Major
Probable
Mô tả
Fluconazole inhibits hydroxychloroquine metabolism and both drugs prolong the QT interval, creating compounded arrhythmia risk.
Cơ chế
Fluconazole inhibits CYP2D6 and CYP3A4 pathways involved in hydroxychloroquine metabolism; both drugs independently block hERG channels.
Ý nghĩa lâm sàng
Increased hydroxychloroquine plasma levels combined with additive hERG blockade significantly elevates torsades de pointes risk.
Xử trí
Avoid combination; use antifungal agents with minimal CYP inhibitory effect or alternative antimalarial/rheumatologic therapy.