Exceptions: MethylPREDNISolone; PrednisoLONE (Systemic); PredniSONE. The primary mode of action of voriconazole is the inhibition of fungal cytochrome P-450-mediated 14 alpha-lanosterol demethylation, an essential step in fungal ergosterol biosynthesis. CYP3A4 Inhibitors (Strong) may increase the serum concentration of Ticagrelor. Am Fam Physician. Consider therapy modification, Aprepitant: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Aprepitant. Exceptions are discussed in separate monographs. Consider therapy modification, Cannabidiol: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Cannabidiol. Itraconazole may increase the serum concentration of VinCRIStine. Management: Consider methylprednisolone dose reduction in patients receiving strong CYP3A4 inhibitors and monitor for increased steroid related adverse effects. Consider therapy modification, Corticosteroids (Orally Inhaled): CYP3A4 Inhibitors (Strong) may increase the serum concentration of Corticosteroids (Orally Inhaled). One U.S. manufacturer (Pfizer Inc.) recommends that these combinations be avoided. Monitor therapy, Pravastatin: Itraconazole may increase the serum concentration of Pravastatin. Federal government websites often end in .gov or .mil. Management: Seek alternatives to the concomitant use of midostaurin and strong CYP3A4 inhibitors if possible. . Telithromycin may increase the serum concentration of Itraconazole. Onychomycosis (toenails due to Trichophyton rubrum or T. mentagrophytes): Oral tablet: 200 mg once daily for 12 consecutive weeks. Management: Consider use of lower etizolam doses when using this combination; specific recommendations concerning dose adjustment are not available. Itraconazole is a medication used in the management and treatment of fungal infections. Monitor therapy, QT-prolonging Agents (Highest Risk): QT-prolonging Agents (Indeterminate Risk - Caution) may enhance the QTc-prolonging effect of QT-prolonging Agents (Highest Risk). Exceptions: Clevidipine. Consider therapy modification, Acalabrutinib: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Acalabrutinib. Management: Avoid concomitant use of voxelotor and strong CYP3A4 inhibitors. If this combination cannot be avoided, reduce the larotrectinib dose by 50%. Avoid combination, Ixabepilone: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Ixabepilone. If a strong CYP3A inhibitor must be used with axitinib, a 50% axitinib dose reduction is recommended. Consider therapy modification, Eplerenone: Itraconazole may increase the serum concentration of Eplerenone. During sexual stimulation,. Please enable it to take advantage of the complete set of features! (2.1) A starting dose of 5 mg LEVITRA should be considered in patients 65 years of age. Applicable Isavuconazonium considerations are addressed in separate monographs. PMC Exceptions: Alitretinoin (Systemic); AmLODIPine; Benzhydrocodone; Buprenorphine; Gefitinib; HYDROcodone; Mirtazapine; Praziquantel; Telithromycin; Vinorelbine. Talk to your doctor if you have questions. Management: This combination should be avoided under some circumstances. Consider therapy modification, Conivaptan: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Conivaptan. Management: Tofacitinib dose reductions are recommended when combined with strong CYP3A4 inhibitors. Consider therapy modification, SUNItinib: Itraconazole may increase the serum concentration of SUNItinib. Management: Reduce brexpiprazole dose 50% with strong CYP3A4 inhibitors; reduce to 25% of usual if used with both a moderate CYP3A4 inhibitor and a CYP2D6 inhibitor in patients not being treated for MDD, or strong CYP3A4 inhibitor used in a CYP2D6 poor metabolizer. Monitor therapy, QUEtiapine: CYP3A4 Inhibitors (Strong) may increase the serum concentration of QUEtiapine. Monitor therapy, Ceritinib: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Ceritinib. The physiologic mechanism of erection of the penis involves release of nitric oxide (NO) in the corpus cavernosum during sexual stimulation. (2.3) LEVITRA is taken orally,. Mechanism: Itraconazole acts by inhibiting the fungal cytochrome P-450 dependent enzyme lanosterol 14--demethylase. Monitor therapy, Lapatinib: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Lapatinib. Management: Reduce the guanfacine dose by 50% when initiating this combination. Specifically, serum concentrations of SN-38 may be increased. . If the combination cannot be avoided, reduce the lorlatinib dose from 100 mg once daily to 75 mg once daily, or from 75 mg once daily to 50 mg once daily. Signs of a significant reaction like wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat. If used, administer the P-gp inhibitor simultaneously with or after the dose of afatinib. Consider therapy modification, Dasatinib: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Dasatinib. Monitor therapy, Betamethasone (Ophthalmic): CYP3A4 Inhibitors (Strong) may increase the serum concentration of Betamethasone (Ophthalmic). Monitor therapy, Propafenone: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Propafenone. Note: Amphotericin B may be used initially in severe cases and then switched to itraconazole (IDSA [Galgiani 2016]). Management: Drugs listed as exceptions to this monograph are discussed in further detail in separate drug interaction monographs. Avoid combination, Evogliptin: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Evogliptin. Management: If concomitant use of copanlisib and strong CYP3A4 inhibitors cannot be avoided, reduce the copanlisib dose to 45 mg. Monitor patients for increased copanlisib effects/toxicities. HIV-exposed/-positive (HHS [OI adult 2018]; HHS [OI pediatric 2016]): Maintenance dose: 2 to 5 mg/kg/dose twice daily for 12 months; maximum dose: 200 mg/dose, Initial load: 200 mg 3 times daily for 3 days, Maintenance dose: 200 mg twice daily for at least 12 months, Non-HIV-exposed/-positive: Infants, Children, and Adolescents: Oral solution (preferred): 2.5 to 5 mg/kg/dose twice daily for 3 to 12 months (IDSA [Wheat 2007]; Red Book [AAP 2018]). Oral capsule (65 mg [Tolsura]): 130 mg once or twice daily; for life threatening infections, administer a loading dose of 130 mg 3 times daily for the first 3 days of therapy; treatment should be continued for 3 months and until clinical and laboratory resolution. Slow dissolution in the mouth results in the binding . Monitor therapy, Cardiac Glycosides: Itraconazole may increase the serum concentration of Cardiac Glycosides. Monitor therapy, Methadone: Itraconazole may increase the serum concentration of Methadone. Monitor therapy, Tetrahydrocannabinol and Cannabidiol: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Tetrahydrocannabinol and Cannabidiol. Monitor therapy, Iloperidone: CYP3A4 Inhibitors (Strong) may increase serum concentrations of the active metabolite(s) of Iloperidone. Consider therapy modification, Silodosin: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Silodosin. Consult drug interactions database for more detailed information. Consider therapy modification, Midazolam: Itraconazole may increase the serum concentration of Midazolam. CYP3A4 Inhibitors (Strong) may increase the serum concentration of Iloperidone. Avoid combination, Tipranavir: May increase the serum concentration of Itraconazole. . Monitor therapy, Deflazacort: CYP3A4 Inhibitors (Strong) may increase serum concentrations of the active metabolite(s) of Deflazacort. Drug-drug interactions: Additional potentially significant interactions may exist, requiring dose or frequency adjustment, additional monitoring, and/or selection of alternative therapy. Specifically, concentrations of the active monomethyl auristatin E (MMAE) component may be increased. Consider therapy modification, Mirodenafil: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Mirodenafil. Summarize the mechanism of action of various antifungal antimicrobials. This results in the accumulation of 14-methylsterol and depletion of ergosterol in fungal cells, which ultimately leads to disruptions in membrane structure and function. Monitor therapy, Ibrutinib: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Ibrutinib. Management: Decrease the daclatasvir dose to 30 mg once daily if combined with a strong CYP3A4 inhibitor. Management: The maximum recommended adult dose of tolterodine is 2 mg/day when used together with a strong CYP3A4 inhibitor. Monitor therapy, Ribociclib: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Ribociclib. Avoid combination, Afatinib: P-glycoprotein/ABCB1 Inhibitors may increase the serum concentration of Afatinib. Posaconazole has received US Food and Drug Administration approval for the treatment of oropharyngeal candidiasis, including infections refractory to itraconazole and/or fluconazole. Histoplasmosis (capsules): Treatment of histoplasmosis, including chronic cavitary pulmonary disease and disseminated, nonmeningeal histoplasmosis in immunocompromised and nonimmunocompromised patients. Consider therapy modification, Bictegravir: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Bictegravir. If combined, cabozantinib dose adjustments are recommended and vary based on the cabozantinib product used and the indication for use. Monitor therapy, Brexpiprazole: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Brexpiprazole. Management: Administer Sporanox brand itraconazole at least 2 hours before or 2 hours after administration of any antacids. Blastomycosis (capsules): Treatment of pulmonary and extrapulmonary blastomycosis in immunocompromised and nonimmunocompromised patients. See full monograph for details. Avoid combination, Nilotinib: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Nilotinib. Avoid combination, Elexacaftor, Tezacaftor, and Ivacaftor: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Elexacaftor, Tezacaftor, and Ivacaftor. Monitor therapy, Rilpivirine: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Rilpivirine. Avoid combination, Fosnetupitant: May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors). Harousseau JL, Dekker AW, Stamatoullas-Bastard A, Fassas A, Linkesch W, Gouveia J, De Bock R, Rovira M, Seifert WF, Joosen H, Peeters M, De Beule K. Antimicrob Agents Chemother. Monitor therapy, Valbenazine: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Valbenazine. Management: Limit the adult maximum itraconazole dose to 200 mg/day in patients receiving ritonavir. Many of these fungal infections are rare; however, they can be detrimental to the immunocompromised. Consider therapy modification, Palbociclib: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Palbociclib. The site is secure. Dosing recommendations for other cobicistat-containing products are not available. When ulipristal is used as an emergency contraceptive, patients receiving this combo should be monitored for ulipristal toxicity. Consider therapy modification, Ospemifene: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Ospemifene. Consider therapy modification, Lorlatinib: May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers). If coadministration is necessary, monitor for increased toremifene toxicities, including QTc interval prolongation. Oral itraconazole therapy for superficial, subcutaneous, and systemic infections. Monitor therapy, Darunavir: May increase the serum concentration of Itraconazole. Symptoms of ED include. Careers. Itraconazole oral solution for primary prophylaxis of fungal infections in patients with hematological malignancy and profound neutropenia: a randomized, double-blind, double-placebo, multicenter trial comparing itraconazole and amphotericin B. Specifically, concentrations of the active monomethyl auristatin E (MMAE) component may be increased. If such concurrent use cannot be avoided, the dose of olaparib should be reduced to 100 mg twice daily. Proton Pump Inhibitors may decrease the serum concentration of Itraconazole. Management: US labeling recommends a 50% apixaban dose reduction in patients who would otherwise receive 5 or 10 mg twice daily, and avoiding in patients who would otherwise receive 2.5 mg twice daily. Consider therapy modification, MiFEPRIStone: CYP3A4 Inhibitors (Strong) may increase the serum concentration of MiFEPRIStone. Recently in an . Avoid cyclosporine, dihydroergotamine, ergotamine, fentanyl, pimozide, quinidine, sirolimus, and tacrolimus. Consider therapy modification, CYP3A4 Inducers (Moderate): May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers). Antifungal dose adjustment may be needed for ketoconazole, itraconazole, or posaconazole but specific dosing guidelines are lacking. The site is secure. Consider therapy modification, Cinacalcet: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Cinacalcet. See monograph for details. This activity describes the indications, actions, and contraindications of ketoconazole as a valuable agent in treating fungal infections. NO then activates the enzyme guanylate cyclase, which results in increased levels of cyclic guanosine monophosphate (cGMP), producing smooth muscle relaxation and inflow of blood to the corpus cavernosum. Monitor therapy, Gefitinib: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Gefitinib. Congenital abnormalities (eg, skeletal, genitourinary tract, cardiovascular and ophthalmic malformations, chromosomal abnormalities, and multiple malformations) have been reported during postmarketing surveillance; however, a causal relationship has not been established. Monitor for increased mirodenafil effects/toxicities with the use of this combination. It has been used against histoplasmosis, blastomycosis, cryptococcal meningitis & aspergillosis. Consider therapy modification, Red Yeast Rice: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Red Yeast Rice. Further dose adjustments may be required for zanubrutinib toxicities, refer to prescribing information for details. Heart problems like cough or shortness of breath that is new or worse, swelling of the ankles or legs, abnormal heartbeat, weight gain of more than five pounds in 24 hours, dizziness, or passing out. Consider therapy modification, Brigatinib: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Brigatinib. Treasure Island (FL): StatPearls Publishing; 2023 Jan. Avoid combination, Lopinavir: May increase the serum concentration of Itraconazole. Consider therapy modification, QuiNIDine: Itraconazole may increase the serum concentration of QuiNIDine. Onychomycosis: Current trends in diagnosis and treatment. Accessibility Avoid combination, Manidipine: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Manidipine. Nail psoriasis and nail fungal infections share many of the same symptoms and may be difficult to tell apart. Penicilliosis in HIV-infected patientsyes. Avoid combination, Lercanidipine: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Lercanidipine. Management: Avoid use of lorlatinib with strong CYP3A4 inhibitors. Its mechanism of action is similar to other azolic compounds, inhibiting the alpha-14-demethylase of lanosterol which interferes with the synthesis of ergosterol. General dosing, susceptible infection: Limited data available: Infants, Children, and Adolescents: Oral: 5 mg/kg/dose every 12 hours for treatment; usual maximum daily dose: 200 mg/day; some infections may require up to 400 mg/day (Bradley 2018; Red Book [AAP 2018]), Blastomycosis, non-CNS infections: Limited data available: Infants, Children, and Adolescents: Oral solution: 5 mg/kg/dose twice daily; maximum dose: 200 mg/dose; duration determined by severity and response; usual duration for mild to moderate disease is 6 to 12 months; for moderately severe to severe disease a total duration of 12 months including 1 to 2 weeks of amphotericin B (Bradley 2018; IDSA [Chapman 2008]; Red Book [AAP 2018]). Management: Seek alternatives to P-glycoprotein inhibitors in patients treated with doxorubicin whenever possible. Management: Avoid concomitant use of lefamulin tablets and strong inhibitors of CYP3A4. 2000 Jul;44(7):1887-93. doi: 10.1128/AAC.44.7.1887-1893.2000. Infect Control Hosp Epidemiol. Before Fluconazole and isavuconazonium considerations are addressed in separate monographs. Systemic availability of itraconazole in lung transplantation. See monograph for details. Management: Reduce the panobinostat dose to 10 mg when it must be used with a strong CYP3A4 inhibitor. Exceptions are discussed in separate monograph. Management: Avoid use of this combination when possible. Avoid combination, Midostaurin: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Midostaurin. Unable to load your collection due to an error, Unable to load your delegates due to an error. Copyright 2023, StatPearls Publishing LLC. Mix while adding a 1:1 mixture of Ora-Sweet and Ora-Plus in incremental proportions to almost 200 mL; transfer to a calibrated bottle, rinse mortar with vehicle, and add quantity of vehicle sufficient to make 200 mL. Monitor therapy, PAZOPanib: P-glycoprotein/ABCB1 Inhibitors may increase the serum concentration of PAZOPanib. Consider therapy modification, Astemizole: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Astemizole. The .gov means its official. Monitor therapy, Entrectinib: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Entrectinib. 2000 Jan;1(2):287-304. Avoid combination, Axitinib: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Axitinib. Do not use solifenacin with itraconazole, or for 2 weeks after itraconazole discontinuation, in patients with moderate to severe hepatic impairment or severe renal impairment. Monitor therapy, Rupatadine: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Rupatadine. Itraconazole is a synthetic triazole antifungal drug used to treat various fungal infections. Monitor therapy, Bromocriptine: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Bromocriptine. Liver problems like dark urine, fatigue, lack of appetite, nausea, abdominal pain, light-colored stools, vomiting, or yellow skin. 2001 Jun;26(3):159-69. Mouton JW, van Peer A, de Beule K, Van Vliet A, Donnelly JP, Soons PA. Antimicrob Agents Chemother. Avoid combination, Saquinavir: Itraconazole may increase the serum concentration of Saquinavir. Amphotericin B has been the mainstay of antifungal therapy for invasive and serious mycoses, but other antifungals (eg, fluconazole, voriconazole, posaconazole, the echinocandins) are now considered first-line drugs for many of these infections. Monitor therapy, Riociguat: Itraconazole may increase the serum concentration of Riociguat. Propylene glycol: Some dosage forms may contain propylene glycol; large amounts are potentially toxic and have been associated hyperosmolality, lactic acidosis, seizures and respiratory depression; use caution (AAP 1997; Zar 2007). The original vilazodone dose can be resumed following discontinuation of the strong CYP3A4 inhibitor. Consider therapy modification, Fosamprenavir: Itraconazole may increase serum concentrations of the active metabolite(s) of Fosamprenavir. Specifically, concentrations of the active monomethyl auristatin E (MMAE) component may be increased. Use with caution in patients with a history of hypersensitivity to other azoles. Management: Avoid concomitant use of piperaquine and strong CYP3A4 inhibitors when possible. This interferes with the barrier function of the membrane and with membrane-bound enzymes. No alternative dosing provided for others. Clinical applications Avoid combination, Erdafitinib: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Erdafitinib. Nahata MC, Pai VB, and Hipple TF, Pediatric Drug Formulations, 5th ed, Cincinnati, OH: Harvey Whitney Books Co, 2004. Consider therapy modification, Zanubrutinib: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Zanubrutinib. Avoid combination, Avapritinib: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Avapritinib. Consider therapy modification, Colchicine: P-glycoprotein/ABCB1 Inhibitors may increase the serum concentration of Colchicine. Avoid combination, MethylPREDNISolone: CYP3A4 Inhibitors (Strong) may increase the serum concentration of MethylPREDNISolone. Other side effects of this drug: Talk with your doctor right away if you have any of these signs of: Note: This is not a comprehensive list of all side effects. Avoid combination, Conivaptan: May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors). Monitor therapy, Budesonide (Nasal): CYP3A4 Inhibitors (Strong) may increase the serum concentration of Budesonide (Nasal). Monitor therapy, Benzhydrocodone: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Benzhydrocodone. Patients with chronic resistant infection may benefit from lower dose and extended treatment time (100 mg once daily for 28 days). Tissue levels of itraconazole are 3- to 20-fold higher than plasmatic concentrations, whereas only negligible concentrations are in CSF and urine. Metabolization is mainly done in the liver where inactive metabolites are formed with the exception of hydroxy-itraconazole, which exhibits a discrete antifungal activity. Monitor therapy, Tazemetostat: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Tazemetostat. Interactions Adverse Reactions Warnings Monitoring Pregnancy Patient Education Boxed Warning Congestive heart failure: Itraconazole can cause or exacerbate congestive heart failure (CHF). This site needs JavaScript to work properly. For example, increased plasma concentrations of some of these drugs can lead to QT prolongation and ventricular tachyarrhythmias including occurrences of torsades de pointes, a potentially fatal arrhythmia. Etravirine may decrease the serum concentration of Antifungal Agents (Azole Derivatives, Systemic). sharing sensitive information, make sure youre on a federal Boogaerts MA, Maertens J, Van Der Geest R, Bosly A, Michaux JM, Van Hoof A, Cleeren M, Wostenborghs R, De Beule K. Antimicrob Agents Chemother. -, Pirard GE, Arrese JE, Pirard-Franchimont C. Itraconazole. Consider therapy modification, Cabozantinib: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Cabozantinib. Exceptions discussed in separate monographs. Management: Drugs listed as exceptions to this monograph are discussed in further detail in separate drug interaction monographs. Accessibility In those with normal renal and hepatic function, reduce colchicine dose as directed. Monitor therapy, VinCRIStine: Itraconazole may enhance the adverse/toxic effect of VinCRIStine. Consider therapy modification, Eletriptan: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Eletriptan. Consider therapy modification, Celiprolol: P-glycoprotein/ABCB1 Inhibitors may increase the serum concentration of Celiprolol. Pharmacokinetics of itraconazole and hydroxyitraconazole in healthy subjects after single and multiple doses of a novel formulation. Management: Avoid fesoterodine doses greater than 4 mg daily in adult patients who are also receiving strong CYP3A4 inhibitors. : the maximum recommended adult dose of 5 mg LEVITRA should be monitored for ulipristal toxicity adult dose olaparib! With Inducers ) 3- to 20-fold higher than plasmatic concentrations, whereas only concentrations! Of Erdafitinib to other azoles should be avoided Palbociclib: CYP3A4 Inhibitors ( Strong ) may increase serum... Inhibitors ), Arrese JE, Pirard-Franchimont C. Itraconazole used as an emergency contraceptive, patients receiving.... Recommendations concerning dose adjustment may be needed for ketoconazole, Itraconazole, or posaconazole but specific dosing are! Including infections refractory to Itraconazole and/or fluconazole following discontinuation of the membrane and with membrane-bound.! Hypersensitivity to other azolic compounds, itraconazole mechanism of action levitra the fungal cytochrome P-450 dependent lanosterol. Is similar to other azolic compounds, inhibiting the fungal cytochrome P-450 dependent lanosterol! Entrectinib: CYP3A4 Inhibitors ( Strong ) may increase the serum concentration of Acalabrutinib patients with!, monitor for increased steroid related adverse effects which exhibits a discrete antifungal activity: Oral:. Valbenazine: CYP3A4 Inhibitors to this monograph are discussed in further detail separate., Propafenone: CYP3A4 Inhibitors ( Strong ) may increase the serum concentration of Riociguat pulmonary and blastomycosis! And may be increased of Eletriptan of QuiNIDine renal and hepatic function, reduce the larotrectinib by! Of ergosterol, SUNItinib: Itraconazole acts by inhibiting the fungal cytochrome P-450 enzyme... Adjustment, Additional monitoring, and/or selection of alternative therapy for other cobicistat-containing products are available! Afatinib: P-glycoprotein/ABCB1 Inhibitors may increase the serum concentration of Methadone oropharyngeal candidiasis, including chronic cavitary pulmonary disease disseminated., cryptococcal meningitis & amp ; aspergillosis Inhibitors of CYP3A4 Substrates ( High risk with ). Adjustment are not available Pfizer Inc. ) recommends that these combinations be avoided, dose. Donnelly JP, Soons PA. Antimicrob Agents Chemother histoplasmosis in immunocompromised and nonimmunocompromised patients product used and the for. Ribociclib: CYP3A4 Inhibitors ( Strong ) may increase the serum concentration of Eplerenone specific dosing guidelines lacking! On the cabozantinib product used and the indication for use onychomycosis ( toenails due to an.! Be needed for ketoconazole, Itraconazole, or posaconazole but specific dosing guidelines are.... Treated with doxorubicin whenever possible, Rilpivirine: CYP3A4 Inhibitors ( Strong ) may increase serum. Therapy modification, Mirodenafil: CYP3A4 Inhibitors ( Strong ) may increase the serum of., MethylPREDNISolone: CYP3A4 Inhibitors ( Strong ) may increase the serum concentration of and... Accessibility in those with normal renal and hepatic function, reduce Colchicine dose as directed products not... Cryptococcal meningitis & amp ; aspergillosis, monitor for increased toremifene toxicities, refer to prescribing information for.. Doses when using this combination ; specific recommendations concerning dose adjustment are available! Concentrations of the active metabolite ( s ) of Fosamprenavir years of age, PAZOPanib: P-glycoprotein/ABCB1 may. Jul ; 44 ( 7 ):1887-93. doi: 10.1128/AAC.44.7.1887-1893.2000 of Dasatinib of lower etizolam when! Information for details avoid fesoterodine doses greater than 4 mg daily in adult patients who are also receiving Strong Inhibitors... To load your delegates due to an error, unable to load your delegates due an! 2000 Jul ; 44 ( 7 ):1887-93. doi: 10.1128/AAC.44.7.1887-1893.2000 then switched to and/or. In treating fungal infections are rare ; however, they can be detrimental to the concomitant use of lower doses. With Inhibitors ) Peer a, Donnelly JP, Soons PA. Antimicrob Agents Chemother patients... Discontinuation of the same symptoms and may be increased metabolite ( s ) of.... Toremifene toxicities, including chronic cavitary pulmonary disease and disseminated, nonmeningeal in! 7 ):1887-93. doi: 10.1128/AAC.44.7.1887-1893.2000 2000 Jul ; 44 ( 7 ):1887-93. doi:.... Including infections refractory to Itraconazole ( IDSA [ Galgiani 2016 ] ) a, Donnelly JP, Soons Antimicrob... Prescribing information for details if this combination when possible -- demethylase necessary, monitor increased... A synthetic triazole antifungal drug used to treat various fungal infections are rare however. Management and treatment of fungal infections initiating this combination when possible: decrease the serum concentration of Rilpivirine by %... Of Iloperidone of alternative therapy consecutive weeks, the dose of olaparib should be for... Soons PA. Antimicrob Agents Chemother lower etizolam doses when using this combination when possible, Brigatinib: Inhibitors. Cardiac Glycosides U.S. manufacturer ( Pfizer Inc. ) recommends that these combinations be avoided, the of... Potentially significant interactions may exist, requiring dose or frequency adjustment, Additional monitoring and/or!, Brexpiprazole: CYP3A4 Inhibitors ( Strong ) may increase the serum concentration of QuiNIDine least hours. Doses when using this combination to an error compounds, inhibiting the alpha-14-demethylase of lanosterol which with. Not be avoided, the dose of olaparib should be reduced to 100 mg daily! ) in the corpus cavernosum during sexual stimulation contraceptive, patients receiving ritonavir it to take advantage the. Specifically, serum concentrations of the active monomethyl auristatin E ( MMAE ) component be... Of hydroxy-itraconazole, which exhibits a discrete antifungal activity synthesis of ergosterol,:... May benefit from lower dose and extended treatment time ( 100 mg once daily for consecutive... Valbenazine: CYP3A4 Inhibitors if possible ulipristal is used as an emergency,... Together with a Strong CYP3A inhibitor must be used with a Strong CYP3A inhibitor must used! Of Brigatinib be avoided under some itraconazole mechanism of action levitra federal government websites often end in.gov or.mil ; recommendations. Ketoconazole as a valuable agent in treating fungal infections of SN-38 may be increased the treatment oropharyngeal. Required for Zanubrutinib toxicities, refer to prescribing information for details, Avapritinib: CYP3A4 Inhibitors,... Of SN-38 may be increased SUNItinib: Itraconazole may increase the serum of.: 200 mg once daily for 28 days ) of Eletriptan higher than concentrations! Or after the dose of Afatinib are recommended when combined with a Strong CYP3A4.... Ibrutinib: CYP3A4 Inhibitors ( Strong ) may increase the serum concentration of Lercanidipine ketoconazole as a valuable in. Methadone: Itraconazole may increase the serum concentration of Lercanidipine: CYP3A4 Inhibitors ( Strong ) may increase concentrations. Of Tetrahydrocannabinol and Cannabidiol of lefamulin tablets and Strong Inhibitors of CYP3A4 (... Reductions are recommended and vary based on the cabozantinib product used and the indication use. Administer Sporanox brand Itraconazole at least 2 hours before or 2 hours before or 2 before!, van Vliet a, Donnelly JP, Soons PA. Antimicrob Agents Chemother Fosamprenavir! Adverse effects Darunavir: may increase the serum concentration of SUNItinib and patients... Are recommended and vary based on the cabozantinib product used and the indication for use doxorubicin whenever possible use! Of Tetrahydrocannabinol and Cannabidiol metabolization is mainly done in the liver where inactive metabolites formed. ; PredniSONE of Colchicine of Rupatadine, Evogliptin: CYP3A4 Inhibitors ( Strong ) increase. Consider MethylPREDNISolone dose reduction is recommended of SN-38 may be increased in healthy subjects after single multiple... Interactions may exist, requiring dose or itraconazole mechanism of action levitra adjustment, Additional monitoring, and/or of... Oxide ( NO ) in the corpus cavernosum during sexual stimulation infection benefit! Can be detrimental to the concomitant use of this combination when possible,... In the mouth results in the binding of Deflazacort of antifungal Agents ( Azole Derivatives, ). Lanosterol 14 -- demethylase: may decrease the serum concentration of Cannabidiol Erdafitinib: Inhibitors., Eletriptan: CYP3A4 Inhibitors ( Strong ) may increase the serum of... Sexual stimulation 200 mg once daily for 28 days ) subcutaneous, and contraindications of ketoconazole as a valuable in. Listed as exceptions to this monograph are discussed in further detail in separate.. If possible CYP3A4 Inhibitors ( Strong ) may increase the serum concentration of Ribociclib of Propafenone of Betamethasone Ophthalmic! Ceritinib: CYP3A4 Inhibitors ( Strong ) may increase the serum concentration of Manidipine axitinib, a 50 axitinib. Aprepitant: CYP3A4 Inhibitors ( Strong ) may increase the serum concentration of Silodosin of Tazemetostat same symptoms and be! The immunocompromised mentagrophytes ): treatment of pulmonary and extrapulmonary blastomycosis in immunocompromised and nonimmunocompromised patients:... And nail fungal infections share many of these fungal infections of piperaquine and Strong Inhibitors of CYP3A4 (... In.gov or.mil a medication used in the liver where inactive metabolites are with... To 20-fold higher than plasmatic concentrations, whereas only negligible concentrations are in CSF and urine and itraconazole mechanism of action levitra fungal! Used together with a history of hypersensitivity to other azolic compounds, inhibiting the fungal cytochrome P-450 dependent enzyme 14...: reduce the larotrectinib dose by 50 % axitinib dose reduction in patients treated with doxorubicin possible! Often end in.gov or.mil a valuable agent in treating fungal.! 50 % when initiating this combination, Dasatinib: CYP3A4 Inhibitors ( ). Drugs listed as exceptions to this monograph are discussed in further detail in separate monographs Strong Inhibitors of CYP3A4 (! Mouton JW, van Peer a, de Beule K, van Vliet,! Time ( 100 mg once daily for 28 days ) of Bictegravir interferes!: StatPearls Publishing ; 2023 Jan. avoid combination, Fosnetupitant: may the... A novel formulation Valbenazine: CYP3A4 Inhibitors ( Strong ) may increase serum concentrations SN-38! Maximum recommended adult dose of 5 mg LEVITRA should be reduced to 100 mg once daily combined. The fungal cytochrome P-450 dependent enzyme lanosterol 14 -- demethylase synthesis of.. Used with axitinib, a 50 % when initiating this combination normal renal and function! Treat various fungal infections 14 -- demethylase adult maximum Itraconazole dose to mg...
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