MajorAntiplatelet agents – P2Y12 receptor inhibitors×Antifungals, triazole derivatives
Updated · Methodology
Mechanism
Fluconazole inhibits CYP2C19, the key enzyme converting clopidogrel into its active metabolite. Active levels fall by 25–50% and the antiplatelet effect weakens.
Symptoms
The patient feels no symptoms – the weakened antiplatelet effect is silent. Risk of recurrent coronary events and stent thrombosis rises.
Management
For a short fluconazole course, the effect is clinically minor. For prolonged systemic therapy (>14 days), an alternative antiplatelet is ticagrelor (not CYP2C19-dependent). Alternative antifungal: echinocandins for systemic mycoses.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- FDA: Plavix (clopidogrel) prescribing information (2009)– ; DailyMed setid de8b0b67-eb25-4684-83b5-7ad785314227
- AEMPS: Ficha técnica: Clopidogrel (nº registro 71676), sección 4.5 (2024)– AEMPS, CIMA, nº registro 71676, revisión 02/2024, sección 4.5