Drug Interaction Report

Aripiprazole Injection and Posaconazole: Interaction Details

Name: Aripiprazole Injection and Posaconazole Interaction
Creator: Dr. Brian Staiger, PharmD, BCPS

A pharmacist-reviewed analysis of the Aripiprazole Injection and Posaconazole interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Jul 11, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Posaconazole

Noxafil

Aripiprazole Injection

Abilify Abilify Maintena® Abilify® Aristad Initio® Aristada® Opipza

Medically reviewed by

Dr. Brian Staiger, PharmD, BCPS

Updated Jul 11, 2026

Editorial policy · Data sources

Interaction severity

Contraindicated

These should generally not be used together.

Minor

Moderate

Major

Contraindicated

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.

Of 347 documented Aripiprazole Injection interactions, 20 are rated contraindicated — including this one.

Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.

Onset

unspecified

Evidence

theoretical

Severity

Contraindicated

What happens

Increased ARIPiprazole exposure and an increased risk of QT interval prolongation

Interaction Deep Dive

Use of posaconazole and ARIPiprazole is contraindicated, as it may increase ARIPiprazole exposure and risk of QT interval prolongation⁵. Reduce ARIPiprazole dose by 50% if taking with posaconazole and by 25% if taking with dual CYP3A/CYP2D6 inhibitors ². If posaconazole use exceeds 14 days, reduce ARIPiprazole IM dose 400 mg to 300 mg, or 300 mg to 200 mg ³. Avoid ARIPiprazole extended release 2-months in patients on strong dual CYP3A/CYP2D6 inhibitors. If posaconazole use exceeds 14 days, use 720 mg once every 2 months. Similarly, if coadministered for less than 14 days, then no dosage adjustment of ARIPiprazole is needed. Increase the ARIPiprazole dose once posaconazole is discontinued ¹. If coadministered, reduce Aristada(R) to the next lower strength, no dose change for 441 mg monthly is needed if tolerated ⁴.

Why it happens (mechanism)

Inhibition of CYP3A-mediated metabolism of ARIPiprazole; additive QT interval prolongation

Literature reports

1 report — 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.

Common questions

Can I take Aripiprazole Injection and Posaconazole together?

Increased 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 Posaconazole 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.

Questions for your pharmacist

Does my dose of Aripiprazole Injection or Posaconazole 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 (5)

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: NOXAFIL(R) intravenous injection, oral delayed-release tablets, oral suspension, posaconazole intravenous injection, oral delayed-release tablets, oral suspension. Merck Sharp & Dohme LLC (per FDA), Rahway, NJ, 2024. DailyMed

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Posaconazole

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Beyond drug–drug

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:

Posaconazole + Activated Charcoal Coffee Charcoal European Mandrake Glucomannan Guar Gum Gum Arabic Slippery Elm Tragacanth + 9 more

major · moderate · minor — check everything you take with our drug–supplement interaction checker.

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A message from HelloPharmacist

About our interaction database: depth, not breadth

HelloPharmacist doesn't license one of the big commercial interaction databases, so what you'll find here is not a complete list of every known drug interaction. Instead, each entry is researched, analyzed, and written up individually — documented from the published literature, reviewed by a pharmacist, and cited so you can check every source yourself.

If a combination isn't listed here, it means we haven't documented it yet — never that it's safe. For screening a full medication list, we recommend pairing this site with a comprehensive tool like the Drugs.com Interaction Checker and, most importantly, a review by your own pharmacist. For a deep, plain-English, fully sourced explanation of a specific documented interaction — that's exactly what we built this for.

This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.