Antifungals, azoles(continued)
▶Proton pump inhibitorsdecrease the absorption of
posaconazole(oral suspension). Avoid.oStudy
▶Voriconazoleincreases the exposure toproton pump inhibitors
(esomeprazole, omeprazole). Adjust dose.oStudy
▶Antifungals, azoles(fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure toquetiapine. Avoid.
oStudy
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure toquetiapine. Avoid.
rStudy
▶Antifungals, azoles(fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure toranolazine.r
Study→Also seeTABLE 9p. 849
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure toranolazine. Avoid.
rStudy→Also seeTABLE 9p. 849
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure toreboxetine. Avoid.
oStudy
▶Miconazoleis predicted to increase the concentration of
reboxetine. Use with caution and adjust dose.o
Theoretical
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure toregorafenib. Avoid.
oStudy
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure torepaglinide.o
Study
▶Antifungals, azoles(fluconazole, itraconazole, ketoconazole,
miconazole, voriconazole)are predicted to increase the
exposure toretinoids(alitretinoin). Adjustalitretinoindose.
oTheoretical
▶Antifungals, azoles(fluconazole, ketoconazole, voriconazole)are
predicted to increase the risk of tretinoin toxicity when given
withretinoids(tretinoin).oStudy
▶Antifungals, azoles(fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure toribociclib.o
Study→Also seeTABLE 9p. 849
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure toribociclib. Avoid or
adjustribociclibdose.oStudy→Also seeTABLE 9p. 849
▶Antifungals, azoles(itraconazole, posaconazole)increase the
concentration ofrifabutinandrifabutindecreases the
concentration ofantifungals, azoles(itraconazole,
posaconazole). Avoid.rStudy
▶Fluconazoleincreases the risk of uveitis when given with
rifabutin. Adjust dose.rStudy
▶Rifabutinis predicted to decrease the exposure to
isavuconazole. Avoid.rTheoretical
▶Ketoconazoleis predicted to increase the concentration of
rifabutinandrifabutinis predicted to decrease the
concentration ofketoconazole. Avoid.rTheoretical
▶Miconazoleis predicted to increase the concentration of
rifabutin. Use with caution and adjust dose.o
Theoretical
▶Rifabutindecreases the concentration ofvoriconazoleand
voriconazoleincreases the concentration ofrifabutin. Avoid or
adjustvoriconazoledose,p. 377.rStudy
▶Rifampicinslightly decreases the exposure tofluconazole.
Adjust dose.oStudy
▶Rifampicinis predicted to decrease the exposure to
isavuconazole. Avoid.rStudy
▶Rifampicinmarkedly decreases the exposure toitraconazole.
Avoid and for 14 days after stoppingrifampicin.oStudy
▶Rifampicinmarkedly decreases the exposure toketoconazole
andketoconazolepotentially decreases the exposure to
rifampicin. Avoid.oStudy
▶Rifampicinis predicted to decrease the exposure to
posaconazole. Avoid.oAnecdotal
▶Rifampicinvery markedly decreases the exposure to
voriconazole. Avoid.oStudy
▶Itraconazoleis predicted to increase the exposure toriociguat.
Avoid.oStudy▶Ketoconazolemoderately increases the exposure toriociguat.
Avoid.oStudy
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure torisperidone. Adjust dose.
oStudy→Also seeTABLE 9p. 849
▶Antifungals, azoles(itraconazole, ketoconazole)are predicted to
moderately increase the exposure torivaroxaban. Avoid.
rStudy
▶Antifungals, azoles(fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure toruxolitinib.o
Theoretical
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure toruxolitinib. Adjust dose
and monitor side effects.oStudy
▶Antifungals, azoles(fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure tosaxagliptin.n
Study
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure tosaxagliptin.o
Study
▶Fluconazoleis predicted to increase the exposure toselexipag.
qTheoretical
▶Antifungals, azoles(fluconazole, isavuconazole, itraconazole,
ketoconazole, posaconazole, voriconazole)are predicted to
increase the exposure tosimeprevir. Avoid.rStudy
▶Antifungals, azoles(fluconazole, isavuconazole, posaconazole)
increase the concentration ofsirolimus. Monitor and adjust
dose.oStudy
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the concentration ofsirolimus. Avoid.
rStudy
▶Miconazoleis predicted to increase the concentration of
sirolimus. Monitor and adjust dose.oStudy
▶Oralsodium bicarbonatedecreases the absorption of
ketoconazole.oStudy
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure tosolifenacin. Adjust
solifenacinortamsulosin with solifenacindose; avoid in
hepatic and renal impairment.rStudy
▶Voriconazoleis predicted to increase the exposure toSSRIs
(citalopram).rTheoretical→Also seeTABLE 9p. 849
▶Antifungals, azoles(fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure toSSRIs(dapoxetine).
Adjustdapoxetinedose with moderate inhibitors of CYP3A4.
oTheoretical
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to moderately increase the exposure toSSRIs
(dapoxetine). Avoid potent inhibitors of CYP3A4 or adjust
dapoxetinedose.rStudy
▶St John’s Wortis predicted to decrease the exposure to
isavuconazole. Avoid.rTheoretical
▶St John’s Wortmoderately decreases the exposure to
voriconazole. Avoid.oStudy
▶Miconazolepotentially increases the exposure tostatins
(atorvastatin).rAnecdotal
▶Antifungals, azoles(fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure tostatins(atorvastatin).
Monitor and adjust dose.rStudy→Also seeTABLE 1p. 847
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure tostatins(atorvastatin).
Avoid or adjust dose and monitor rhabdomyolysis.r
Study→Also seeTABLE 1p. 847
▶Antifungals, azoles(fluconazole, miconazole)are predicted to
increase the exposure tostatins(fluvastatin).r
Theoretical→Also seeTABLE 1p. 847
▶Miconazoleis predicted to increase the exposure tostatins
(simvastatin). Avoid.rTheoretical
▶Antifungals, azoles(fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure tostatins(simvastatin).
Use with caution and adjustsimvastatindose,p. 134.r
Study→Also seeTABLE 1p. 847
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure tostatins(simvastatin).
Avoid.rStudy→Also seeTABLE 1p. 847876 Antifungals, azoles—Antifungals, azoles BNFC 2018 – 2019
Interactions|Appendix 1A1