Isavuconazole (Cresemba) and Ketamine Therapy | Tovani Health
Cresemba (Isavuconazole) — Triazole antifungal (invasive aspergillosis, mucormycosis)
Verdict at Tovani Health
Moderate CYP3A4 inhibitor — less potent than voriconazole/posaconazole but still real.
Isavuconazole and ketamine are compatible with planning. Used for invasive aspergillosis and mucormycosis. CYP3A4 inhibition is moderate — less aggressive than voriconazole or posaconazole — but still meaningful enough that chronic dosing affects ketamine plasma levels. Notable advantages over older azoles include better tolerability (less QT prolongation, less visual disturbance than voriconazole) and IV/oral interchangeability. We dose-adjust KAP modestly downward for chronic users.
If you take Cresemba regularly and are considering at-home ketamine therapy, the combination is safe with monitoring or modest dose adjustment. This page covers the brief pharmacologic context and what we do at intake.
How Cresemba interacts with ketamine
Isavuconazole inhibits fungal CYP51 for its therapeutic effect and inhibits human CYP3A4 (moderate strength). Prodrug isavuconazonium is hydrolyzed to active isavuconazole. Hepatic metabolism.
What we do at intake
Disclose dose, indication, and duration. Modest KAP dose adjustment.
Bottom line
Isavuconazole and ketamine are compatible with planning. Used for invasive aspergillosis and mucormycosis. CYP3A4 inhibition is moderate — less aggressive than voriconazole or posaconazole — but still meaningful enough that chronic dosing affects ketamine plasma levels. Notable advantages over older azoles include better tolerability (less QT prolongation, less visual disturbance than voriconazole) and IV/oral interchangeability. We dose-adjust KAP modestly downward for chronic users.
Ready to find out if at-home ketamine fits your situation?
We’ll note that you’re on Cresemba (Isavuconazole) at intake. The eligibility check takes 5 minutes and gives you an honest answer about whether at-home ketamine fits your specific situation.
FL and NJ residents only. Benjamin Soffer, DO — Tovani Health.
Sources
The verdict and clinical guidance on this page are based on the following peer-reviewed literature and FDA prescribing information.
- Ketamine: A Review of Clinical Pharmacokinetics and Pharmacodynamics in Anesthetic and Pain Therapy. Peltoniemi MA, Hagelberg NM, Olkkola KT, Saari TI. Clinical Pharmacokinetics. 2016. PMID: 27028535
Clinically reviewed
Reviewed by Benjamin Soffer, DO on May 23, 2026. Dr. Soffer is a board-certified physician (American Board of Internal Medicine) licensed in Florida and New Jersey, prescribing at-home ketamine therapy through Tovani Health.
This page is general information about how this medication interacts with at-home ketamine therapy at Tovani Health. It is not a substitute for medical advice from your prescribing physician about your specific situation. Always discuss medication changes with the doctor who prescribed them.