Drug Interaction between Itraconazole and Amiodarone

Itraconazole is an azole antifungal agent used to prevent and treat fungal and yeast infections.
Amiodarone is an anti-arrhythmic drug used for the management of life-threatening heart rhythm disorders of the ventricles like persistent ventricular fibrillation / tachycardia.

The concomitant use of both Itraconazole and Amiodarone can lead to a major drug interaction. This is because Itraconazole (an Azole compound) is a potent inhibitor of CYP450 3A4 isoenzyme responsible for the metabolic clearance of Amiodarone. Amiodarone is known to prolong QT interval. High plasma levels of Amiodarone potentiate the risk of ventricular arrhythmias such as ventricular tachycardia and torsade de pointes, cardiac arrest and sudden death.
Ketoconazole is another potent inhibitor of CYP450 2C19 and 3A4 isoenzymes which will lead to similar interaction.

This is considered a major drug interaction in which an alternative is strongly advised.

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