Itraconazole reduces the clearance of
busulfan by a modest 20%. There is some limited evidence that
ketoconazole may increase the risk of
hepatic veno-occlusive disease in those given high-dose
busulfan.
Although the rise in levels is only moderate, it would be prudent to monitor for
busulfan toxicity. Fluconazole appears not to interact, and so may be a useful alternative.