Aripiprazole Injection and Fluconazole: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Jul 11, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Fluconazole
Aripiprazole Injection
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.
What happens
Increased ARIPiprazole or ARIPiprazole lauroxil (prodrug of ARIPiprazole) exposure and an increased risk of QT interval prolongation
Interaction Deep Dive
Coadministration of fluconazole together with a CYP3A4 substrate known to prolong the QT interval, such as ARIPiprazole or ARIPiprazole lauroxil (prodrug of ARIPiprazole), is contraindicated as it increase CYP3A4 substrate exposure and may also increase risk for additive QT interval prolongation. Fluconazole-mediated CYP3A4 inhibition may continue for 4 to 5 days after discontinuation because of the long half-life56. ARIPiprazole is a substrate of CYP3A4 and QT interval prolongation has been reported with use 4.
Why it happens (mechanism)
Inhibition of CYP3A4-mediated metabolism of ARIPiprazole or ARIPiprazole lauroxil (prodrug of ARIPiprazole); additive QT interval prolongation
Literature reports
2 reports — tap to read
a) Concomitant use of ARIPiprazole with ketoconazole resulted in increased AUC and Cmax of ARIPiprazole by 1.6-fold and 1.4-fold, respectively. Concomitant use also increased the AUC and Cmax of dehydro-ARIPiprazole by 1.7-fold and 1.5-fold, respectively 31. When ketoconazole is given concomitantly with ARIPiprazole, the ARIPiprazole oral dose should be reduced to one-half of its normal dose and long-acting injectables should be reduced to next lowest dose available. Other strong inhibitors of CYP3A4 would be expected to have similar effects and need similar dose reductions; moderate inhibitors have not been studied 2.
b) Case reports have described QT prolongation and torsades de pointes associated with fluconazole 78.
Common questions
Can I take Aripiprazole Injection and Fluconazole together?
Increased ARIPiprazole or ARIPiprazole lauroxil (prodrug of ARIPiprazole) exposure and an increased risk of QT interval prolongation Always confirm with your pharmacist or prescriber before making any change.
How serious is the Aripiprazole Injection and Fluconazole interaction?
It is rated contraindicated. These should generally not be used together.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
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 Aripiprazole Injection or Fluconazole 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 (8)
- Product Information: ABILIFY ASIMTUFII(R) intramuscular extended-release suspension, aripiprazole intramuscular extended-release suspension. Otsuka America Pharmaceutical Inc (per FDA), Rockville, MD, 2023.
- Product Information: ABILIFY(R) oral tablets, oral solution, intramuscular injection, aripiprazole oral tablets, oral solution, intramuscular injection. Otsuka America Pharmaceutical Inc (per FDA), Rockville, MD, 2022. DailyMed
- Product Information: ABILIFY MAINTENA(R) intramuscular extended-release injection, aripiprazole intramuscular extended-release injection. Otsuka America Pharmaceutical Inc (per FDA), Rockville, MD, 2020.
- Product Information: ARISTADA(R) intramuscular extended-release injection, aripiprazole lauroxil intramuscular extended-release injection. Alkermes Inc (per FDA), Waltham, MA, 2018.
- Product Information: DIFLUCAN(R) oral tablets, suspension, fluconazole oral tablets, suspension. Roerig (per FDA), New York, NY, 2024. DailyMed
- Product Information: DIFLUCAN(R) intravenous injection, fluconazole intravenous injection. Roerig (per FDA), New York, NY, 2024. DailyMed
- Khazan M & Mathis AS: Probable cause of torsades de pointes induced by fluconazole. Pharmacotherapy 2002; 22(12):1632-1637.
- Wassmann S, Nickenig G, & Bohm M: Long QT syndrome and torsade de pointes in a patient receiving fluconazole. Ann Intern Med 1999; 131:797. PubMed
Keep reading about Fluconazole
Keep reading about Aripiprazole Injection
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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