Abametapir and Itraconazole: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jun 30, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Abametapir
No brand names on recordItraconazole
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
Abametapir is a lotion used to treat head lice. Even though you only put it on your scalp, it can briefly slow down a liver enzyme (called CYP3A4) that your body uses to break down many medicines. Itraconazole (Sporanox, Tolsura) is an antifungal that this same enzyme clears from your body.
If the enzyme is slowed, itraconazole could build up higher than expected, which may raise the chance of side effects. This is based on how the drugs work rather than on real cases, so it is more of a caution than a known problem. The good news is your care team can manage this easily, usually by spacing out the timing. Talk with your pharmacist or doctor before using both.
Mechanism: Abametapir inhibits CYP3A4. Itraconazole is a CYP3A4 substrate (and itself a strong CYP3A4 inhibitor), so co-exposure would be expected to increase itraconazole systemic exposure (AUC/Cmax).
- Direction: Increased itraconazole exposure; enhanced effect/adverse-effect risk. Neither drug's activity depends on CYP3A4 activation.
- Onset: Rapid; enzyme inhibition from topical abametapir may persist up to ~2 weeks.
- Evidence: Theoretical.
- Management: Avoid CYP3A4 substrates for 2 weeks after abametapir application; if the substrate is essential, avoid abametapir. Monitor for itraconazole toxicity if co-use is unavoidable.
What happens
Increased exposure of CYP3A4 substrate
Interaction Deep Dive
For the two-week period following abametapir application, refrain from administering CYP3A4 substrates. Should avoiding these substrates not be possible, then abametapir itself should not be used 1.
Why it happens (mechanism)
Inhibition of CYP3A4-mediated metabolism by abametapir
How to manage this interaction
Both medicines can usually be used safely with a little planning by your care team. Here is what typically happens:
- Timing: Your team may avoid starting itraconazole for about 2 weeks after abametapir lotion is used, since the enzyme effect can linger.
- Choosing the order: If the itraconazole cannot wait, your prescriber may hold off on the abametapir instead.
- Monitoring: If both are needed together, your team may watch you more closely for itraconazole side effects.
Keep taking everything as prescribed and let your pharmacist or doctor know you use both so they can pick the safest schedule.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Abametapir and Itraconazole together?
Abametapir can slow the enzyme that clears itraconazole, so avoid using itraconazole within about 2 weeks of applying abametapir; check with your pharmacist or doctor about timing. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Abametapir and Itraconazole interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "rapid". Effects can appear quickly, often within about 24 hours of combining the drugs.
How is the Abametapir and Itraconazole interaction managed?
Both medicines can usually be used safely with a little planning by your care team. Here is what typically happens: Timing: Your team may avoid starting itraconazole for about 2 weeks after abametapir lotion is used, since the enzyme effect can linger. Choosing the order: If the itraconazole cannot wait, your prescriber may hold off on the abametapir instead. Monitoring: If both are needed togethe… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Abametapir or Itraconazole need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (1)
- Product Information: XEGLYZE(TM) topical lotion, abametapir topical lotion. Dr Reddy’s Laboratories Inc (per FDA), Princeton, NJ, 2020. DailyMed
Keep reading about Abametapir
Keep reading about Itraconazole
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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