Antifungals, azoles(continued)
▶Antifungals, azoles(fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure tobedaquiline. Avoid
prolonged use.nTheoretical→Also seeTABLE 9p. 849
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure tobedaquiline. Avoid
prolonged use.nStudy→Also seeTABLE 9p. 849
▶Antifungals, azoles(itraconazole, ketoconazole)are predicted to
increase the exposure tobeta blockers, non-selective(nadolol).
oStudy
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure tobeta 2 agonists
(salmeterol). Avoid.rStudy
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)
slightly increase the exposure tobortezomib.oStudy
▶Fluconazoleis predicted to increase the exposure tobosentan.
Avoid.rStudy
▶Bosentanis predicted to decrease the exposure to
isavuconazole. Avoid.rTheoretical
▶Itraconazoleis predicted to increase the exposure tobosentan.
oTheoretical
▶Ketoconazolemoderately increases the exposure tobosentan.
oStudy
▶Voriconazoleis predicted to increase the exposure tobosentan.
Avoid.rTheoretical
▶Antifungals, azoles(fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure tobosutinib. Avoid or
adjust dose.rTheoretical→Also seeTABLE 9p. 849
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to markedly increase the exposure tobosutinib.
Avoid or adjust dose.rStudy→Also seeTABLE 9p. 849
▶Isavuconazoleslightly increases the exposure tobupropion.
Adjust dose.oStudy
▶Antifungals, azoles(fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure tobuspirone. Use with
caution and adjust dose.oStudy
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure tobuspirone. Adjust
buspironedose.rStudy
▶Miconazoleis predicted to increase the concentration of
buspirone. Use with caution and adjust dose.o
Theoretical
▶Antifungals, azoles(fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure tocabozantinib.
oTheoretical→Also seeTABLE 9p. 849
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)
slightly increase the exposure tocabozantinib.o
Study→Also seeTABLE 9p. 849
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure toisavuconazole.oTheoretical
▶Miconazoleis predicted to increase the exposure tocalcium
channel blockers(amlodipine, clevidipine, felodipine, lacidipine,
lercanidipine, nicardipine, nifedipine, nimodipine, verapamil).
Use with caution and adjust dose.oTheoretical
▶Antifungals, azoles(fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure tocalcium channel
blockers(amlodipine, felodipine, lacidipine, lercanidipine,
nicardipine, nifedipine, nimodipine). Monitor and adjust dose.
oStudy
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure tocalcium channel blockers
(amlodipine, felodipine, lacidipine, nicardipine, nifedipine,
nimodipine). Monitor and adjust dose.oStudy
▶Fluconazole(high-dose) is predicted to increase the exposure
tocalcium channel blockers(diltiazem, verapamil).o
Theoretical
▶Posaconazoleis predicted to increase the exposure tocalcium
channel blockers(diltiazem, verapamil).oTheoretical
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure tocalcium channel blockers
(diltiazem, verapamil).rStudy
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to markedly increase the exposure tocalcium channel
blockers(lercanidipine). Avoid.rStudy▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure tocannabis extract. Use
with caution and adjust dose.oTheoretical
▶Antifungals, azoles(fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure toceritinib.o
Theoretical→Also seeTABLE 9p. 849
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure toceritinib. Avoid or adjust
ceritinibdose.rStudy→Also seeTABLE 9p. 849
▶Antifungals, azoles(fluconazole, isavuconazole, itraconazole,
ketoconazole, posaconazole, voriconazole)increase the
concentration ofciclosporin.rStudy
▶Miconazoleincreases the concentration ofciclosporin. Monitor
and adjust dose.rAnecdotal
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to moderately increase the exposure tocilostazol.
Adjustcilostazoldose.oStudy
▶Fluconazoleis predicted to increase the exposure tocilostazol.
Adjustcilostazoldose.oTheoretical
▶Miconazoleis predicted to increase the exposure tocilostazol.
Use with caution and adjust dose.oTheoretical
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to moderately increase the exposure tocinacalcet.
Adjust dose.oStudy
▶Antifungals, azoles(fluconazole, voriconazole)potentially
increase the exposure toclobazam. Adjust dose.o
Theoretical
▶Fluconazoleis predicted to decrease the efficacy ofclopidogrel.
Avoid.rTheoretical
▶Voriconazoleis predicted to decrease the efficacy of
clopidogrel. Avoid.oStudy
▶Cobicistatis predicted to increase the exposure toantifungals,
azoles(fluconazole, posaconazole).oTheoretical
▶Cobicistatis predicted to increase the exposure toantifungals,
azoles(itraconazole, ketoconazole). Adjust dose.o
Theoretical
▶Cobicistatis predicted to increase the exposure to
isavuconazole. Avoid or monitor side effects.rStudy
▶Cobicistatis predicted to affect the exposure tovoriconazole.
Avoid.oTheoretical
▶Antifungals, azoles(fluconazole, isavuconazole, miconazole,
posaconazole)are predicted to increase the exposure to
cobimetinib.rTheoretical
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to markedly increase the exposure tocobimetinib.
Avoid or monitor for toxicity.rStudy
▶Antifungals, azoles(fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure tocolchicine. Adjust
colchicinedose with moderate inhibitors of CYP3A4.r
Study
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure tocolchicine. Avoid potent
inhibitors of CYP3A4 or adjustcolchicinedose.rStudy
▶Corticosteroids(prednisone)potentially decrease the exposure
toisavuconazole. Use with caution or avoid.o
Theoretical
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure tocorticosteroids
(beclometasone)(risk with beclometasone is likely to be lower
than with other corticosteroids).oTheoretical
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure tocorticosteroids
(betamethasone, budesonide, ciclesonide, deflazacort,
dexamethasone, fludrocortisone, fluticasone, hydrocortisone,
methylprednisolone, mometasone, prednisolone, prednisone,
triamcinolone). Avoid or monitor side effects.rStudy
▶Miconazoleis predicted to increase the concentration of
corticosteroids(methylprednisolone). Monitor and adjust dose.
oTheoretical
▶Antifungals, azoles(fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure tocorticosteroids
(methylprednisolone). Monitor and adjust dose.oStudy
▶Fluconazoleincreases the anticoagulant effect ofcoumarins.
Monitor INR and adjust dose.rStudy872 Antifungals, azoles—Antifungals, azoles BNFC 2018 – 2019
Interactions|Appendix 1A1