Itraconazole

An azole antifungal, FDA-approved for blastomycosis, histoplasmosis, aspergillosis and fungal nail infections (onychomycosis).

psilodex.org/m/itraconazole · data v2026.10.05

Clinical contraindication: None listed; No label contraindication covering psilocybin was found. This is not a finding that the combination has been shown to be without risk.
Psilocybin evidence: No psilocybin data
Half-life: 16–28 h; Approximate, in adults. Source under Interaction below.

Named in state rules?

Not namedColorado

Not namedOregon

PendingNew Mexico

Cite asPsilodex, “Itraconazole”, v2026.10.05. psilodex.org/m/itraconazole

Clinical data and state rules are separate facts. Both are shown; neither is a decision.

What it is used for

FDA status

FDA-approved

FDA-approved for

Blastomycosis
Histoplasmosis
Aspergillosis (when amphotericin B is not tolerated or fails)
Fungal nail infection (onychomycosis) of toenails and fingernails

Sources [1]

Other safety

Boxed warning: congestive heart failure (not used for nail infections in people with heart failure) and serious cardiac events with many co-administered CYP3A4-metabolized drugs, several of which are contraindicated.

About the medication itself, separate from any interaction with psilocybin.

Sources [1]

01 Interaction with psilocybin

It may slow how the body clears psilocybin by blocking a minor clearing enzyme. Also, its label warns of heart failure and heart-rhythm (QT) effects.

Detail Itraconazole is a potent CYP3A4 (liver enzyme) inhibitor. CYP3A4 metabolized psilocin in lab studies (Thomann 2024), so itraconazole may raise psilocin levels. However, psilocin is removed mainly by glucuronidation and conversion to 4-HIAA. There are no psilocybin data. Psilocybin briefly raises heart rate and blood pressure. Also, its boxed warning covers heart failure and QT prolongation (a heart-rhythm change) from raised levels of other drugs. Sources [1][2]

Human data with psilocybin: No psilocybin data; based on how it works and its label
Half-life: 16–28 h (single dose); 34–42 h with repeated dosing (FDA label, checked 2026-10-04)

Evidence types on this record

No psilocybin dataNo psilocybin data: no human data with psilocybin or another classic psychedelic; the text draws on the medication's own pharmacology and its label or reference facts

02 Pharmacology relevant to psilocybin

2 listed · counted on reports

Liver injury: The label or source warns of liver injury, from raised liver enzymes to liver failure. Liver disease also affects how the body clears psilocin. Sources [1]
QT-prolonging: Lengthens the QT interval on an ECG, a measure of the heart’s electrical recovery between beats. A long QT raises the risk of a dangerous heart rhythm, more so with other QT-prolonging drugs or low potassium or magnesium. Sources [1]

03 State rules

Plain-language summary · official text governs

CO4 CCR 755-1

Not named

No provision names this medication or its class.

Colorado · checked 2026-10-04

OROAR 333-333

Not named

No provision names this medication or its class.

Oregon · checked 2026-10-04

NM7.35.3 NMAC (proposed)

Pending

New Mexico's clinical rules (proposed 7.35.3 NMAC) are not final. No provision naming this medication has been found.

New Mexico · checked 2026-10-04

04 Conditions to ask about

None linked

No condition named in state rules is linked to this medication.

05 Sources

SPORANOX (itraconazole) capsules (Janssen) · FDA label (DailyMed) — revised 2026-07 | QT-prolonging: Boxed Warning, Drug Interactions "For example, increased plasma concentrations of some of these drugs can lead to QT prolongation and ventricular tachyarrhythmias including occurrences of torsade de pointes, a potentially fatal arrhythmia." | Liver injury: Warnings, Hepatic Effects "SPORANOX® has been associated with rare cases of serious hepatotoxicity, including liver failure and death." | "Itraconazole and its major metabolite, hydroxy-itraconazole, are potent CYP3A4 inhibitors." | "The terminal half-life of itraconazole generally ranges from 16 to 28 hours after single dose and increases to 34 to 42 hours with repeated dosing."
Thomann J, Kolaczynska KE, Stoeckmann OV, et al. In vitro and in vivo metabolism of psilocybin’s active metabolite psilocin. Front Pharmacol 2024;15:1391689. — Abstract: "recombinant CYP2D6 and CYP3A4 enzymes metabolized nearly 100% and 40% of psilocin, respectively." "MAO-A transformed psilocin into minimal amounts of 4-HIAA and 4-HTP." "In conclusion, MAO-A, CYP2D6, and CYP3A4 are involved in psilocin's metabolism." Introduction: "Around 33% of a psilocybin dose is renally excreted as 4-HIAA."

Record history

v2026.10.02First published.
2026-10-04Last reviewed against its sources.

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