ANTIPSYCHOTICS AND AZOLES - OTHER ANTIPSYCHOTICS

The levels of some antipsychotics may be raised by azole antifungals:
  • Aripiprazole levels are predicted to be increased by itraconazole and ketoconazole.
  • Haloperidol levels are raised by 30% or more by itraconazole, but there was wide
    variation between subjects. Adverse neurological effects were seen in some subjects.
  • Quetiapine levels are increased 6-fold by ketoconazole. Other azole antifungals are
    predicted to interact similarly.
  • Risperidone levels were raised by about 80% by itraconazole in one study.
    Ketoconazole would be expected to interact similarly.
    Monitor for signs of adverse antipsychotic effects if these azoles are given, and consider reducing the dose as necessary. The manufacturers of aripiprazole suggest halving its dose if itraconazole or ketoconazole are given.
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