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Drug Interactions between allopurinol / lesinurad and fluconazole

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

fluconazole lesinurad

Applies to: fluconazole and allopurinol / lesinurad

MONITOR: Coadministration with inhibitors of CYP450 2C9 may increase the plasma concentrations of lesinurad, which is primarily metabolized by the isoenzyme. According to the manufacturer, administration of lesinurad with the moderate CYP450 2C9 inhibitor fluconazole (200 mg daily) increased lesinurad peak plasma concentration (Cmax) and systemic exposure (AUC) by approximately 35% and 55%, respectively, compared to administration of lesinurad alone. In a cross-study pharmacogenomic analysis conducted in patients receiving single or multiple doses of lesinurad, patients who were deficient in CYP450 2C9 activity (i.e., CYP450 2C9 poor metabolizers) had an approximately 1.8-fold higher exposure to lesinurad at the 400 mg dose than extensive metabolizers.

MANAGEMENT: Caution is advised when lesinurad is prescribed with CYP450 2C9 inhibitors. Patients should be closely monitored for adverse renal effects such as serum creatinine elevations, renal function impairment, and nephrolithiasis. It may be advisable to avoid concomitant use with a potent CYP450 2C9 inhibitor such as gemfibrozil.

References

  1. "Product Information. Zurampic (lesinurad)." Astra-Zeneca Pharmaceuticals (2015):

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Drug and food interactions

No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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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.

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