Miconazole and Domperidone: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Miconazole
Domperidone
No brand names on record
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 domperidone exposure and an increased risk of QT interval prolongation
Interaction Deep Dive
Coadministration of miconazole, a CYP3A4 inhibitor1, with domperidone may result in increased plasma concentrations of domperidone and have an effect on QT interval prolongation. Concomitant use of domperidone and miconazole may increase the risk of serious cardiac events, including ventricular arrhythmias and sudden cardiac death, and therefore should be undertaken with caution. Case-control studies demonstrated an association of serious ventricular arrhythmias and sudden cardiac death, particularly with domperidone doses greater than 30 mg/day and in patients older than 60 years. Domperidone should be initiated at the lowest possible dose and titrated with caution. Discontinue domperidone if the patient experiences dizziness, palpitations, syncope, or seizure 2.
Why it happens (mechanism)
Inhibition of CYP3A4-mediated domperidone metabolism
Common questions
Can I take Miconazole and Domperidone together?
Increased domperidone exposure and an increased risk of QT interval prolongation Always confirm with your pharmacist or prescriber before making any change.
How serious is the Miconazole and Domperidone 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.
Questions for your pharmacist
- Does my dose of Miconazole or Domperidone 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)
- Product Information: ORAVIG(R) buccal tablets, miconazole buccal tablets. Praelia Pharmaceuticals, Inc (per FDA), Cary, NC, 2013.
- Teva Canada Limited: Dear Healthcare Professional letter for domperidone maleate. Teva Canada Limited. Toronto, Canada. 2012.
Keep reading about Miconazole
Keep reading about Domperidone
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Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
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