avatrombopag + fluconazole

Combination of **avatrombopag** (a small molecule thrombopoietin receptor agonist that increases platelet production by stimulating the thrombopoietin receptor, used for chronic immune thrombocytopenia and thrombocytopenia in chronic liver disease) and **fluconazole** (an azole antifungal which acts as a moderate dual inhibitor of CYP2C9 and CYP3A4/5). Coadministration leads to significantly increased exposure to avatrombopag (AUC ~2.16x, Cmax ~1.17x), requires dose adjustment and monitoring for increased platelet count due to CYP-mediated metabolic inhibition. Used clinically where both antiplatelet elevation and antifungal treatment are required, but with specific dose modification guidance.[1][2][3][4][5][6]