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Fluconazole Disease Interactions

There are 4 disease interactions with fluconazole:

Major

Fluconazole (applies to fluconazole) hepatotoxicity

Major Potential Hazard, Low plausibility. Applicable conditions: 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 Treatment should be withdrawn if persistent elevations or worsening of liver enzyme levels occur.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. Holechek MJ "Medication review: fluconazole." ANNA J 18 (1991): 585-6
  3. Wells C, Lever AM "Dose-dependent fluconazole hepatotoxicity proven on biopsy and rechallenge ." J Infect 24 (1992): 111-2
  4. Franklin IM, Elias E, Hirsch C "Fluconazole-induced jaundice." Lancet 336 (1990): 565
  5. "Product Information. Diflucan (fluconazole)." Roerig Division, New York, NY.
  6. Gearhart MO "Worsening of liver function with fluconazole and review of azole antifungal hepatotoxicity." Ann Pharmacother 28 (1994): 1177-81
  7. Guillaume MP, Deprez C, Cogan E "Subacute mitochondrial liver disease in a patient with AIDS: possible relationship to prolonged fluconazole administration." Am J Gastroenterol 91 (1996): 165-8
  8. Grant SM, Clissold SP "Fluconazole: a review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in superficial and systemic mycoses." Drugs 39 (1990): 877-916
  9. Jacobson MA, Hanks DK, Ferrell LD "Fatal acute hepatic necrosis due to fluconazole." Am J Med 96 (1994): 188-90
  10. Ruhnke M, Yeates RA, Pfaff G, Sarnow E, Hartmann A, Trautmann M "Single-dose pharmacokinetics of fluconazole in patients with liver cirrhosis." J Antimicrob Chemother 35 (1995): 641-7
View all 10 references
Moderate

Azole antifungals (applies to fluconazole) QT prolongation

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Arrhythmias

Some azole antifungals have been associated with prolongation of the QT interval on the ECG. Rare cases of QT prolongation and torsade de pointes have been reported during postmarketing experience; such reports usually involved seriously ill patients with multiple confounding 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 (applies to fluconazole) hemodialysis

Moderate Potential Hazard, High plausibility.

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 (applies to fluconazole) renal dysfunction

Moderate Potential Hazard, High plausibility.

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. "Product Information. Diflucan (fluconazole)." Roerig Division, New York, NY.
  3. 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

Fluconazole drug interactions

There are 526 drug interactions with fluconazole

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
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.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.