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