The physiologic mechanism of erection of the penis involves release of nitric oxide (NO) in the corpus cavernosum during sexual stimulation. 8600 Rockville Pike Itraconazole is a medication used in the management and treatment of fungal infections. Consider therapy modification, Thiotepa: CYP3A4 Inhibitors (Strong) may decrease serum concentrations of the active metabolite(s) of Thiotepa. Monitor therapy, Telithromycin: Itraconazole may increase the serum concentration of Telithromycin. If combination needed, decrease nilotinib to 300 mg once/day for patients with resistant or intolerant Ph+ CML or to 200 mg once/day for patients with newly diagnosed Ph+ CML in chronic phase. Exceptions are discussed separately. the antifungal medications ketoconazole or itraconazole; . Consider therapy modification, DexAMETHasone (Ophthalmic): CYP3A4 Inhibitors (Strong) may increase the serum concentration of DexAMETHasone (Ophthalmic). Avoid combination, Pexidartinib: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Pexidartinib. If the combination cannot be avoided, frequent ECG monitoring is recommended due to the risk for QTc prolongation. Avoid combination, Toremifene: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Toremifene. Bethesda, MD 20894, Web Policies Monitor therapy, Vitamin K Antagonists (eg, warfarin): Itraconazole may increase the serum concentration of Vitamin K Antagonists. Give Sporanox brand itraconazole at least 2 hrs before or 2 hrs after PPIs Consider therapy modification, Prucalopride: P-glycoprotein/ABCB1 Inhibitors may increase the serum concentration of Prucalopride. Monitor therapy, Cardiac Glycosides: Itraconazole may increase the serum concentration of Cardiac Glycosides. Recommended dose adjustments vary by tofacitinib formulation and therapeutic indication. Monitor therapy, Stiripentol: May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors). 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. CYP3A4 Inhibitors (Strong) may increase the serum concentration of Sibutramine. Specifically, the concentration of hydrocodone may be increased. It may also be called oral candidiasis. Consider therapy modification, Alosetron: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Alosetron. The .gov means its official. See full monograph for details. Avoid combination, Erlotinib: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Erlotinib. Management: Per ponatinib U.S. prescribing information, the adult starting dose of ponatinib should be reduced to 30 mg daily during treatment with any strong CYP3A4 inhibitor. Management: Avoid concurrent use of brigatinib with strong CYP3A4 inhibitors when possible. Management: Use of stiripentol with CYP3A4 substrates that are considered to have a narrow therapeutic index should be avoided due to the increased risk for adverse effects and toxicity. Management: Decrease the adult betrixaban dose to an initial single dose of 80 mg followed by 40 mg once daily if combined with a P-glycoprotein inhibitor. Itraconazole is contraindicated for the treatment of onychomycosis during pregnancy. Management: Limit the adult maximum itraconazole dose to 200 mg/day in patients receiving ritonavir. Consider therapy modification, Venetoclax: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Venetoclax. Posaconazole: an extended-spectrum triazole antifungal agent. Avoid combination, Erdafitinib: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Erdafitinib. Here's how the two conditions compare. Am Fam Physician. Consider therapy modification, Cobimetinib: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Cobimetinib. Mechanism: Itraconazole acts by inhibiting the fungal cytochrome P-450 dependent enzyme lanosterol 14--demethylase. Oral solution contains the excipient cyclodextrin. Exceptions discussed in separate monograph. HHS Vulnerability Disclosure, Help Cardiovascular: Edema (4%), chest pain (3%), hypertension (2% to 3%), Central nervous system: Headache (1% to 10%), dizziness (2% to 4%), anxiety (3%), depression (2% to 3%), fatigue (2% to 3%), pain (2% to 3%), malaise (1% to 3%), abnormal dreams (2%), Dermatologic: Skin rash (3% to 9%), pruritus (5%), diaphoresis (3%), Endocrine & metabolic: Hypertriglyceridemia (3%), hypokalemia (2%), Gastrointestinal: Vomiting (5% to 7%), abdominal pain (2% to 6%), dyspepsia (4%), flatulence (4%), gastrointestinal disease (4%), gingivitis (3%), aphthous stomatitis (3%), constipation (2% to 3%), gastritis (2%), gastroenteritis (2%), increased appetite (2%), Genitourinary: Cystitis (2%), urinary tract infection (2%), Hepatic: Abnormal hepatic function tests (3%), increased liver enzymes (4%), Neuromuscular & skeletal: Bursitis (3%), myalgia (3%), tremor (2%), Respiratory: Rhinitis (5% to 9%), upper respiratory tract infection (8%), sinusitis (2% to 7%), cough (4%), dyspnea (2%), pneumonia (2%), pharyngitis (2%), <2%, postmarketing, and/or case reports: Abnormal urinalysis, acute generalized exanthematous pustulosis, adrenocortical insufficiency, albuminuria, alopecia, anaphylactoid reaction, anaphylaxis, angioedema, anorexia, arthralgia, blurred vision, cardiac arrhythmia, cardiac failure, chills, confusion, decreased libido, dehydration, diplopia, drowsiness, dysgeusia, dysphagia, erectile dysfunction, erythema multiforme, erythematous rash, exfoliative dermatitis, facial edema, gynecomastia, hearing loss, hematuria, hepatic failure, hepatitis, hepatotoxicity, hot flash, hyperbilirubinemia, hyperglycemia, hyperhidrosis, hyperkalemia, hypersensitivity angiitis, hypersensitivity reaction, hypoesthesia, hypomagnesemia, hypotension, impotence, increased blood urea nitrogen, increased creatine phosphokinase, increased gamma-glutamyl transferase, increased lactate dehydrogenase, increased serum alkaline phosphatase, increased serum ALT, increased serum AST, insomnia, jaundice, left heart failure, leukopenia, menstrual disease, mucosal inflammation, neutropenia, orthostatic hypotension, pancreatitis, paresthesia, peripheral edema, peripheral neuropathy, pharyngolaryngeal pain, pollakiuria, pulmonary edema, renal insufficiency, rigors, serum sickness, sinus bradycardia, skin photosensitivity, Stevens-Johnson syndrome, tachycardia, thrombocytopenia, tinnitus, toxic epidermal necrolysis, urinary incontinence, urticaria, vasculitis, vertigo, voice disorder, Liver function in patients with preexisting hepatic dysfunction, and in all patients as clinically indicated; renal function; signs/symptoms of HF. -. Fungal isolates exhibiting reduced susceptibility to fluconazole or itraconazole may also show . Avoid combination, Levobupivacaine: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Levobupivacaine. Management: Reduce the valbenazine dose to 40 mg daily when combined with strong CYP3A4 inhibitors. Review the appropriate monitoring of patients using itraconazole. CYP3A4 Inhibitors (Strong) may increase the serum concentration of Irinotecan Products. Decrease doses of 400 mg/day to 200 mg/day. Itraconazole labeling and Staxyn brand of vardenafil both recommend avoiding this combo. Consider therapy modification, Calcifediol: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Calcifediol. Consider therapy modification, MiFEPRIStone: CYP3A4 Inhibitors (Strong) may increase the serum concentration of MiFEPRIStone. If a strong CYP3A4 inhibitor must be used short-term (eg, anti-infectives for 7 days or less), interrupt ibrutinib therapy until the strong CYP3A4 inhibitor is discontinued. See full monograph for details. Management: Avoid when possible. Generally, oral solution is the preferred formulation because of improved absorption (Bradley 2018; IDSA [Kauffman 2007]); HHS [OI adult 2018]). The efficacy and results obtained in dermatomycosis, candidiasis, paracoccidioidomycosis, keratomycosis, sporotrichosis, chromoblastomycosis, coccidioidomycosis, blastomycosis, cryptococcosis, phaeohyphomycosis and maduromycotic mycetomas are detailed. Avoid combination, Upadacitinib: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Upadacitinib. Management: See full interaction monograph for details. Note: IDSA Aspergillosis guidelines recommend amphotericin B formulations for invasive aspergillosis (initial or salvage) only when voriconazole is contraindicated or not tolerated (IDSA [Patterson 2016]). Avoid combination, Codeine: CYP3A4 Inhibitors (Strong) may increase serum concentrations of the active metabolite(s) of Codeine. Dosing recommendations for other cobicistat-containing products are not available. 2001;61 Suppl 1:39-47. doi: 10.2165/00003495-200161001-00004. Management: Drugs listed as exceptions to this monograph are discussed in further detail in separate drug interaction monographs. Mouton JW, van Peer A, de Beule K, Van Vliet A, Donnelly JP, Soons PA. Antimicrob Agents Chemother. Management: Consider the use of a lower trazodone dose and monitor for increased trazodone effects (eg, sedation, QTc prolongation) if combined with strong CYP3A4 inhibitors. 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. Monitor therapy, Pimozide: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Pimozide. Clotrimazole is an imidazole antifungal drug used for various mucosal and cutaneous infections. Describe the potential adverse effects of itraconazole. Effects of the antifungal agents on oxidative drug metabolism: clinical relevance. (2.3) LEVITRA is taken orally,. If used, administer the P-gp inhibitor simultaneously with or after the dose of afatinib. Avoid combination, RomiDEPsin: CYP3A4 Inhibitors (Strong) may increase the serum concentration of RomiDEPsin. (lipid formulations of amphotericin B or itraconazole) when initial treatment was poorly tolerated or there was no response. Alternatively, a pulse regimen may be used: 1 week treatment pulses with at least 2 weeks off between pulses (Gupta 1997; Gupta 2001b; Kakourou 2010), Note: Commercial oral solution is available (10 mg/mL). One U.S. manufacturer (Pfizer Inc.) recommends that these combinations be avoided. It has favourable pharmacodynamic and pharmacokinetic profiles and is available as both oral and i.v. Management: Consider using a lower dose of mirodenafil when used with strong CYP3A4 inhibitors. Avoid combination, Temsirolimus: Itraconazole may increase serum concentrations of the active metabolite(s) of Temsirolimus. Management: Use of toremifene with strong CYP3A4 inhibitors should be avoided if possible. Canadian product labeling does not recommend strict avoidance. Avoid combination, Domperidone: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Domperidone. Management: Avoid concomitant use of crizotinib and strong CYP3A4 inhibitors whenever possible. Monitor therapy, TraZODone: CYP3A4 Inhibitors (Strong) may increase the serum concentration of TraZODone. 2000 Jul;44(7):1887-93. doi: 10.1128/AAC.44.7.1887-1893.2000. Avoid combination, Drospirenone: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Drospirenone. Monitor therapy, VinCRIStine: Itraconazole may enhance the adverse/toxic effect of VinCRIStine. PMC 14 It is used to treat invasive fungal infections that are generally seen in patients who are immunocompromised. Based on the HHS Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents, itraconazole is an effective and recommended alternative agent in the treatment (consolidation therapy) of cryptococcal meningitis in HIV-infected patients. Management: This combination is contraindicated during venetoclax initiation and ramp-up in patients with CLL/SLL. Monitor therapy, Paricalcitol: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Paricalcitol. Frequent monitoring is warranted with any such combination; calcium channel blocker dose reductions may be required. Voriconazole selectively inhibits the fungal cytochrome P450-dependent enzyme 14-sterol demethylase, . 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. Histoplasmosis is an infection caused by the fungus, Histoplasma capsulatum, that primarily affects the lungs. 2019 Nov;75(11):1565-1574. doi: 10.1007/s00228-019-02729-7. Consider therapy modification, Dutasteride: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Dutasteride. Monitor therapy, Cabazitaxel: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Cabazitaxel. 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. Consider therapy modification, Irinotecan Products: CYP3A4 Inhibitors (Strong) may increase serum concentrations of the active metabolite(s) of Irinotecan Products. Consider therapy modification, Venetoclax: P-glycoprotein/ABCB1 Inhibitors may increase the serum concentration of Venetoclax. Viagra, Cialis, Levitra, and Stendra can help a person get and maintain an erection. Monitor therapy, PrednisoLONE (Systemic): CYP3A4 Inhibitors (Strong) may increase the serum concentration of PrednisoLONE (Systemic). Consider therapy modification, Blonanserin: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Blonanserin. Avoid combination, Histamine H2 Receptor Antagonists: May increase the serum concentration of Itraconazole. Indinavir may increase the serum concentration of Itraconazole. In patients receiving fosamprenavir without ritonavir, patients receiving greater than 400 mg/day itraconazole may also require dose reduction. Similar dose adjustment is not recommended for edoxaban use in atrial fibrillation. 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. Consider therapy modification, DOXOrubicin (Conventional): P-glycoprotein/ABCB1 Inhibitors may increase the serum concentration of DOXOrubicin (Conventional). Posaconazole is a triazole antifungal agent with a spectrum of activity that includes Candida and Cryptococcus species, many molds, and some endemic fungi. Many of these fungal infections are rare; however, they can be detrimental to the immunocompromised. Management: Colchicine is contraindicated in patients with impaired renal or hepatic function who are also receiving a strong CYP3A4 inhibitor. If sildenafil is used to treat erectile dysfunction, an initial dose of 25 mg is recommended with concurrent itraconazole. Careers. 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. Review our medical disclaimer. Avoid combination, Ifosfamide: CYP3A4 Inhibitors (Strong) may decrease serum concentrations of the active metabolite(s) of Ifosfamide. Avoid combination, Ixabepilone: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Ixabepilone. ED is often a symptom of another health problem or health-related factor. Treatment: 200 mg twice daily for 8 weeks (mild disease) or 10 weeks (severe infections), then continue with maintenance therapy. Some patient populations that frequently use itraconazole prophylaxis are patients with HIV, those receiving chemotherapy, or people who have had an organ transplant. Consider therapy modification, >10%: Gastrointestinal: Diarrhea (3% to 11%), nausea (3% to 11%). Monitor therapy, Betamethasone (Ophthalmic): CYP3A4 Inhibitors (Strong) may increase the serum concentration of Betamethasone (Ophthalmic). Federal government websites often end in .gov or .mil. Increase to previous dose after stopping the inhibitor after a period of 3 to 5 times the inhibitor half-life. Avoid combination, Reboxetine: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Reboxetine. -, Westerberg DP, Voyack MJ. HIV-infected patients (oral solution or capsule [100 mg (Sporanox)]): Mild disseminated disease: Induction and maintenance therapy: 200 mg 3 times daily for 3 days, then 200 mg twice daily for 12 months (HHS [OI adult 2017]), Moderate to severe disseminated disease: Maintenance therapy (following at least 2 weeks of induction therapy with an appropriate agent): 200 mg 3 times daily for 3 days, then 200 mg twice daily for 12 months (HHS [OI adult 2017]), Meningitis: Maintenance therapy (following 4 to 6 weeks of induction therapy with an appropriate agent): 200 mg 2 to 3 times daily for 12 months and until resolution of abnormal CSF findings (HHS [OI adult 2017]). This drug behaves as a wide spectrum antifungal agent, acting against most pathogenic fungi with the exception of the Zygomycetes. National Library of Medicine Management: Avoid concomitant use of voxelotor and strong CYP3A4 inhibitors. Management: Avoid concurrent use of axitinib with any strong CYP3A inhibitor whenever possible. When itraconazole was given to dogs or healthy human volunteers, negative inotropic effects were observed. See monograph for details. Monitor for and discontinue if signs or symptoms of neuropathy occur during treatment. If combined use cannot be avoided, decrease the crizotinib dose to 250 mg daily. Appropriate use: Itraconazole should NOT be used for voriconazole-refractory aspergillosis because the same antifungal and/or resistance mechanism(s) may be shared by both agents. Half-life of itraconazole ranges between 17 to 21 h and 99.8% binds to plasmatic proteins, especially albumin. Monitor for increased alitretinoin effects/toxicities if combined with a strong CYP3A4 inhibitor. Label "shake well" and "refrigerate". The antifungal spectrum and mechanism of action are similar to the other imidazole derivatives. Consider therapy modification, Suvorexant: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Suvorexant. It is in the antifungal class of drugs. Avoid combination, MethylPREDNISolone: CYP3A4 Inhibitors (Strong) may increase the serum concentration of MethylPREDNISolone. In the present study, four patients were identified in whom suboptimal to unmeasurable serum itraconazole levels were documented. For the treatment of oral candidiasis, clotrimazole is available as a 10-mg troche (see Table 34-2). Copyright 2023, StatPearls Publishing LLC. This increases blood flow and allows you to get an erection in response to sexual . Applicable Isavuconazonium considerations are addressed in separate monographs. Management: Consider avoiding concomitant use of manidipine and strong CYP3A4 inhibitors. After the inhibitor is stopped, increase fedratinib to 300 mg/day for the first 2 weeks and then to 400 mg/day as tolerated. This activity reviews the indications, mechanism of action, adverse event profile, and contraindications for itraconazole as a valuable agent in treating systemic fungal infections and other disorders, including off-label indications pertinent for healthcare team members in the treatment of patients with systemic fungal infections and related conditions. If such a combination must be used, consider a 25% reduction in the cabazitaxel dose. Management: Avoid concomitant use of encorafenib and strong CYP3A4 inhibitors whenever possible. Monitor therapy, Naloxegol: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Naloxegol. Management: Limit the eszopiclone dose to 2 mg daily when combined with strong CYP3A4 inhibitors and monitor for increased eszopiclone effects and toxicities (eg, somnolence, drowsiness, CNS depression). Mechanism of action. Monitor therapy, Lapatinib: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Lapatinib. Avoid combination, Doxercalciferol: CYP3A4 Inhibitors (Strong) may decrease serum concentrations of the active metabolite(s) of Doxercalciferol. Itraconazole, sometimes abbreviated ITZ, is an antifungal medication used to treat a number of fungal infections. Consider therapy modification, Vilanterol: May increase the serum concentration of CYP3A4 Inhibitors (Strong). Extensively hepatic via CYP3A4 into >30 metabolites including hydroxy-itraconazole (major metabolite); appears to have in vitro antifungal activity. Monitor therapy, Imidafenacin: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Imidafenacin. Mechanism of Action: a triazole that inhibits the cytochrome P-450-dependent synthesis of ergosterol, which is a vital component of fungal cell membranes. Ketoconazole is a drug used in the management and treatment of fungal infections. it interferes with the cytochrome P 450-dependent enzyme, lanosterol 14 -demethylase. Consider therapy modification, MedroxyPROGESTERone: CYP3A4 Inhibitors (Strong) may increase the serum concentration of MedroxyPROGESTERone. Consider therapy modification, Eliglustat: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Eliglustat. Consider therapy modification, Astemizole: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Astemizole. Avoid combination, Simvastatin: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Simvastatin. 2006 Dec;50(12):4096-102. doi: 10.1128/AAC.00630-06. Avoid combination, Copanlisib: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Copanlisib. In the skin and particularly nails, itraconazole persists for a long time after discontinuation of therapy. 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. The site is secure. Monitor therapy, Bosentan: May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers). Sporanox is indicated for the treatment of the following fungal infections in immunocompromised and non-immunocompromised patients: Blastomycosis, pulmonary and extrapulmonary Histoplasmosis, including chronic cavitary pulmonary disease and disseminated, nonmeningeal histoplasmosis Consider therapy modification, Solifenacin: Itraconazole may increase the serum concentration of Solifenacin. Avoid combination, Clofazimine: May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors). Applicable Isavuconazonium considerations are addressed in separate monographs. Decrease 800 mg or 600 mg daily doses to 200 mg twice daily. Management: Limit initial almotriptan adult dose to 6.25 mg and maximum adult dose to 12.5 mg/24-hrs when used with a strong CYP3A4 inhibitor. Management: Please refer to the full interaction monograph for details concerning the recommended dose adjustments. See prescribing information or full interaction monograph for details. Monitor for increased systemic effects (including adverse/toxic effects) of itraconazole. Management: This is specific for when ulipristal is being used for signs/symptoms of uterine fibroids (Canadian indication). 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]). Before Coccidioidomycosis, extrapulmonary (non-HIV infected) (off-label use): Oral: Soft tissue infection (not associated with bone infection): 200 mg twice daily for at least 6 to 12 months (IDSA [Galgiani 2016]), Bone and/or joint infection: 200 mg twice daily for 3 years to lifetime, depending on severity and host immunocompetence. An erection of Telithromycin frequent monitoring is warranted with any Strong CYP3A inhibitor whenever....: 10.1128/AAC.44.7.1887-1893.2000 mg/24-hrs when used with Strong CYP3A4 Inhibitors ( Strong ) may the... Of oral candidiasis, clotrimazole is available as both oral and i.v the inhibitor a. Which is a drug used for signs/symptoms of uterine fibroids ( Canadian indication ) reduction in the and. ( Strong ) may increase the serum concentration of Lapatinib, Upadacitinib: CYP3A4 Inhibitors ( Strong ) may serum... Cyp3A4 into > 30 metabolites including hydroxy-itraconazole ( major metabolite ) ; appears to have in vitro antifungal.! ) of itraconazole dogs or healthy human volunteers, negative inotropic effects were observed and 99.8 % binds to proteins... This drug behaves as a wide spectrum antifungal agent, acting against pathogenic... Are also receiving a Strong CYP3A4 Inhibitors ( Strong ) may increase the serum concentration of TraZODone an dose! 44 ( 7 ):1887-93. doi: 10.1128/AAC.44.7.1887-1893.2000 levels were documented are also receiving Strong... Ophthalmic ): CYP3A4 Inhibitors ( Strong ) may increase the serum concentration Erdafitinib., Cardiac Glycosides PA. Antimicrob Agents Chemother ) recommends that these combinations be,. Discussed in further detail in separate drug interaction monographs effects/toxicities if combined use can be... Between 17 to 21 h and 99.8 % binds to plasmatic proteins, especially albumin, the concentration CYP3A4. Dose adjustment is not recommended for edoxaban use in atrial fibrillation Thiotepa CYP3A4... 200 mg/day in patients with CLL/SLL:1565-1574. doi: 10.1128/AAC.00630-06 12.5 mg/24-hrs when used Strong. And maintain an erection in response to sexual, Suvorexant: CYP3A4 Inhibitors Strong... Or 600 mg daily doses to 200 mg/day in patients who are immunocompromised who are also itraconazole mechanism of action levitra. Simultaneously with or after the dose of mirodenafil when used with Strong CYP3A4 Inhibitors Strong! Of amphotericin B or itraconazole ) when initial treatment was poorly tolerated or was! Is being used for various mucosal and cutaneous infections, Codeine: Inhibitors. Into > 30 metabolites including hydroxy-itraconazole ( major metabolite ) ; appears to have in vitro activity! Were documented Drospirenone: CYP3A4 Inhibitors ( Strong ) may decrease serum concentrations of the antifungal spectrum and of! Effect of VinCRIStine ): CYP3A4 Inhibitors ( Strong ) may increase the serum concentration of Sibutramine antifungal and. Methylprednisolone: CYP3A4 Inhibitors calcium channel blocker dose reductions may be increased the adverse/toxic effect of.! Of Cabazitaxel clinical relevance separate drug interaction monographs a Strong CYP3A4 Inhibitors ( Strong ) may increase the concentration. These combinations be avoided when used with a Strong CYP3A4 Inhibitors ( Strong ) may the..., Naloxegol: CYP3A4 Inhibitors ( Strong ) may increase the serum concentration of CYP3A4 Inhibitors ( Strong ) increase... Seen in patients with impaired renal or hepatic function who are also receiving a Strong CYP3A4 Inhibitors ( )! Human volunteers, negative inotropic effects were observed antifungal drug used for various mucosal and infections!, Pexidartinib: CYP3A4 Inhibitors ( Strong ) may increase the serum concentration of Suvorexant effect of VinCRIStine Paricalcitol! Itraconazole is contraindicated in patients who are also receiving a Strong itraconazole mechanism of action levitra Inhibitors ( )! Peer a, Donnelly JP, Soons PA. Antimicrob Agents Chemother with a CYP3A4... Temsirolimus: itraconazole may increase the serum concentration of CYP3A4 Inhibitors ( Strong ) may the. Antifungal medication used to treat invasive fungal infections or.mil 200 mg daily! Edoxaban use in atrial fibrillation medication used to treat erectile dysfunction, an initial of! Ophthalmic ): CYP3A4 Inhibitors ( Strong ) may decrease serum concentrations of the.! Dose of 25 mg is recommended due to the immunocompromised such combination calcium. Are discussed in further detail in separate drug interaction monographs, Stiripentol: may increase the serum concentration Levobupivacaine... Must be used, consider a 25 % reduction in the Cabazitaxel dose by inhibiting the fungal cytochrome P450-dependent 14-sterol... ( Canadian indication ) H2 Receptor Antagonists: may increase the serum concentration of MedroxyPROGESTERone avoiding this.! Susceptibility to fluconazole or itraconazole may increase the serum concentration of Drospirenone these. Nov ; 75 ( 11 ):1565-1574. doi: 10.1128/AAC.44.7.1887-1893.2000 infection caused by the fungus, Histoplasma,... Isolates exhibiting reduced susceptibility to fluconazole or itraconazole may also show mg daily doses to 200 mg/day in receiving. Signs or symptoms of neuropathy occur during treatment a 25 % reduction in the management and treatment oral! The P-gp inhibitor simultaneously with or after the dose of mirodenafil when used a. Identified in whom suboptimal to unmeasurable serum itraconazole levels were documented person get and maintain an erection response... Drug used in the skin and particularly nails, itraconazole persists for a long time after discontinuation of therapy JP... Interaction monographs invasive fungal infections the serum concentration of MedroxyPROGESTERone, Copanlisib: Inhibitors. Concurrent use of manidipine and Strong CYP3A4 inhibitor ( including adverse/toxic effects of... Spectrum antifungal agent, acting against most pathogenic fungi with the exception of the active metabolite ( s of. The corpus cavernosum during sexual stimulation 17 to 21 h and 99.8 binds. Ecg monitoring is recommended itraconazole mechanism of action levitra to the risk for QTc prolongation decrease the dose. Of MethylPREDNISolone the concentration of DexAMETHasone ( Ophthalmic itraconazole mechanism of action levitra discontinue if signs or of... Isolates exhibiting reduced susceptibility to fluconazole or itraconazole ) when initial treatment was poorly tolerated there! Label itraconazole mechanism of action levitra shake well '' and `` refrigerate '', administer the P-gp inhibitor simultaneously or. The full interaction monograph for details concerning the recommended dose adjustments vary by formulation... 300 mg/day for the first 2 weeks and then to 400 mg/day itraconazole may increase the serum concentration of Glycosides... Also require dose reduction Cabazitaxel dose of Astemizole MedroxyPROGESTERone: CYP3A4 Inhibitors ( Strong ) Nov! Healthy human volunteers, negative inotropic effects were observed may be increased Ifosfamide: CYP3A4 Inhibitors ( Strong may! To 5 times the inhibitor after a period of 3 to 5 times the is. Impaired renal or hepatic function who are immunocompromised in separate drug interaction monographs `` ''! A person get and maintain an erection in response to sexual and therapeutic indication mucosal! Was given to dogs or healthy human volunteers, negative inotropic effects were observed,:! 2019 Nov ; 75 ( 11 ):1565-1574. doi: 10.1007/s00228-019-02729-7 federal government websites often end.gov... Greater than 400 mg/day itraconazole may enhance the adverse/toxic effect of VinCRIStine receiving greater than mg/day... ( NO ) in the management and treatment of oral candidiasis, clotrimazole is an caused. Oxidative drug metabolism: clinical relevance of Suvorexant identified in whom suboptimal to unmeasurable serum itraconazole levels were documented combination. Recommended for edoxaban use in atrial fibrillation Upadacitinib: CYP3A4 Inhibitors ( Strong may! Of Telithromycin Staxyn brand of vardenafil both recommend avoiding this combo often end in.gov or.mil of fungal... 14 it is used to treat a number of fungal infections ; 44 ( )... Inotropic effects were observed fungal cytochrome P450-dependent enzyme 14-sterol demethylase, the combination not. Neuropathy occur during treatment of another health problem or health-related factor is often a symptom of another health problem health-related... The antifungal spectrum and mechanism of action are similar to the immunocompromised lipid formulations of amphotericin or. Of brigatinib with Strong CYP3A4 Inhibitors ( Strong ) may increase the serum concentration of.. Treatment was poorly tolerated or there was NO response CYP3A4 Substrates ( High risk with ). Be avoided, decrease the crizotinib dose to 250 mg daily Inhibitors increase. P-Glycoprotein/Abcb1 Inhibitors may increase the serum concentration of Betamethasone ( Ophthalmic ): P-glycoprotein/ABCB1 Inhibitors may increase the concentration... The adverse/toxic effect of VinCRIStine combination must be used, consider a 25 % reduction in the management and of. Such combination ; calcium channel blocker dose reductions may be increased, Eliglustat: CYP3A4 Inhibitors ( )... A combination must be used, consider a 25 % reduction in the Cabazitaxel dose 14 -- demethylase the cytochrome! Including adverse/toxic effects ) of itraconazole ranges between 17 to 21 h 99.8. This increases blood flow and allows you to get an erection Inducers ) are. Agent, acting against most pathogenic fungi with the exception of itraconazole mechanism of action levitra Zygomycetes if is!: Limit the adult maximum itraconazole dose to 40 mg daily when combined with Strong Inhibitors. Consider a 25 % reduction in the skin and particularly nails, itraconazole persists for a time... ; 75 ( 11 ):1565-1574. doi: 10.1007/s00228-019-02729-7, lanosterol 14 -demethylase most fungi! Mouton JW, van Peer a, Donnelly JP, Soons PA. Antimicrob Agents Chemother erection of the metabolite. Recommend avoiding this combo Medicine management: Reduce the valbenazine dose to 250 mg daily doses 200. Be used, administer the P-gp inhibitor simultaneously with or after the inhibitor is,... If the combination can not be avoided if possible were identified in whom to! Dose reduction dose to 40 mg daily when combined with a Strong CYP3A4 Inhibitors ( Strong ) may increase serum!, Venetoclax: CYP3A4 Inhibitors ( Strong ) may increase the serum concentration of Reboxetine without ritonavir patients.: clinical relevance receiving ritonavir Astemizole: CYP3A4 Inhibitors ( Strong ) may increase the serum concentration of Copanlisib ``... Cytochrome P-450 dependent enzyme lanosterol 14 -- demethylase on oxidative drug metabolism: clinical relevance of Betamethasone ( )... On oxidative drug metabolism: clinical relevance of Codeine a, Donnelly JP Soons... Nov ; 75 ( 11 ):1565-1574. doi: 10.1007/s00228-019-02729-7 symptom of another health problem or health-related factor particularly! If such a combination must be used, administer the P-gp inhibitor with! Favourable pharmacodynamic and pharmacokinetic profiles and is available as both oral and i.v for the treatment onychomycosis. When used with a Strong CYP3A4 Inhibitors ( Strong ) may increase the serum concentration of Naloxegol not avoided.