Drug Interaction Report

Miconazole and Amiodarone: Interaction Details

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

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Amiodarone

Nexterone Pacerone
+

Miconazole

Aloe Vesta Antifungal Baza Conazol Miconazole Critic-Aid Clear Cruex Prescription Strength DermaFungal Dermagran Desenex
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
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 45 documented Miconazole interactions, 24 are rated major — 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
Major

What happens

Increased amiodarone exposure

Interaction Deep Dive

If miconazole, a CYP3A4 inhibitor1, is used concomitantly with amiodarone, a CYP3A4 inhibitor and substrate, the exposure of amiodarone may be increased 2. Additional monitoring and amiodarone dose adjustment may be warranted. Amiodarone has a variable and long half-life; potential drug interaction may occur even after amiodarone is discontinued 2.

Why it happens (mechanism)

Inhibition of CYP3A4-mediated metabolism of amiodarone by miconazole

Common questions

Can I take Miconazole and Amiodarone together?

Increased amiodarone exposure Always confirm with your pharmacist or prescriber before making any change.

How serious is the Miconazole and Amiodarone 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 Miconazole or Amiodarone 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 (2)

  1. Product Information: ORAVIG(R) buccal tablets, miconazole buccal tablets. Praelia Pharmaceuticals, Inc (per FDA), Cary, NC, 2013.
  2. Product Information: NEXTERONE(R) intravenous injection, amiodarone HCl intravenous injection. Baxter Healthcare Corporation (per FDA), Deerfield, IL, 2011. DailyMed
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Amiodarone

Keep reading about Amiodarone

All Amiodarone interactions (141)
Also serious with: Deuruxolitinib Colchicine Ketoconazole Topical Galantamine
Miconazole

Keep reading about Miconazole

All Miconazole interactions (45) Miconazole drug information
Also serious with: Deuruxolitinib Pimozide Warfarin Ifosfamide Injection
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:

Amiodarone + Activated Charcoal American Hellebore Arsenic Beer Cesium Ephedra Grapefruit Siberian Cocklebur + 202 more
Miconazole + Grapefruit St. John's Wort Acacia Rigidula Adrafinil African Wild Potato American Elder Astaxanthin Ayahuasca + 124 more

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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.