Antifungals, azoles(continued)
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to moderately to markedly increase the exposure to
grazoprevir. Avoid.rStudy
▶Antifungals, azoles(fluconazole, isavuconazole, posaconazole)
are predicted to increase the concentration ofguanfacine.
Adjustguanfacinedose,p. 231.oTheoretical
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure toguanfacine. Adjust
guanfacinedose,p. 231.oStudy
▶H 2 receptor antagonistsare predicted to decrease the
absorption ofitraconazole. Administeritraconazolecapsules
with an acidic beverage.oStudy
▶H 2 receptor antagonistsare predicted to decrease the
absorption ofketoconazole. Administerketoconazolewith an
acidic beverage.oStudy
▶H 2 receptor antagonistsare predicted to decrease the exposure
toposaconazole. Avoid use of posaconazole oral suspension.
oStudy
▶Itraconazoleincreases the concentration ofhaloperidol.
oStudy
▶Fluconazoleslightly increases the exposure toHIV-protease
inhibitors(tipranavir). Avoid or adjust dose.oStudy
▶HIV-protease inhibitorsare predicted to increase the exposure
toisavuconazole. Avoid or monitor side effects.rStudy
▶HIV-protease inhibitorsare predicted to increase the exposure
toitraconazole. Use with caution and adjust dose.rStudy
▶HIV-protease inhibitorsare predicted to increase the exposure
toketoconazole. Use with caution and adjust dose.o
Study
▶Miconazoleis predicted to increase the concentration ofHIV-
protease inhibitors. Use with caution and adjust dose.
oTheoretical
▶Posaconazoleis predicted to increase the exposure toHIV-
protease inhibitors.oStudy
▶HIV-protease inhibitorsare predicted to affect the exposure to
voriconazoleandvoriconazolepotentially affects the exposure
toHIV-protease inhibitors.rStudy→Also seeTABLE 9p. 849
▶Antifungals, azoles(fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure toibrutinib. Adjust
ibrutinibdose with moderate inhibitors of CYP3A4.r
Study
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to very markedly increase the exposure toibrutinib.
Avoid potent inhibitors of CYP3A4 or adjustibrutinibdose.
rStudy
▶Idelalisibis predicted to increase the exposure to
isavuconazole. Avoid or monitor side effects.rStudy
▶Antifungals, azoles(fluconazole, posaconazole)are predicted to
increase the exposure toimatinib.oTheoretical
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure toimatinib.oStudy
▶Imatinibis predicted to decrease the exposure to
isavuconazole.oTheoretical
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the risk of toxicity when given with
irinotecan. Avoid.oStudy
▶Antifungals, azoles(fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure toivabradine. Adjust
ivabradinedose.rTheoretical
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure toivabradine. Avoid.
rStudy
▶Antifungals, azoles(fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure toivacaftor. Adjust
ivacaftordose with moderate inhibitors of CYP3A4,p. 186.
rStudy
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure toivacaftor. Adjust
ivacaftorp. 186orlumacaftor with ivacaftorp. 187dose with
potent inhibitors of CYP3A4.rStudy
▶Lanthanumis predicted to decrease the absorption of
ketoconazole. Separate administration by at least 2 hours.
oTheoretical▶Antifungals, azoles(fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure tolapatinib.o
Study→Also seeTABLE 9p. 849
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure tolapatinib. Avoid.
oStudy→Also seeTABLE 9p. 849
▶Antifungals, azoles(fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure tolomitapide. Avoid.
oTheoretical→Also seeTABLE 1p. 847
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to markedly increase the exposure tolomitapide.
Avoid.rStudy→Also seeTABLE 1p. 847
▶Clotrimazoleis predicted to increase the exposure to
lomitapide. Separate administration by 12 hours.o
Theoretical
▶Lumacaftoris predicted to decrease the exposure to
antifungals, azoles(itraconazole, ketoconazole, posaconazole,
voriconazole). Avoid or monitor efficacy.oTheoretical
▶Lumacaftoris predicted to decrease the exposure to
fluconazole. Adjust dose.nTheoretical
▶Antifungals, azoles(fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure tolurasidone.o
Study
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure tolurasidone. Avoid.
rStudy
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure tomacitentan.o
Study
▶Macrolides(clarithromycin)are predicted to increase the
exposure toisavuconazole. Avoid or monitor side effects.
rStudy
▶Macrolides(erythromycin)are predicted to increase the
exposure toisavuconazole.oTheoretical
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to markedly increase the exposure tomaraviroc.
Adjust dose.rStudy
▶Metoclopramidepotentially decreases the absorption of
posaconazole(oral suspension).oStudy
▶Antifungals, azoles(fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure tomidazolam. Monitor
side effects and adjust dose.rStudy
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to markedly to very markedly increase the exposure
tomidazolam. Avoid or adjust dose.rStudy
▶Miconazoleis predicted to increase the exposure to
intravenousmidazolam. Use with caution and adjust dose.
oTheoretical
▶Miconazoleis predicted to increase the exposure to oral
midazolam. Avoid.oTheoretical
▶Antifungals, azoles(fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure tomidostaurin.
oTheoretical
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to very markedly increase the exposure to
midostaurin. Avoid or monitor for toxicity.rStudy
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure tomirabegron. Adjust
mirabegrondose in hepatic and renal impairment.o
Study
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure tomirtazapine.o
Study
▶Mitotaneis predicted to decrease the exposure to
isavuconazole. Avoid.rStudy
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure tomodafinil.nTheoretical
▶Antifungals, azoles(itraconazole, ketoconazole)increase the risk
of neutropenia when given withmonoclonal antibodies
(brentuximab vedotin). Monitor and adjust dose.rStudy
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure tomonoclonal antibodies
(trastuzumab emtansine). Avoid.rTheoretical
▶Isavuconazoleincreases the exposure tomycophenolate.
oStudy874 Antifungals, azoles—Antifungals, azoles BNFC 2018 – 2019
Interactions|Appendix 1A1