▶ 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
ketoconazole. Use with caution and adjust dose.o
▶ Miconazole is predicted to increase the concentration of HIVprotease inhibitors
. Use with caution and adjust dose.
▶ 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
dose with moderate inhibitors of CYP3A4, p. 983.
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to very markedly increase the exposure to ibrutinib.
Avoid potent inhibitors of CYP3A4 or adjust ibrutinib dose,
▶ 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
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the risk of toxicity when given with
▶ 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
▶ 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
p. 295 dose with potent inhibitors of CYP3A4.
▶ Lanthanum is predicted to decrease the absorption of
. Separate administration by at least 2 hours.
▶ 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
Study → Also see TABLE 9 p. 1377
slightly decreases the exposure to voriconazole.
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure to
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
. 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,
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to
▶ Posaconazole moderately increases the exposure to lurasidone.
BNF 78 Antifungals, azoles — Antifungals, azoles 1403
Antifungals, azoles (continued)
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to
macitentan.o ▶ Macrolides (clarithromycin) are predicted to increase the
isavuconazole. Avoid or monitor side effects.
▶ 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.
▶ 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
midazolam. Use with caution and adjust dose.
▶ Miconazole is predicted to increase the exposure to oral
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure to
▶ 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
dose in hepatic and renal impairment, p. 781.
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to
mirtazapine.o ▶ Mitotane is predicted to decrease the exposure to
▶ 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
increases the exposure to mycophenolate.
▶ 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.
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to
netupitant.o ▶ Netupitant is predicted to decrease the exposure to
▶ Fluconazole slightly to moderately increases the exposure to
▶ 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
▶ 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
▶ 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
▶ 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
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to olaparib. Avoid potent
inhibitors of CYP3A4 or adjust
olaparib dose, p. 1005.o ▶ Miconazole is predicted to increase the exposure to opioids
are predicted to increase the exposure to opioids (alfentanil,
buprenorphine, fentanyl, oxycodone)
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to opioids (alfentanil,
buprenorphine, fentanyl, oxycodone, sufentanil). Monitor and
▶ 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
▶ 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
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
▶ 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
1404 Antifungals, azoles — Antifungals, azoles BNF 78
▶ Miconazole greatly increases the anticoagulant effect of
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure to phosphodiesterase
predicted to increase the exposure to phosphodiesterase type-5
inhibitors (avanafil, vardenafil). Avoid.rStudy → Also see
▶ Miconazole is predicted to increase the exposure to
phosphodiesterase type-5 inhibitors (sildenafil). Use with caution
▶ 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 →
▶ 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
▶ 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 →
▶ 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
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
▶ Miconazole is predicted to increase the exposure to pimozide.
▶ 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
▶ Proton pump inhibitors decrease the absorption of
itraconazole. Administer itraconazole capsules with an acidic
▶ Proton pump inhibitors decrease the absorption of
ketoconazole. Administer ketoconazole with an acidic
▶ 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
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure to
Study → 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
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
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