Dosages & Reactions

Interactions:

Acenocoumarol
Adverse Effect: An increased risk of bleeding
Clinical Management: Avoid concurrent use of itraconazole and acenocoumarol. If the two must be used together, monitor coagulation parameters (international normalized ratio (INR) and prothrombin time (PT)) carefully during and after itraconazole therapy. Close clinical monitoring is essential and dosage adjustment of the anticoagulant agent may be necessary. Even then, safe use of this combination is not assured.
Alprazolam
Adverse Effect: increased alprazolam serum concentrations and potential alprazolam toxicity (sedation, slurred speech, CNS depression)
Clinical Management: The concomitant administration of alprazolam and itraconazole is contraindicated.
Amlodipine
Adverse Effect: Increased amlodipine serum concentrations and toxicity (dizziness, hypotension, flushing, headache, peripheral edema)
Clinical Management: Observe for development of toxicity associated with amlodipine (peripheral edema, dizziness, hypotension, flushing, headache). Consider reducing the dose of amlodipine or withdrawing one of the agents.
Amphotericin B
Adverse Effect: Pharmacodynamic antagonism between these agents
Clinical Management: Monitor patients for therapeutic effectiveness if these medications are given concomitantly.
Antacids Comb.
Adverse Effect: Loss of itraconazole efficacy
Clinical Management: Antacids should be taken at least one hour before or two hours after itraconazole.
Astemizole
Adverse Effect: An increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest)
Clinical Management: The concurrent use of astemizole and itraconazole is contraindicated.
Atorvastatin
Adverse Effect: an increased risk of myopathy or rhabdomyolysis
Clinical Management: If concurrent therapy is required, monitor the patient for signs and symptoms of myopathy or rhabdomyolysis.
Buspirone
Adverse Effect: increased buspirone plasma concentrations; increased buspirone side effects (impaired psychomotor performance, sedation)
Clinical Management: Itraconazole should be avoided in patients treated with buspirone.
Busulphan
Adverse Effect: Increased risk of busulfan toxicity (myelosuppression, hemorrhagic cystitis, neurotoxicity, busulfan lung)
Clinical Management: Concurrent administration of itraconazole with busulfan should be undertaken with caution.
Carbamazepine
Adverse Effect: Loss of itraconazole efficacy
Clinical Management: Monitor antifungal therapy for clinical efficacy; larger itraconazole doses may be required in some situations.
Cimetidine
Adverse Effect: Loss of itraconazole efficacy
Clinical Management: Itraconazole should be administered with a cola beverage if the patient is receiving an H2 receptor antagonist, such as cimetidine.
Cisapride
Adverse Effect: An increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest)
Clinical Management: Coadministration of cisapride with itraconazole is contraindicated.
Clarithromycin
Adverse Effect: Increased itraconazole and clarithromycin concentrations
Clinical Management: Monitor patients for signs and symptoms of itraconazole and clarithromycin toxicity.
Cyclosporin
Adverse Effect: Increases Cyclosporine concentrations
Clinical Management: Monitor Cyclosporine concentrations and adjust the dosage accordingly.
Diazepam
Adverse Effect: increased diazepam serum concentrations and diazepam adverse effects (sedation, slurred speech, CNS depression)
Clinical Management: Monitor patients for excessive sedation and CNS depression. Counsel patients that they may experience enhanced or prolonged sedative effects.
Digoxin
Adverse Effect: An increased risk of digoxin toxicity (nausea, vomiting, arrhythmias)
Clinical Management: When itraconazole and digoxin are given concurrently, the digoxin dose may need to be reduced; serum digoxin levels should be monitored.
Docetaxel
Adverse Effect: an increased risk of docetaxel toxicity
Clinical Management: Concurrent administration of itraconazole with docetaxel should be undertaken with caution.
Famotidine
Adverse Effect: loss of itraconazole efficacy
Clinical Management: Itraconazole should be administered with a cola beverage if the patient is receiving an H2 receptor antagonist, such as famotidine.
Felodipine
Adverse Effect: Increased felodipine serum concentrations and toxicity (dizziness, hypotension, flushing, headache, peripheral edema)
Clinical Management: The concurrent use of itraconazole and felodipine should be avoided. If these agents must be used together, observe for development of toxicity associated with felodipine (peripheral edema, dizziness, hypotension, flushing, headache). Substantial decreases in the felodipine dose may be necessary.
INH
Adverse Effect: Loss of itraconazole efficacy
Clinical Management: Monitor itraconazole effectiveness and adjust the dose as needed; larger itraconazole doses may be required in some situations.
Indinavir
Adverse Effect:Increase in the Plasma concentration of Indinavir
Clinical Management: Monitor for therapeutic effect and decrease the dose of Indinavir if required.
Lansoprazole
Adverse Effect: loss of itraconazole efficacy
Clinical Management: Itraconazole should be administered with a cola beverage in patients receiving Lansoprazole.
Lovastatin
Adverse Effect: an increased risk of myopathy or rhabdomyolysis
Clinical Management: Concomitant use of itraconazole and lovastatin is contraindicated.
Midazolam
Adverse Effect: increased midazolam plasma concentrations and potential midazolam toxicity
Clinical Management: Concurrent use of oral midazolam and itraconazole is contraindicated.
Mifepristone
Adverse Effect: Inhibition of Mifepristone metabolism resulting in increased serum levels of Mifepristone
Clinical Management: Monitor for the therapeutic effects and adjust the dose accordingly.
Nifedipine
Adverse Effect: Increased nifedipine serum concentrations and toxicity (dizziness, hypotension, flushing, headache, peripheral edema)
Clinical Management: Observe for development of toxicity associated with nifedipine (peripheral edema, dizziness, hypotension, flushing, headache). Consider reducing the dose of nifedipine or withdrawing one of the agents.
Omeprazole
Adverse Effect: loss of itraconazole efficacy
Clinical Management: Itraconazole should be administered with a cola beverage in patients receiving Omeprazole.
Pantoprazole
Adverse Effect: loss of itraconazole efficacy
Clinical Management: Itraconazole should be administered with a cola beverage in patients receiving Pantoprazole .
Phenindione
Adverse Effect: An increased risk of bleeding
Clinical Management: Avoid concurrent use of itraconazole and phenindione. If the two must be used together, monitor coagulation parameters (international normalized ratio (INR) and prothrombin time (PT) times) carefully during and after itraconazole therapy. Close clinical monitoring is essential and dosage adjustment of Phenindione may be necessary. Even then, safe use of this combination is not assured.
Phenobarbitone
Adverse Effect: Loss of itraconazole efficacy
Clinical Management: If combination therapy is necessary, monitor antifungal therapy for loss of efficacy.
Phenytoin
Adverse Effect: Decreased serum itraconazole concentrations and loss of antimycotic efficacy
Clinical Management: The concurrent use of phenytoin and itraconazole should be avoided. If use of these two agents is necessary, monitor patients for loss of antifungal efficacy. An alternative antifungal agent should be considered.
Pimozide
Adverse Effect: Increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest)
Clinical Management: The concurrent administration of itraconazole and pimozide is contraindicated.
Quinidine
Adverse Effect: an increased risk of quinidine toxicity (ventricular arrhythmias, hypotension, exacerbation of heart failure)
Clinical Management: The concomitant administration of itraconazole and quinidine is contraindicated.
Ranitidine
Adverse Effect: loss of itraconazole efficacy
Clinical Management: Itraconazole should be administered with a cola beverage if the patient is receiving an H2 receptor antagonist, such as ranitidine.
Rifampicin
Adverse Effect: Loss of itraconazole efficacy
Clinical Management: Monitor itraconazole effectiveness and adjust the dose as needed; larger itraconazole doses may be required in some situations.
Roxatidine
Adverse Effect: loss of itraconazole efficacy
Clinical Management: Itraconazole should be administered with a cola beverage if the patient is receiving an H2 receptor antagonist, such as roxatidine.
Simvastatin
Adverse Effect: an increased risk of myopathy or rhabdomyolysis
Clinical Management: Concomitant administration of itraconazole and simvastatin is contraindicated.
Terfenadine
Adverse Effect: cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest)
Clinical Management: The concurrent use of itraconazole and terfenadine is contraindicated.
Verapamil
Adverse Effect: Increased verapamil serum concentrations and toxicity (dizziness, hypotension, flushing, headache, peripheral edema)
Clinical Management: Observe the patient for development of toxicity associated with verapamil (peripheral edema, dizziness, hypotension, flushing, headache). Consider reducing the dose of verapamil or withdrawing one of the agents.
Vinblastine
Adverse Effect: an increased risk of neurotoxicity and paralytic ileus
Clinical Management: Patients who receive vinca alkaloids and itraconazole concurrently should be monitored for the development of neurotoxicity.
Vincristine
Adverse Effect: an increased risk of neurotoxicity and paralytic ileus
Clinical Management:Monitor for the development of neurotoxicity, including paresthesias, muscle weakness, and paralytic ileus. The dose of the Vincristine should be adjusted accordingly.
Warfarin
Adverse Effect: An increased risk of bleeding
Clinical Management: Avoid concurrent use of itraconazole and warfarin. If the two must be used together, monitor coagulation parameters (international normalized ratio (INR)) carefully during and after itraconazole therapy. Close clinical monitoring is essential and dosage adjustment of the anticoagulant agent may be necessary. Even then, safe use of this combination is not assured.

Ibuprofen

Imipenem and Cilastatin

ImipramineHydrochloride

ImmuneGlobulin

Indomethacin

Insulin (Regular)

InsulinGlargine (rDNA) inj