Drug interactions between Plendil and Sporanox
| Results for the following 2 drugs: |
|---|
| Plendil (felodipine) |
| Sporanox (itraconazole) |
Interactions between your selected drugs
itraconazole ↔ felodipine
Applies to:Sporanox (itraconazole) and Plendil (felodipine)
CONTRAINDICATED: Coadministration with itraconazole may significantly increase the plasma concentrations of felodipine. The mechanism is decreased clearance and/or first-pass metabolism of felodipine due to inhibition of CYP450 3A4 enzymatic activity by itraconazole. In nine healthy volunteers, administration of a single 5 mg oral dose of felodipine following pretreatment with itraconazole 200 mg once daily for 4 days resulted in an average of nearly 8-fold increase in felodipine peak plasma concentration (Cmax), 6-fold increase in systemic exposure (AUC), and 2-fold increase in elimination half-life compared to administration with placebo. The decreases in blood pressure and increases in heart rate were also significantly greater during the itraconazole phase than during the placebo phase. There have been case reports of leg and ankle edema in patients treated with itraconazole and other dihydropyridine calcium channel blockers. Pharmacodynamically, itraconazole exhibits a dose-related negative inotropic effect, which may be additive to those of calcium channel blockers (CCBs). It is conceivable that coadministration may potentiate the risk of ventricular dysfunction, congestive heart failure, and peripheral and pulmonary edema, particularly in patients with preexisting risk factors (e.g., a history of congestive heart failure; cardiac disease such as ischemic and valvular disease; significant pulmonary disease such as chronic obstructive pulmonary disorder; edematous disorders such as renal failure). Itraconazole alone has also been associated with postmarketing reports of congestive heart failure, peripheral edema, and pulmonary edema in patients treated for onychomycosis and/or systemic fungal infections. Heart failure was more frequently reported in patients receiving a dosage of 400 mg/day, although there were also cases reported among those receiving lower daily dosages.
MANAGEMENT: Because the interaction between itraconazole and felodipine cannot be managed by dosage reduction of the latter, concomitant use is considered contraindicated.
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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