Major
Probable
Descripción
Fluconazole inhibits hydroxychloroquine metabolism and both drugs prolong the QT interval, creating compounded arrhythmia risk.
Mecanismo
Fluconazole inhibits CYP2D6 and CYP3A4 pathways involved in hydroxychloroquine metabolism; both drugs independently block hERG channels.
Relevancia clínica
Increased hydroxychloroquine plasma levels combined with additive hERG blockade significantly elevates torsades de pointes risk.
Manejo clínico
Avoid combination; use antifungal agents with minimal CYP inhibitory effect or alternative antimalarial/rheumatologic therapy.