Itraconazole thrombocytopenia with

In a study using the UK General Practice Research Database to determine rates of drug-induced, rare, serious adverse effects on the liver, kidneys, skin, or blood, occurring within 45 days of completing a prescription or refill in 54 803 users of either fluconazole or itraconazole, three had illnesses for which a fluconazole-induced cause could not be ruled out one with thrombocytopenia, one with neutropenia, and one with an abnormal liver function test just after receiving fluconazole (31). The rates were 2.8/100 000 prescriptions (95% Cl = 0.8, 10) for serious, adverse blood events and 1.4/100 000 prescriptions (95% Cl = 0.25, 8.2) for serious, adverse liver events. These results suggest that fluconazole does not commonly have serious adverse effects on the liver, kidneys, skin, or blood. 

A patient taking tacrolimus 0.085 mg/kg bd with itraconazole 200-400 mg/day developed ketoacidosis, neutropenia, and thrombocytopenia, requiring the withdrawal of both drugs (114). 

Bortezomib In a retrospective medical record review of six adults with relapsed multiple myeloma who received intravenous bortezomib + oral dexamethasone, three who also took itraconazole had new or worsening peripheral neuropathy and grade 4 thrombocytopenia [13 ]. One patient who took lansoprazole alone and two who did not take itraconazole or lansoprazole had no such reactions. The authors noted that itraconazole inhibits CYP3A4 and lansoprazole inhibits CYP2C19. 

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