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Study

▶ Fluconazole slightly increases the exposure to HIV-protease

inhibitors (tipranavir). Avoid or adjust dose.oStudy

▶ HIV-protease inhibitors are predicted to increase the exposure

to isavuconazole. Avoid or monitor side effects.rStudy

▶ HIV-protease inhibitors are predicted to increase the exposure

to itraconazole. Use with caution and adjust dose.rStudy

▶ HIV-protease inhibitors are predicted to increase the exposure

to

Study

ketoconazole. Use with caution and adjust dose.o

▶ Miconazole is predicted to increase the concentration of HIVprotease inhibitors

o

. Use with caution and adjust dose.

Theoretical

▶ Posaconazole is predicted to increase the exposure to HIVprotease inhibitors.oStudy

▶ HIV-protease inhibitors are predicted to affect the exposure to

voriconazole and voriconazole potentially affects the exposure

to HIV-protease inhibitors.rStudy → Also see TABLE 9 p. 1377

▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)

are predicted to increase the exposure to ibrutinib. Adjust

ibrutinib

r

dose with moderate inhibitors of CYP3A4, p. 983.

Study

▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to very markedly increase the exposure to ibrutinib.

Avoid potent inhibitors of CYP3A4 or adjust ibrutinib dose,

p. 983.rStudy

▶ Idelalisib is predicted to increase the exposure to

isavuconazole. Avoid or monitor side effects.rStudy

▶ Antifungals, azoles (fluconazole, posaconazole) are predicted to

increase the exposure to imatinib.oTheoretical

▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to increase the exposure to imatinib.oStudy

▶ Imatinib is 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 to ivabradine. Adjust

ivabradine dose, p. 211.rTheoretical

▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to increase the exposure to

r

ivabradine. Avoid.

Study

▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)

are predicted to increase the exposure to ivacaftor. Adjust

ivacaftor p. 293 or tezacaftor with ivacaftor p. 295 dose with

moderate inhibitors of CYP3A4.rStudy

▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to increase the exposure to ivacaftor. Adjust

ivacaftor p. 293 or lumacaftor with ivacaftor p. 294 or tezacaftor

with ivacaftor

r

p. 295 dose with potent inhibitors of CYP3A4.

Study

▶ Lanthanum is predicted to decrease the absorption of

ketoconazole

o

. Separate administration by at least 2 hours.

Theoretical

▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)

are predicted to increase the exposure to

Study → Also see TABLE 9 p. 1377

lapatinib.o ▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to increase the exposure to

o

lapatinib. Avoid.

Study → Also see TABLE 9 p. 1377

▶ Letermovir

o

slightly decreases the exposure to voriconazole.

Study

▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)

are predicted to increase the exposure to

o

lomitapide. Avoid.

Theoretical → Also see TABLE 1 p. 1375

▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to markedly increase the exposure to lomitapide.

Avoid.rStudy → Also see TABLE 1 p. 1375

▶ Clotrimazole is predicted to increase the exposure to

lomitapide

Theoretical

. Separate administration by 12 hours.o ▶ Lumacaftor is predicted to decrease the exposure to

antifungals, azoles (itraconazole, ketoconazole, posaconazole,

voriconazole). Avoid or monitor efficacy.oTheoretical

▶ Lumacaftor is predicted to decrease the exposure to

fluconazole. Adjust dose.nTheoretical

▶ Antifungals, azoles (fluconazole, isavuconazole) are predicted to

increase the exposure to lurasidone. Adjust lurasidone dose,

p. 398.oStudy

▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to increase the exposure to

r

lurasidone. Avoid.

Study

▶ Posaconazole moderately increases the exposure to lurasidone.

Avoid.rStudy

BNF 78 Antifungals, azoles — Antifungals, azoles 1403

Interactions | Appendix 1

A1

Antifungals, azoles (continued)

▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to increase the exposure to

Study

macitentan.o ▶ Macrolides (clarithromycin) are predicted to increase the

exposure to

r

isavuconazole. Avoid or monitor side effects.

Study

▶ Macrolides (erythromycin) are predicted to increase the

exposure to isavuconazole.oTheoretical

▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to markedly increase the exposure to maraviroc.

Adjust dose.rStudy

▶ Metoclopramide potentially decreases the absorption of

posaconazole (oral suspension).oStudy

▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)

are predicted to increase the exposure to midazolam. Monitor

side effects and adjust dose.rStudy

▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to markedly to very markedly increase the exposure

to midazolam. Avoid or adjust dose.rStudy

▶ Miconazole is predicted to increase the exposure to

intravenous

o

midazolam. Use with caution and adjust dose.

Theoretical

▶ Miconazole is predicted to increase the exposure to oral

midazolam. Avoid.oTheoretical

▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)

are predicted to increase the exposure to

o

midostaurin.

Theoretical

▶ 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 to mirabegron. Adjust

mirabegron

o

dose in hepatic and renal impairment, p. 781.

Study

▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to increase the exposure to

Study

mirtazapine.o ▶ Mitotane is predicted to decrease the exposure to

isavuconazole. Avoid.rStudy

▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to increase the exposure to modafinil.nTheoretical

▶ Antifungals, azoles (itraconazole, ketoconazole) increase the risk

of neutropenia when given with monoclonal antibodies

(brentuximab vedotin). Monitor and adjust dose.rStudy

▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to increase the exposure to monoclonal antibodies

(trastuzumab emtansine). Avoid.rTheoretical

▶ Isavuconazole

o

increases the exposure to mycophenolate.

Study

▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)

are predicted to increase the exposure to naloxegol. Adjust

naloxegol dose and monitor side effects, p. 65.oStudy

▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to markedly increase the exposure to naloxegol.

Avoid.rStudy

▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to increase the exposure to

Study

netupitant.o ▶ Netupitant is predicted to decrease the exposure to

isavuconazole.oTheoretical

▶ Fluconazole slightly to moderately increases the exposure to

nevirapine.oStudy

▶ Nevirapine is predicted to decrease the exposure to

isavuconazole. Avoid.rTheoretical

▶ Nevirapine moderately decreases the exposure to itraconazole.

Avoid and for 14 days after stopping nevirapine.oStudy

▶ Nevirapine moderately decreases the exposure to

ketoconazole. Avoid.rStudy

▶ Nevirapine is predicted to decrease the exposure to

voriconazole and voriconazole increases the exposure to

nevirapine. Monitor and adjust dose.rTheoretical

▶ Antifungals, azoles (fluconazole, posaconazole) are predicted to

increase the exposure to nilotinib.oTheoretical → Also

see TABLE 9 p. 1377

▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to moderately increase the exposure to nilotinib.

Avoid.rStudy → Also see TABLE 9 p. 1377

▶ Antifungals, azoles (itraconazole, ketoconazole) are predicted to

increase the exposure to nintedanib.oStudy

▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to increase the exposure to

o

nitisinone. Adjust dose.

Theoretical

▶ Fluconazole moderately increases the exposure to NSAIDs

(celecoxib). Adjust celecoxib dose, p. 1132.oStudy

▶ Voriconazole slightly increases the exposure to NSAIDs

(diclofenac). Monitor and adjust dose.oStudy

▶ Voriconazole moderately increases the exposure to NSAIDs

(ibuprofen). Adjust dose.oStudy

▶ Fluconazole increases the exposure to NSAIDs (parecoxib).

Monitor and adjust dose.oStudy

▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)

are predicted to increase the exposure to olaparib. Avoid

moderate inhibitors of CYP3A4 or adjust

o

olaparib dose, p. 1005.

Theoretical

▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to increase the exposure to olaparib. Avoid potent

inhibitors of CYP3A4 or adjust

Study

olaparib dose, p. 1005.o ▶ Miconazole is predicted to increase the exposure to opioids

(alfentanil)

Theoretical

. Use with caution and adjust dose.o ▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)

are predicted to increase the exposure to opioids (alfentanil,

buprenorphine, fentanyl, oxycodone)

o

. Monitor and adjust dose.

Study

▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to increase the exposure to opioids (alfentanil,

buprenorphine, fentanyl, oxycodone, sufentanil). Monitor and

adjust dose.rStudy

▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to increase the exposure to opioids (methadone).

Adjust dose.rTheoretical → Also see TABLE 9 p. 1377

▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)

are predicted to increase the exposure to opioids (methadone,

sufentanil).oTheoretical → Also see TABLE 9 p. 1377

▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to increase the exposure to ospemifene. Avoid in

poor CYP2C9 metabolisers.oStudy

▶ Fluconazole increases the exposure to ospemifene. Use with

caution or avoid.oStudy

▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)

are predicted to increase the exposure to oxybutynin.n Theoretical

▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to increase the exposure to oxybutynin.nStudy

▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to increase the exposure to palbociclib. Avoid or

adjust palbociclib dose, p. 992.rStudy

▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to increase the exposure to panobinostat. Adjust

panobinostat

o

dose; in hepatic impairment avoid, p. 936.

Study → Also see TABLE 9 p. 1377

▶ Posaconazole is predicted to increase the exposure to

panobinostat. Adjust dose.oTheoretical

▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to increase the exposure to

r

paritaprevir. Avoid.

Study

▶ Posaconazole is predicted to increase the exposure to

paritaprevir (with ritonavir and ombitasvir) and paritaprevir

(with ritonavir and ombitasvir) is predicted to increase the

exposure to posaconazole. Avoid.rStudy

▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)

are predicted to increase the exposure to

Theoretical → Also see TABLE 9 p. 1377

pazopanib.o ▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to increase the exposure to pazopanib. Avoid or

adjust pazopanib dose, p. 993.oStudy → Also see TABLE 9

p. 1377

1404 Antifungals, azoles — Antifungals, azoles BNF 78

Interactions | Appendix 1

A1

▶ Miconazole greatly increases the anticoagulant effect of

phenindione.rTheoretical

▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)

are predicted to increase the exposure to phosphodiesterase

type-5 inhibitors

Theoretical

(avanafil). Adjust avanafil dose, p. 812.o ▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to increase the exposure to phosphodiesterase type-5

inhibitors (avanafil, vardenafil). Avoid.rStudy → Also see

TABLE 9 p. 1377

▶ Miconazole is predicted to increase the exposure to

phosphodiesterase type-5 inhibitors (sildenafil). Use with caution

and adjust dose.rTheoretical

▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)

are predicted to increase the exposure to phosphodiesterase

type-5 inhibitors (sildenafil). Monitor or adjust sildenafil dose

with moderate inhibitors of CYP3A4, p. 813.oStudy →

Also see TABLE 9 p. 1377

▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to increase the exposure to phosphodiesterase type-5

inhibitors (sildenafil). Avoid potent inhibitors of CYP3A4 or

adjust sildenafil dose, p. 813.rStudy → Also see TABLE 9

p. 1377

▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)

are predicted to increase the exposure to phosphodiesterase

type-5 inhibitors (tadalafil).rTheoretical

▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to increase the exposure to phosphodiesterase type-5

inhibitors (tadalafil). Use with caution or avoid.rStudy

▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)

are predicted to increase the exposure to phosphodiesterase

type-5 inhibitors (vardenafil). Adjust dose.rTheoretical →

Also see TABLE 9 p. 1377

▶ Antifungals, azoles (itraconazole, ketoconazole) are predicted to

increase the exposure to pibrentasvir.oTheoretical

▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)

are predicted to increase the exposure to

r

pimozide. Avoid.

Theoretical → Also see TABLE 9 p. 1377

▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to increase the exposure to

Study → Also see TABLE 9 p. 1377

pimozide. Avoid.r

▶ Miconazole is predicted to increase the exposure to pimozide.

Avoid.oTheoretical

▶ Pioglitazone potentially decreases the exposure to

isavuconazole. Use with caution or avoid.oTheoretical

▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to slightly increase the exposure to ponatinib.

Monitor and adjust ponatinib dose, p. 994.oStudy

▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to moderately increase the exposure to

praziquantel.nStudy

▶ Proton pump inhibitors decrease the absorption of

itraconazole. Administer itraconazole capsules with an acidic

beverage, p. 597.oStudy

▶ Proton pump inhibitors decrease the absorption of

ketoconazole. Administer ketoconazole with an acidic

beverage, p. 681.oStudy

▶ Proton pump inhibitors decrease the absorption of

posaconazole (oral suspension). Avoid.oStudy

▶ Voriconazole increases the exposure to proton pump inhibitors

(esomeprazole, omeprazole). Adjust dose.oStudy

▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)

are predicted to increase the exposure to

o

quetiapine. Avoid.

Study

▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to increase the exposure to

r

quetiapine. Avoid.

Study

▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)

are predicted to increase the exposure to

Study → Also see TABLE 9 p. 1377

ranolazine.r

▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to increase the exposure to

r

ranolazine. Avoid.

Study → Also see TABLE 9 p. 1377

▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to increase the exposure to

o

reboxetine. Avoid.

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