Moderate
Probable
Descripción
Fluconazole inhibits CYP3A4 and CYP2C19, increasing aripiprazole plasma concentrations and the risk of aripiprazole adverse effects.
Mecanismo
Aripiprazole is metabolized by CYP3A4 and CYP2D6; fluconazole inhibition of CYP3A4 reduces aripiprazole clearance, potentially increasing exposure by 30–50%.
Relevancia clínica
Elevated aripiprazole levels may cause akathisia, sedation, and metabolic adverse effects; dose adjustment may be needed.
Manejo clínico
Reduce aripiprazole dose by approximately 50% during fluconazole co-therapy; monitor for adverse effects and restore dose after antifungal completion.