Capsule Commentaries: Selected Oral Antifungal Drug-Drug Interactions with Itraconazole and Terbinafine

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James Del Rosso


antifungal, drug-drug interaction, itraconazole, terbinafine, therapy


This article provides a review of selected drug-drug interactions with itraconazole and terbinafine that are clinically relevant with potential for toxicity. These include itraconazole and certain statin agents, itraconazole and digoxin, and terbinafine and some antidepressants, with commentary suggestions on management.


Katz HI, Gupta AK. Oral antifungal drug interactions: a mechanistic approach to understanding their cause. Dermatol Clin. 2003 Jul;21(3):543-563.

Shear N, Drake L, Gupta AK, et al. The implications and management of drug interactions with itraconazole, fluconazole and terbinafine. Dermatology. 2000;201(3):196-203.

Dybro AM, Damkier P, Rasmussen TB, et al. Statin-associated rhabdomyolysis triggered by drug-drug interaction with itraconazole. BMJ Case Rep. 2016 Sep 7;2016. pii: bcr2016216457.

Tatro DS. Drug Interactions Facts, Wolters Kluwer Health Inc, St. Louis, Missouri, USA, 2005, p 718.

Alderman CP, Allcroft PD. Digoxin-itraconazole interaction: possible mechanisms.
Ann Pharmacother. 1997;31(4):438-440.

Angirasa AK, Koch AZ. P-glycoprotein as the mediator of itraconazole-digoxin interaction. J Am Podiatr Med Assoc. 2002;92(8):471-472.

Jalava KM, Partanen J, Neuvonen PJ. Itraconazole decreases renal clearance of digoxin. Ther Drug Monit. 1997 Dec;19(6):609-13.

Van Der Kuy PH, Van Den Heuvel HA, Kempen RW, et al. Pharmacokinetic interaction between nortriptyline and terbinafine. Ann Pharmacother. 2002;36(11):1712-1714.

Castberg I, Helle J, Aamo TO. Prolonged pharmacokinetic drug interaction between terbinafine and amitriptyline. Ther Drug Monit. 2005 Oct;27(5):680-2.

Tatro DS. Drug Interactions Facts, Wolters Kluwer Health Inc, St. Louis, Missouri, USA, 2005, p 1507.

Yasui-Furukori N, Saito M, Inoue Y, et al. Terbinafine increases the plasma concentration of paroxetine after a single oral administration of paroxetine in healthy subjects. Eur J Clin Pharmacol. 2007;63(1):51-56.

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