Drug interactions between fluconazole and Prevacid IV
|Prevacid IV (lansoprazole)|
Interactions between your selected drugs
Consumer information for this interaction is not currently available.
ADJUST DOSE: Coadministration with fluconazole may significantly increase the plasma concentrations of omeprazole and other proton pump inhibitors (PPIs). The proposed mechanism is fluconazole inhibition of PPI metabolism via CYP450 2C19 and 3A4. In 18 healthy volunteers, administration of a single 20 mg oral dose of omeprazole on day 5 of multiple once daily dosing of fluconazole 100 mg resulted in approximately 2.4- and 6.3-fold increases in omeprazole peak plasma concentration (Cmax) and systemic exposure (AUC), respectively, compared to administration of omeprazole alone. Terminal half-life of omeprazole was increased from 0.85 hour to 2.59 hours by fluconazole. Since all PPIs are metabolized by CYP450 2C19 and 3A4, a similar interaction with fluconazole should be expected. Omeprazole does not appear to affect the gastrointestinal absorption of fluconazole like it does some other azole antifungal agents. In a study of 12 healthy volunteers, omeprazole 20 mg/day for 7 days increased median gastric pH from 1.1 to 4.7, but had no effect on the Cmax or AUC of a single 100 mg oral dose of fluconazole. The median bioavailability ratio of fluconazole before and after omeprazole treatment was 1.00.
MANAGEMENT: According to the manufacturers, dosage adjustment of omeprazole is not normally required when used with dual inhibitors of CYP450 2C19 and 3A4 such as fluconazole. However, it may be necessary in patients receiving higher dosages, such as those with Zollinger-Ellison syndrome. Patients should be monitored for potentially increased adverse effects of PPIs during coadministration with fluconazole. The same precaution may be applicable to other PPIs.
- "Product Information. Aciphex (rabeprazole)" Janssen Pharmaceuticals, Titusville, NJ.
- "Product Information. Protonix (pantoprazole)" Wyeth-Ayerst Laboratories, Philadelphia, PA.
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
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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