beta blockers, non-selective (nadolol).
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to beta2 agonists
▶ Antifungals, azoles (itraconazole, ketoconazole) are predicted to
increase the exposure to bictegravir. Use with caution or
▶ Posaconazole is predicted to increase the exposure to
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole)
slightly increase the exposure to bortezomib.oStudy
▶ Fluconazole is predicted to increase the exposure to bosentan.
▶ Bosentan is predicted to decrease the exposure to
isavuconazole. Avoid.rTheoretical
is predicted to increase the exposure to bosentan.
moderately increases the exposure to bosentan.
▶ Voriconazole is predicted to increase the exposure to bosentan.
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure to bosutinib. Avoid or
adjust dose.rTheoretical → Also see TABLE 9 p. 1377
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to markedly increase the exposure to bosutinib.
Avoid or adjust dose.rStudy → Also see TABLE 9 p. 1377
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to brigatinib. Adjust
brigatinib dose, p. 971.rStudy
▶ Isavuconazole slightly increases the exposure to bupropion.
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure to buspirone. Use with
caution and adjust dose.oStudy
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to buspirone. Adjust
▶ Miconazole is predicted to increase the concentration of
are predicted to increase the exposure to
Theoretical → Also see TABLE 9 p. 1377
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole)
slightly increase the exposure to
Study → Also see TABLE 9 p. 1377
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to isavuconazole.oTheoretical
▶ Miconazole is predicted to increase the exposure to calcium
channel blockers (amlodipine, clevidipine, felodipine, lacidipine,
lercanidipine, nicardipine, nifedipine, nimodipine, verapamil).
Use with caution and adjust dose.oTheoretical
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure to calcium channel
blockers (amlodipine, felodipine, lacidipine, lercanidipine,
nicardipine, nifedipine, nimodipine)
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to calcium channel blockers
(amlodipine, felodipine, lacidipine, nicardipine, nifedipine,
nimodipine). Monitor and adjust dose.oStudy
▶ Fluconazole (high-dose) is predicted to increase the exposure
channel blockers (diltiazem, verapamil).oTheoretical
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to calcium channel blockers
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to markedly increase the exposure to calcium channel
blockers (lercanidipine). Avoid.rStudy
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to cannabis extract. Use
with caution and adjust dose.oTheoretical
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure to
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to moderately increase the exposure to cariprazine.
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure to
Theoretical → Also see TABLE 9 p. 1377
ceritinib.o ▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to ceritinib. Avoid or adjust
ceritinib dose, p. 973.rStudy → Also see TABLE 9 p. 1377
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to increase the concentration of
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole)
increase the concentration of ciclosporin.rStudy
▶ Miconazole increases the concentration of ciclosporin. Monitor
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to moderately increase the exposure to cilostazol.
Adjust cilostazol dose, p. 232.oStudy
▶ Fluconazole is predicted to increase the exposure to cilostazol.
Adjust cilostazol dose, p. 232.oTheoretical
▶ Miconazole is predicted to increase the exposure to cilostazol.
Use with caution and adjust dose.oTheoretical
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to moderately increase the exposure to cinacalcet.
▶ Antifungals, azoles (fluconazole, voriconazole) potentially
clobazam. Adjust dose.o ▶ Fluconazole is predicted to decrease the efficacy of clopidogrel.
▶ Voriconazole is predicted to decrease the efficacy of
▶ Cobicistat is predicted to increase the exposure to antifungals,
azoles (fluconazole, posaconazole).oTheoretical
▶ Cobicistat is predicted to increase the exposure to antifungals,
(itraconazole, ketoconazole). Adjust dose.o ▶ Cobicistat is predicted to increase the exposure to
isavuconazole. Avoid or monitor side effects.rStudy
▶ Cobicistat is predicted to affect the exposure to voriconazole.
BNF 78 Antifungals, azoles — Antifungals, azoles 1401
Antifungals, azoles (continued)
▶ Antifungals, azoles (fluconazole, isavuconazole, miconazole,
posaconazole) are predicted to increase the exposure to
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to markedly increase the exposure to cobimetinib.
Avoid or monitor for toxicity.rStudy
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure to colchicine. Adjust
dose with moderate inhibitors of CYP3A4, p. 1120.
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to colchicine. Avoid potent
inhibitors of CYP3A4 or adjust
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to corticosteroids
(beclometasone) (risk with beclometasone is likely to be lower
than with other corticosteroids).oTheoretical
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to corticosteroids
(betamethasone, budesonide, ciclesonide, deflazacort,
dexamethasone, fludrocortisone, fluticasone, hydrocortisone,
methylprednisolone, mometasone, prednisolone,
triamcinolone). Avoid or monitor side effects.rStudy
▶ Miconazole is predicted to increase the concentration of
(methylprednisolone). Monitor and adjust dose.
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure to corticosteroids
(methylprednisolone). Monitor and adjust dose.oStudy
▶ Fluconazole increases the anticoagulant effect of coumarins.
Monitor INR and adjust dose.rStudy
▶ Itraconazole potentially increases the anticoagulant effect of
▶ Ketoconazole potentially increases the anticoagulant effect of
(warfarin). Monitor INR and adjust dose.r
▶ Miconazole greatly increases the anticoagulant effect of
coumarins. MHRA advises avoid unless INR can be monitored
closely; monitor for signs of bleeding.rStudy
▶ Voriconazole increases the anticoagulant effect of coumarins.
Monitor INR and adjust dose.oStudy
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to moderately increase the exposure to crizotinib.
Avoid.oStudy → Also see TABLE 9 p. 1377
▶ Antifungals, azoles (itraconazole, ketoconazole) are predicted to
increase the exposure to dabigatran. Avoid.rStudy
▶ Isavuconazole is predicted to increase the exposure to
dabigatran. Monitor and adjust dose.oStudy
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to dabrafenib. Use with
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to slightly increase the exposure to
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to markedly to very markedly increase the exposure
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure to
Study → Also see TABLE 9 p. 1377
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to markedly increase the exposure to dasatinib.
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole)
very slightly increase the exposure to
Study → Also see TABLE 9 p. 1377
▶ Antifungals, azoles (fluconazole, voriconazole) moderately
diazepam. Monitor and adjust dose.
▶ Didanosine (buffered) decreases the exposure to antifungals,
azoles (itraconazole, ketoconazole). Separate administration by
2 hours.rStudy → Also see TABLE 1 p. 1375
▶ Isavuconazole slightly increases the exposure to digoxin.
Monitor and adjust dose.oStudy
▶ Itraconazole is predicted to markedly increase the
digoxin. Monitor and adjust dose.r
▶ Ketoconazole is predicted to markedly increase the
concentration of digoxin.rStudy
▶ Posaconazole is predicted to increase the concentration of
▶ Antifungals, azoles (fluconazole, isavuconazole, itraconazole,
ketoconazole, posaconazole, voriconazole) increase the risk of
QT-prolongation when given with
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure to dopamine receptor
agonists (bromocriptine).rTheoretical
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole)
increase the exposure to dopamine receptor agonists
▶ Antifungals, azoles (fluconazole, isavuconazole, itraconazole,
ketoconazole, posaconazole, voriconazole) are predicted to
increase the concentration of dopamine receptor agonists
▶ Isavuconazole is predicted to increase the exposure to
dopamine receptor agonists (pramipexole). Adjust dose.
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to doravirine.nStudy
▶ Ketoconazole moderately increases the exposure to
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to moderately increase the exposure to
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to dutasteride. Monitor
side effects and adjust dose.oTheoretical
▶ Itraconazole is predicted to slightly increase the exposure to
▶ Ketoconazole slightly increases the exposure to edoxaban.
Adjust edoxaban dose, p. 126.rStudy
▶ Efavirenz is predicted to decrease the exposure to
isavuconazole. Avoid.rTheoretical
▶ Efavirenz slightly decreases the exposure to itraconazole.
Avoid and for 14 days after stopping efavirenz.oStudy
moderately decreases the exposure to ketoconazole.
▶ Efavirenz slightly decreases the exposure to posaconazole.
▶ Efavirenz moderately decreases the exposure to voriconazole
and voriconazole slightly increases the exposure to efavirenz.
Adjust dose.rStudy → Also see TABLE 9 p. 1377
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to markedly increase the exposure to eletriptan.
▶ Antifungals, azoles (fluconazole, isavuconazole, itraconazole,
ketoconazole, posaconazole, voriconazole) are predicted to
increase the exposure to eliglustat. Avoid or adjust dose—
consult product literature.rStudy
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to moderately increase the exposure to
encorafenib.oStudy → Also see TABLE 9 p. 1377
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to encorafenib. Avoid or
monitor.rStudy → Also see TABLE 9 p. 1377
▶ Enzalutamide is predicted to decrease the exposure to
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to increase the risk of ergotism when given with
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the risk of ergotism when given with
ergometrine. Avoid.rTheoretical
▶ Miconazole is predicted to increase the exposure to
ergometrine. Avoid.oTheoretical
1402 Antifungals, azoles — Antifungals, azoles BNF 78
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to increase the risk of ergotism when given with
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the risk of ergotism when given with
ergotamine. Avoid.rTheoretical
▶ Miconazole is predicted to increase the exposure to
ergotamine. Avoid.oTheoretical
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure to
erlotinib.o ▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to slightly increase the exposure to erlotinib. Use
with caution and adjust dose.oStudy
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to increase the concentration of everolimus.
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the concentration of
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure to fesoterodine. Adjust
fesoterodine dose with moderate inhibitors of CYP3A4 in
hepatic and renal impairment, p. 777.nStudy
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to moderately increase the exposure to fesoterodine.
Adjust fesoterodine dose with potent inhibitors of CYP3A4;
avoid in hepatic and renal impairment, p. 777.rStudy
▶ Antifungals, azoles (itraconazole, ketoconazole) are predicted to
increase the exposure to fidaxomicin. Avoid.oStudy
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to
fosaprepitant.o ▶ Posaconazole is predicted to increase the exposure to
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure to
gefitinib.o ▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to gefitinib.oStudy
▶ Antifungals, azoles (itraconazole, ketoconazole) potentially
increase the exposure to glecaprevir.oTheoretical
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to moderately to markedly increase the exposure to
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to increase the concentration of guanfacine.
Adjust guanfacine dose, p. 352.oTheoretical
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to guanfacine. Adjust
guanfacine dose, p. 352.oStudy
▶ H2 receptor antagonists are predicted to decrease the
absorption of itraconazole. Administer itraconazole capsules
with an acidic beverage, p. 597.oStudy
▶ H2 receptor antagonists are predicted to decrease the
absorption of ketoconazole. Administer ketoconazole with an
▶ H2 receptor antagonists are predicted to decrease the exposure
oto posaconazole. Avoid use of posaconazole oral suspension.
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