Comment · Sun, May 3, 2020
Itraconazole and stimulants
Original post in this thread
jenny10000 · 2 points
Hi guys
I am currently taking 100mg itraconazole per day. I know that it is a potent CYP3A4 inhibitor but I can't find much information re interactions. Searching for amphetamine and itraconazole shows no interaction.
Yesterday evening I started taking infrequent, small lines of amphetamine, last line was 9am this morning. It has been tested and has no active cuts. At 16.00 today I took my itraconazole and within 25 minutes my heart was pounding really hard and my heart rate was just over 130 bpm (I know, not that bad but the thumping was crazy). 16.30 I took 10mg of diazepam and within half an hour my heart felt pretty much back to normal - not sure if it reduced my blood pressure? Still unsure why this happened since the half life of amphetamine and itraconazole are very long so both are still in my system but my heart is now fine.
There were a few other weekends where I took amphetamine with the same dose and timescale as last night and had no problems other than vasoconstriction, while on itraconazole.
A few weeks ago I took a couple of sensible doses of 3MMC with no problems other than some vasoconstriction which I am prone to (even before the itraconazole). After the 3M…
What they were answering
jenny10000 · 1 points
u/misteryouaresodumb you seem so know your shit...any advice please?
So I now found out that amphetamine uses CYP2D6 and I did see somewhere that itraconazole is also a CYP2D6 inhibitor although this does seem to vary depending on where I look.
Yesterday I stopped the amphetamine at 9am and waited until midnight to take the itraconazole and my heart was a bit bangy again, sorted with diazepam. Won't be taking it on the same day again. Could it be that the amphetamine uses all if the CYP2D6 so when I take itraconazole the effect is massively amplified? Sorry my chemistry knowledge is 0...although when I previously took itraconazole on friday mornings and started the amphetamine on friday nights I had no trouble.
Also with regards to the MDMA I gather that is both a CYP3A4 and CYP2D6 inhibitor. How many days do I need to stop the itraconazole for before taking MDMA?
Thanks so much!
u/MisterYouAreSoDumb
Yeah, the CYP inhibition likely led to higher levels of amphetamine in your system. However, there are also cases of congestive heart failure with itraconazole. So there might be a direct mechanism there at play.
Congestive heart failure associated with itraconazole
Heart failure induced by itraconazole.
Itraconazole decreases left ventricular contractility in isolated rabbit heart: Mechanism of action
So be careful here. I personally would not be taking anything that is taxing on the heart while taking itraconazole.