Ibrutinib and Itraconazole: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Itraconazole
Ibrutinib
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 ibrutinib exposure
Interaction Deep Dive
Use of ibrutinib is not recommended during and for 2 weeks after discontinuation of itraconazole therapy23. Avoid chronic administration of a strong CYP3A inhibitor during ibrutinib therapy. For short-term use (7 days or less) of a strong CYP3A4 inhibitor, consider interrupting ibrutinib therapy for the duration of treatment with the strong CYP3A inhibitor, and monitor patient closely for signs and symptoms of ibrutinib toxicity 1.
Why it happens (mechanism)
Inhibition of CYP3A-mediated metabolism of ibrutinib
Common questions
Can I take Ibrutinib and Itraconazole together?
Increased ibrutinib exposure Always confirm with your pharmacist or prescriber before making any change.
How serious is the Ibrutinib 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 "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 Ibrutinib 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 (3)
- Product Information: IMBRUVICA(R) oral capsules, ibrutinib oral capsules. Pharmacyclics LLC (per manufacturer), Sunnyvale, CA, 2016. DailyMed
- Product Information: SPORANOX(R) oral solution, itraconazole oral solution. Janssen Pharmaceuticals Inc (per FDA), Titusville, NJ, 2024. DailyMed
- Product Information: SPORANOX(R) oral capsules, itraconazole oral capsules. Janssen Pharmaceuticals Inc (per FDA), Titusville, NJ, 2024. DailyMed
Keep reading about Itraconazole
Keep reading about Ibrutinib
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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