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Fluconazole Disease Interactions

There are 4 disease interactions with fluconazole:

Major

Fluconazole (Includes Fluconazole) ↔ Hepatotoxicity

Severe Potential Hazard, Low plausibility

Applies to: Liver Disease

The use of fluconazole has been rarely associated with hepatotoxicity. Reversible idiosyncratic hepatitis, cholestasis and fatal fulminant hepatic failure have been reported, the latter occurring primarily in patients with serious underlying medical conditions and taking multiple concomitant medications. Liver function tests should be performed periodically in patients with preexisting hepatic abnormalities, particularly during prolonged therapy. Treatment should be withdrawn if persistent elevations or worsening of liver enzyme levels occur.

References

  1. Munoz P, Moreno S, Berenguer J, et al "Fluconazole-related hepatotoxicity in patients with acquired immunodeficiency syndrome." Arch Intern Med 151 (1991): 1020-1
  2. Wells C, Lever AM "Dose-dependent fluconazole hepatotoxicity proven on biopsy and rechallenge ." J Infect 24 (1992): 111-2
  3. Franklin IM, Elias E, Hirsch C "Fluconazole-induced jaundice." Lancet 336 (1990): 565
View all 10 references
Moderate

Azole Antifungals (Includes Fluconazole) ↔ Qt Prolongation

Moderate Potential Hazard, Moderate plausibility

Applies to: Long QT Syndrome, Arrhythmias

Most of the azole antifungals have been associated with prolongation of the QT interval. There have been postmarketing rare reports of QT prolongation, and torsade de pointes usually involving patients with risk factors such as structural heart disease, electrolyte abnormalities, and concomitant medications. These drugs should be administered with caution to patients with potentially proarrhythmic conditions. Concomitant use with other medications that have potential to increase the risk of cardiotoxicity should be avoided.

Moderate

Fluconazole (Includes Fluconazole) ↔ Hemodialysis

Moderate Potential Hazard, High plausibility

Applies to: hemodialysis

Fluconazole is substantially removed by hemodialysis. Plasma levels of fluconazole has been shown to reduce by 50% following 3 hours of dialysis. Fluconazole should be administered after hemodialysis.

References

  1. "Product Information. Diflucan (fluconazole)." Roerig Division, New York, NY.
  2. Toon S, Ross CE, Gokal R, Rowland M "An assessment of the effects of impaired renal function and haemodialysis on the pharmacokinetics of fluconazole." Br J Clin Pharmacol 29 (1990): 221-6
  3. Oono S, Tabei K, Tetsuka T, Asano Y "The pharmacokinetics of fluconazole during haemodialysis in uraemic patients." Eur J Clin Pharmacol 42 (1992): 667-70
Moderate

Fluconazole (Includes Fluconazole) ↔ Renal Dysfunction

Moderate Potential Hazard, High plausibility

Applies to: Renal Dysfunction

Fluconazole is primarily eliminated by the kidney. Patients with renal impairment may be at greater risk for adverse effects from fluconazole due to decreased drug clearance. Dosage adjustments are recommended for patients with moderate to severe renal impairment (CrCl <= 50 mL/min) receiving multiple doses of the drug.

References

  1. Debruyne D, Ryckelynck JP "Clinical pharmacokinetics of fluconazole." Clin Pharmacokinet 24 (1993): 10-27
  2. Toon S, Ross CE, Gokal R, Rowland M "An assessment of the effects of impaired renal function and haemodialysis on the pharmacokinetics of fluconazole." Br J Clin Pharmacol 29 (1990): 221-6
  3. "Product Information. Diflucan (fluconazole)." Roerig Division, New York, NY.

fluconazole drug Interactions

There are 651 drug interactions with fluconazole

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

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.

Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. Multum's information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2016 Multum Information Services, Inc. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.

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