Drug interactions between Diflucan and levofloxacin

Results for the following 2 drugs:
Diflucan (fluconazole)
levofloxacin

Interactions between your selected drugs

fluconazole ↔ levofloxacin

Applies to:Diflucan (fluconazole) and levofloxacin

MONITOR: In one case report, coadministration of fluconazole and levofloxacin was suspected in causing QT prolongation and torsade de pointes ventricular arrhythmia. The exact mechanism of interaction is unknown, although both agents have individually been associated with these events on rare occasions. The case patient was a 53-year-old man who was being managed for possible nosocomial pneumonia and received intravenous levofloxacin for 8 doses over 14 days and intravenous fluconazole for 2 doses over 2 days before developing torsade de pointes. His QTc interval was 655 ms and remained prolonged for 12 days after resolution of the arrhythmia, despite discontinuation of both medications and substitution with caspofungin. His medical history includes paroxysmal atrial fibrillation, chronic obstructive pulmonary disease, type I diabetes mellitus, and hemodialysis-dependent diabetic nephropathy. Electrolyte imbalance and prior medications were ruled out as possible causes. However, the patient may have received more fluconazole than intended due to inadvertent administration on a day he did not receive dialysis.

MANAGEMENT: Caution is advised if fluconazole is coadministered with levofloxacin. Patients should be advised to seek medical attention if they experience symptoms that could indicate the occurrence of torsade de pointes such as dizziness, palpitations, or syncope.

See also...

Drug Interaction Classification

The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.


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