Miconazole and Naloxegol: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Naloxegol
Miconazole
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 naloxegol exposure
Interaction Deep Dive
Concomitant use of naloxegol (a CYP3A4 substrate) with a moderate CYP3A4 inhibitor should be avoided, as increased naloxegol exposure may occur. If coadministration is unavoidable, decrease the naloxegol dosage to 12.5 mg once daily and monitor the patient for adverse events1.
Why it happens (mechanism)
Inhibition of CYP3A4-mediated metabolism of naloxegol
Literature reports
1 report — tap to read
a) Coadministration of once daily oral ketoconazole 400 mg (a strong CYP3A4 inhibitor) and naloxegol 25 mg increased the naloxegol Cmax by 9.58-fold and the AUC by 12.85-fold. Additionally, coadministration of oral dilTIAZem 240 mg extended-release (a moderate CYP3A4 inhibitor) with naloxegol 25 mg increased the naloxegol Cmax by 2.86-fold and the AUC by 3.41-fold 1.
Common questions
Can I take Miconazole and Naloxegol together?
Increased naloxegol exposure Always confirm with your pharmacist or prescriber before making any change.
How serious is the Miconazole and Naloxegol 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 Naloxegol 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 (1)
- Product Information: MOVANTIK(R) oral tablets, naloxegol oral tablets. AstraZeneca Pharmaceuticals LP (per FDA), Wilmington, DE, 2020. DailyMed
Keep reading about Naloxegol
Keep reading about Miconazole
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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