Itraconazole and Olmesartan, amlodipine, and hydrochlorothiazide interaction

Itraconazole and Olmesartan, amlodipine, and hydrochlorothiazide: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

From the Itraconazole (Tolsura) label · effective 2025-04-23

Major

Calcium Channel Blockers Felodipine Nisoldipine Contraindicated during and 2 weeks after TOLSURA treatment.

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Major

Diuretics Eplerenone Contraindicated during and 2 weeks after TOLSURA treatment.

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Moderate

Calcium channel blockers can have negative inotropic effects which may be additive to those of itraconazole.

Warnings and precautionsby drug classView label on DailyMed
Moderate

Therefore, when co-administering itraconazole and calcium channel blockers, monitor carefully for signs and symptoms of CHF during treatment due to an increased risk of CHF.

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Moderate

Diltiazem Other dihydropyridines Verapamil Monitor for adverse reactions.

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From the Olmesartan, amlodipine, and hydrochlorothiazide (Olmesartan medoxomil, amlodipine and hydrochlorothiazide) label · effective 2026-01-05

Moderate

• Increased amlodipine exposure when coadministered with CYP3A inhibitors Hydrochlorothiazide ( 7.3 ): • Antidiabetic drugs: Dosage adjustment of antidiabetic may be required.

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Moderate

CYP3A Inhibitors: Co-administration of amlodipine with CYP3A inhibitors (moderate and strong) results in increased systemic exposure to amlodipine and may require dose reduction.

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Moderate

Monitor for symptoms of hypotension and edema when amlodipine is co-administered with CYP3A inhibitors to determine the need for dose adjustment.

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.