, including liver failure and death, reported; discontinue if liver disease develops, and perform liver function tests; readministration discouraged

Prolongs QT interval; caution with concurrent QT-prolonging drugs or congenital long QT (see Black Box Warnings for drugs contraindicated for use with itraconazole)

Can cause or exacerbated CHF; not for the treatment of other indications in patients with evidence of ventricular dysfunction unless benefit clearly outweighs risks; risk factors include cardiac disease such as ischemic and valvular disease; significant pulmonary disease such as chronic obstructive pulmonary disease; and renal failure and other edematous disorders; monitor for signs and symptoms of CHF during treatment; if signs or symptoms of CHF appear or worsen during administration, reassess benefit-risk of continuing treatment

Calcium channel blockers can have negative inotropic effects which may be additive to those of itraconazole. when co-administering itraconazole and calcium channel blockers, monitor carefully for signs and symptoms of CHF during treatment due to an increased risk of CHF

Life-threatening cardiac arrhythmias and/or sudden death reported when coadministered with drugs that are CYP3A4 substrates and are associated with arrhythmias with increased systemic exposure (eg, pimozide, methadone, quinidine)

May cause CNS depression, which may impair mental alertness and subsequently impair ability to operate heavy machinery or performing hazardous tasks

Oral capsule and oral solution are not bioequivalent; do not use interchangeably

Parenteral form is incompatible with most aqueous solutions; use dedicated line, and do not mix with other drugs in any way

If peripheral neuropathy occurs that may be attributable to itraconazole, discontinue treatment

If cystic fibrosis patient does not respond to itraconazole, consider switching to alternative therapy; large differences in itraconazole pharmacokinetic parameters observed in cystic fibrosis patients

Transient or permanent hearing loss reported in patients receiving treatment with itraconazole; several reports included concurrent administration of quinidine, which is contraindicated; the hearing loss usually resolves when treatment is stopped but can persist in some patients

Caution with renal impairment; data are limited

Absorption of itraconazole capsules is reduced when gastric acidity reduced; administer capsules with acidic beverage in patients with reduced gastric acidity and do not administer concomitantly with acid-suppressive therapy; monitor for response

Only oral solution shown to be effective in oral/esophageal candidiasis; oral solution not recommended in patients at immediate risk for systemic candidiasis

Itraconazole should not be used to treat voriconazole-refractory aspergillosis; both agents may share resistance mechanisms

Pregnancy

There are no data on exposure to itraconazole during pregnancy

Published epidemiologic studies of women exposed to short courses of treatment with itraconazole in the first trimester of pregnancy have reported no risk of major birth defects overall and inconclusive findings on the risk of miscarriage

Drug should be used for treatment of systemic fungal infections in pregnancy only if benefit outweighs potential risk; therapy should not be administered for treatment of onychomycosis to pregnant patients or to women contemplating pregnancy; drug should not be administered to women of childbearing potential for treatment of onychomycosis unless they are using effective measures to prevent pregnancy and they begin therapy on the second or third day following the onset of menses; highly effective contraception should be continued throughout therapy and for 2 months following the end of treatment

Animal

In animal reproduction studies, itraconazole was found to cause a dose-related increase in maternal toxicity, embryotoxicity, and teratogenicity in rats at dosage levels of approximately (6-25 times the maximum recommended human dose [MRHD] of 390 mg/day based on mg/kg comparisons), and in mice at dosage levels of ~80 mg/kg/day (12 times the MRHD).

Lactation

Itraconazole is excreted in human milk

No data on the amount of itraconazole in human milk, the effects on the breastfed child, or the effects on milk production

Developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for itraconazole and any potential adverse effects on the breastfed child from itraconazole or from underlying maternal condition

Pregnancy Categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.

Mechanism of Action

Triazole antifungal agent; inhibits cytochrome P450-dependent synthesis of ergosterol, which in turn inhibits cell-membrane formation

Absorption

AUC: 15.6 hr·mcg/mL (Tolsura 130 mg BID); 14.9 hr·mcg/mL (itraconazole 200 mg BID)

AUC (Onmel): 2.27 hr·mcg/mL (fasted); 3.34 hr·mcg/mL (fed)

Trough plasma concentration: 1.2 mcg/mL (Tolsura 130 mg BID); 1 mcg/mL (itraconazole 200 mg BID)

Peak plasma concentration (steady-state): 1.6 mcg/mL (Tolsura 130 mg BID); 1.5 mcg/mL (itraconazole 200 mg BID)

Peak plasma concentration (Onmel): 162 ng/mL (fasted); 213 ng/mL (fed)

Peak plasma time (steady-state): 7 hr (Tolsura 130 mg BID); 5 hr (itraconazole 200 mg BID)

Peak plasma time (Onmel): 2.9 hr (fasted); 5.7 hr (fed)

Effect of food

Effect of food on the steady-state pharmacokinetics of itraconazole following administration (Tolsura 130 mg BID) for 14.5 days under fed and fasted conditions was evaluated in 20 healthy volunteers
A high-fat meal with total caloric content of 919 calories (526 fat calories, 260 carbohydrate calories and 133 protein calories) was used in the study

Distribution

Protein bound: 99.8% (albumin); 0.2% (free drug)

Metabolism

Extensively metabolized by the liver into a large number of metabolites

Mainly metabolized by CYP3A4

Main metabolite is hydroxy-itraconazole, which has in vitro antifungal activity comparable to itraconazole; trough plasma concentrations of this metabolite are about twice those of itraconazole

Elimination

Half-life (fasted): 32-42 hr

Excretion: Urine (35%); feces (54%)

Oral Administration

Do not administer with antacids

Sporanox and generic

Capsule and oral solution formulations are not bioequivalent and thus are not interchangeable
Generally, oral solution is the preferred formulation because of improved absorption (IDSA [Kauffman 2007])
Capsule: Take with food
Solution
- Take on an empty stomach
- When treating oropharyngeal and esophageal candidiasis, solution should be swished vigorously in mouth (10 mL/dose), then swallowed

Tolsura

Administer with food
Swallow whole; do not chew, crush, or break

Storage

Sporanox

Oral solution: Store ≤25°C (77°F); do not freeze
Capsules: Store at 25°C (77°F); excursions permitted 15-30°C (59-86°F)

Omnel

Store at 25°C (77°F); excursions permitted 15-30°C (59-86°F)
Dispense in a tight, light resistant container

Tolsura

Store at 25°C (77°F); excursions permitted 15-30°C (59-86°F)
Dispense in a tight, light resistant container

BRAND	FORM.	UNIT PRICE	PILL IMAGE
itraconazole oral -	100 mg capsule
itraconazole oral -	100 mg capsule
itraconazole oral -	100 mg capsule
itraconazole oral -	10 mg/mL solution
itraconazole oral -	100 mg capsule
itraconazole oral -	100 mg capsule
itraconazole oral -	100 mg capsule
itraconazole oral -	10 mg/mL solution
itraconazole oral -	10 mg/mL solution
itraconazole oral -	100 mg capsule
itraconazole oral -	100 mg capsule
itraconazole oral -	100 mg capsule
itraconazole oral -	100 mg capsule
Sporanox oral -	10 mg/mL solution
Sporanox oral -	100 mg capsule
Tolsura oral -	65 mg capsule

Patient Handout

ITRACONAZOLE SOLUTION - ORAL

(IT-ra-KON-a-zole)

COMMON BRAND NAME(S): Sporanox

WARNING: Itraconazole may rarely cause or worsen heart failure. Tell your doctor right away if you develop symptoms of heart failure, such as shortness of breath, swelling ankles/feet, unusual tiredness, or unusual/sudden weight gain. Consult your doctor for more details.This medication can slow down the removal of other medications from your body, which may cause very serious (possibly fatal) side effects to occur. Examples of affected drugs include certain "blood thinners" (such as ticagrelor), colchicine, certain drugs to treat irregular heartbeat (such disopyramide, dofetilide, dronedarone, quinidine), eplerenone, ergot alkaloids (such as dihydroergotamine, ergotamine, methylergonovine), felodipine, fesoterodine, irinotecan, ivabradine, lurasidone, methadone, midazolam, nisoldipine, pimozide, ranolazine, certain "statin" cholesterol drugs (such as lovastatin, simvastatin), solifenacin, telithromycin, triazolam, among others. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

USES: Itraconazole solution is used to treat fungal infections in the mouth and throat. It belongs to a class of drugs known as azole antifungals. It works by stopping the growth of fungi.

HOW TO USE: Take this medication by mouth without food as directed by your doctor, usually once or twice daily. Swish the solution in your mouth for several seconds, and then swallow.The dosage and length of treatment are based on your medical condition and response to treatment.For the best effect, take this antifungal at evenly spaced times. To help you remember, take this medication at the same time(s) every day.Continue to take this medication until the full prescribed amount is finished, even if symptoms disappear after a few days. Stopping the medication too early may result in a return of the infection.The capsule, tablet, and solution forms of this medication deliver different amounts of medication and may be used for different purposes. Do not switch between the different forms or brands of this drug without your doctor's direction.Tell your doctor if your condition does not get better or if it gets worse.

SIDE EFFECTS: See also Warning section.Nausea/vomiting, diarrhea, headache, stomach upset, or dizziness may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: numbness/tingling of arms/legs, hearing loss, mental/mood changes (such as depression).Itraconazole has rarely caused very serious (possibly fatal) liver disease. Tell your doctor right away if you develop symptoms of liver disease, such as: nausea/vomiting that doesn't stop, loss of appetite, stomach/abdominal pain, yellowing eyes/skin, dark urine.Itraconazole can commonly cause a mild rash that is usually not serious. However, you may not be able to tell it apart from a rare rash that could be a sign of a severe allergic reaction. Get medical help right away if you develop any rash.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

PRECAUTIONS: Before taking itraconazole, tell your doctor or pharmacist if you are allergic to it; or to other azole antifungals (such as ketoconazole); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: heart disease (such as heart failure, coronary artery disease, heart valve disease), liver disease, kidney disease, lung disease (such as chronic obstructive pulmonary disease-COPD).This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis). Alcohol may also increase the risk of serious liver problems.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be at greater risk for hearing loss while using this drug.During pregnancy, this medication should be used only when clearly needed. It may harm an unborn baby. Discuss the risks and benefits with your doctor. Ask about reliable forms of birth control while taking this medication and for 2 months after stopping treatment.Itraconazole passes into breast milk. Consult your doctor before breast-feeding.

DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Itraconazole interacts with many medications. See also Warning section.Other medications can affect the removal of itraconazole from your body, which may affect how itraconazole works. Examples include efavirenz, isoniazid, nevirapine, rifamycins (such as rifabutin), certain drugs used to treat seizures (such as phenytoin), among others.

OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

NOTES: Do not share this medication with others.This medication has been prescribed for your current condition only. Do not use it later to treat or prevent another infection unless your doctor tells you to.Lab and/or medical tests (such as liver function) should be done before you start taking this medication and while you are taking it. Keep all medical and lab appointments. Consult your doctor for more details.

MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

STORAGE: Store at or below 77 degrees F (25 degrees C) away from light and moisture. Do not freeze. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

Formulary

FormularyPatient Discounts

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The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

View explanations for tiers and restrictions

Tier	Description
1	This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
2	This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
3	This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
4	This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
5	This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
6	This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
NC	NOT COVERED – Drugs that are not covered by the plan.

Code	Definition
PA	Prior Authorization Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
QL	Quantity Limits Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
ST	Step Therapy Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
OR	Other Restrictions Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.

Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.

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Sections itraconazole
Dosing & Uses
Interactions
Adverse Effects
Warnings
Pregnancy
Pharmacology
Administration
Images
Patient Handout
Formulary

itraconazole (Rx)

Dosing & Uses

Dosage Forms & Strengths

capsule

oral solution

tablet

Life-threatening Infections

Sporanox

Tolsura

Blastomycosis

Sporanox

Tolsura

Aspergillosis

Sporanox

Tolsura

Histoplasmosis

Sporanox

Tolsura

Onychomycosis

Candidiasis

Esophageal candidiasis

Oropharyngeal candidiasis

Otomycosis (Orphan)

Orphan indication sponsor

Dosage Modifications

Renal impairment

Hepatic impairment

Dosing Considerations

Limitations of use (Tolsura)

Interactions

Interaction Checker

Contraindicated

Serious - Use Alternative

Significant - Monitor Closely

Minor

Contraindicated (45)

Serious - Use Alternative (215)

Monitor Closely (300)

Minor (49)

Adverse Effects

>10%

Systemic fungal infections

1-10% (Systemic fungal infections)

1-10% (Toenail infections)

Frequency Not Defined

Postmarketing Reports

Warnings

Black Box Warnings

Congestive heart failure

Contraindicated drug interactions

Contraindications

Cautions

Pregnancy & Lactation

Pregnancy

Animal

Lactation

Pregnancy Categories

Pharmacology

Mechanism of Action

Absorption

Effect of food

Distribution

Metabolism

Elimination

Administration

Oral Administration

Sporanox and generic

Solution

Tolsura

Storage

Sporanox

Omnel

Tolsura

Images

Patient Handout

Formulary

Plans

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