Can you take Loteprednol ophthalmic with Sporanox?
1 drug interaction and 16 additional warnings found for the following 2 drugs:
- loteprednol ophthalmic
- Sporanox (itraconazole)
Drug interactions
Moderate drug interactions
Moderate:
itraconazole loteprednol ophthalmic
Applies to: Sporanox (itraconazole) and loteprednol ophthalmic
Itraconazole may increase the blood levels of loteprednol ophthalmic. You may be more likely to experience side effects such as swelling, weight gain, high blood pressure, high blood glucose, muscle weakness, depression, acne, thinning skin, stretch marks, easy bruising, bone density loss, cataracts, menstrual irregularities, excessive growth of facial or body hair, and abnormal distribution of body fat, especially in the face, neck, back, and waist. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Other side effects that may occur include decreased ability to fight infections, increased risk of developing infections, and inadequate response to stress such as infection, surgery, trauma, or a severe asthma attack. Children may experience a reduced growth rate due to excessive effects of loteprednol ophthalmic. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
itraconazole Food/Lifestyle
Applies to: Sporanox (itraconazole)
Food increases the absorption of itraconazole capsules but decreases the absorption of itraconazole oral solution. Capsules should be taken immediately after a full meal and the solution be taken on an empty stomach to ensure best results.
Disease interactions
15 potential interactions Applies to: 14 conditions, including COPD, Arrhythmia, Eye Conditions, Heart Disease, and Cataract.
Achlorhydria
Moderate:
Sporanox
The itraconazole in Sporanox has a moderate potential interaction with Achlorhydria.
Itraconazole 100-mg capsules should be administered after a full meal. Under fasted conditions, absorption of itraconazole from the 100-mg capsule formulation was diminished with decreased gastric acidity. Studies conducted under fasted conditions showed that taking the 100-mg capsule formulation with 8 ounces of a non-diet cola beverage enhanced absorption of itraconazole in AIDS patients with relative or absolute achlorhydria; this increase relative to the effects of a full meal is unknown.
Arrhythmia
Moderate:
Sporanox
The itraconazole in Sporanox has a moderate potential interaction with Arrhythmia.
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, such as congenital/acquired QT prolongation, cardiomyopathy (especially when heart failure is present), sinus bradycardia, and existing symptomatic arrhythmias. Concomitant use with other medications that have potential to increase the risk of cardiotoxicity should be avoided.
Cataract
Major:
loteprednol ophthalmic
Loteprednol ophthalmic has a major potential interaction with Cataract.
Prolonged use of corticosteroids may cause posterior subcapsular cataracts and elevated intraocular pressure, the latter of which may lead to glaucoma and/or damage to the optic nerves. Therapy with ophthalmic corticosteroids should be administered cautiously in patients with a history of cataracts, glaucoma, or increased intraocular pressure. If these agents are used for more than 10 days, the manufacturers recommend that intraocular pressure be routinely monitored, including in children. The equatorial and posterior subcapsular portions of the lens should be examined for changes.
COPD
Major:
Sporanox
The itraconazole in Sporanox has a major potential interaction with COPD.
Itraconazole may possess a dose-related negative inotropic effect. Transient, asymptomatic decreases in left ventricular ejection fraction were observed with IV administration in healthy volunteers; these resolved before the next infusion. Additionally, cases of congestive heart failure (CHF), peripheral edema, and pulmonary edema have been reported during postmarketing experience in patients treated for onychomycosis and/or systemic fungal infections. Itraconazole should not be used to treat onychomycosis in patients with evidence of ventricular dysfunction such as CHF or history of CHF; itraconazole should not be used for other indications in such patients unless the benefit clearly outweighs the risk. The risks and benefits of itraconazole therapy should be reviewed carefully in patients with risk factors for CHF (including cardiac disease [e.g., ischemic and valvular disease], significant pulmonary disease [e.g., chronic obstructive pulmonary disease], renal failure and other edematous disorders). Patients with risk factors for CHF should be advised of the signs/symptoms of CHF, treated with caution, and monitored for signs/symptoms of CHF during therapy.
Cystic Fibrosis
Moderate:
Sporanox
The itraconazole in Sporanox has a moderate potential interaction with Cystic Fibrosis.
In a study using itraconazole oral solution in cystic fibrosis patients, therapeutic drug levels varied and were not reached in some patients. Alternative therapy should be considered for patients who do not respond to itraconazole oral solution or itraconazole 100-mg capsules.
Eye Conditions
Major:
loteprednol ophthalmic
Loteprednol ophthalmic has a major potential interaction with Eye Conditions.
The use of ophthalmic corticosteroids is contraindicated in most viral diseases of the cornea and conjunctiva, including epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, and varicella; fungal diseases of ocular structures; mycobacterial infections, including tuberculosis, of the eye; and any acute, purulent, untreated ocular infections. Corticosteroids may decrease host resistance to infectious agents, thus prolonging the course and/or exacerbating the severity of the infection while encouraging the development of new or secondary infection. In addition, administration of ophthalmic corticosteroids in severe ocular disease, especially acute herpes simplex keratitis, may lead to excessive corneal and scleral thinning, increasing the risk for perforation. In less serious ocular infections, therapy with ophthalmic corticosteroids may be administered but only with caution and accompanied by appropriate antimicrobial agents. Besides compromising host immune response, corticosteroids may also mask the symptoms of infection, thus hindering the recognition of potential ineffectiveness of the antibiotic therapy. If infection does not improve or becomes worse during administration of an ophthalmic corticosteroid, the drug should be discontinued and other appropriate therapy initiated.
Fluid Retention
Major:
Sporanox
The itraconazole in Sporanox has a major potential interaction with Fluid Retention.
Itraconazole may possess a dose-related negative inotropic effect. Transient, asymptomatic decreases in left ventricular ejection fraction were observed with IV administration in healthy volunteers; these resolved before the next infusion. Additionally, cases of congestive heart failure (CHF), peripheral edema, and pulmonary edema have been reported during postmarketing experience in patients treated for onychomycosis and/or systemic fungal infections. Itraconazole should not be used to treat onychomycosis in patients with evidence of ventricular dysfunction such as CHF or history of CHF; itraconazole should not be used for other indications in such patients unless the benefit clearly outweighs the risk. The risks and benefits of itraconazole therapy should be reviewed carefully in patients with risk factors for CHF (including cardiac disease [e.g., ischemic and valvular disease], significant pulmonary disease [e.g., chronic obstructive pulmonary disease], renal failure and other edematous disorders). Patients with risk factors for CHF should be advised of the signs/symptoms of CHF, treated with caution, and monitored for signs/symptoms of CHF during therapy.
Glaucoma/Intraocular Hypertension
Major:
loteprednol ophthalmic
Loteprednol ophthalmic has a major potential interaction with Glaucoma/Intraocular Hypertension.
Prolonged use of corticosteroids may cause posterior subcapsular cataracts and elevated intraocular pressure, the latter of which may lead to glaucoma and/or damage to the optic nerves. Therapy with ophthalmic corticosteroids should be administered cautiously in patients with a history of cataracts, glaucoma, or increased intraocular pressure. If these agents are used for more than 10 days, the manufacturers recommend that intraocular pressure be routinely monitored, including in children. The equatorial and posterior subcapsular portions of the lens should be examined for changes.
Heart Disease
Major:
Sporanox
The itraconazole in Sporanox has a major potential interaction with Heart Disease.
Itraconazole may possess a dose-related negative inotropic effect. Transient, asymptomatic decreases in left ventricular ejection fraction were observed with IV administration in healthy volunteers; these resolved before the next infusion. Additionally, cases of congestive heart failure (CHF), peripheral edema, and pulmonary edema have been reported during postmarketing experience in patients treated for onychomycosis and/or systemic fungal infections. Itraconazole should not be used to treat onychomycosis in patients with evidence of ventricular dysfunction such as CHF or history of CHF; itraconazole should not be used for other indications in such patients unless the benefit clearly outweighs the risk. The risks and benefits of itraconazole therapy should be reviewed carefully in patients with risk factors for CHF (including cardiac disease [e.g., ischemic and valvular disease], significant pulmonary disease [e.g., chronic obstructive pulmonary disease], renal failure and other edematous disorders). Patients with risk factors for CHF should be advised of the signs/symptoms of CHF, treated with caution, and monitored for signs/symptoms of CHF during therapy.
Immunodeficiency
Moderate:
Sporanox
The itraconazole in Sporanox has a moderate potential interaction with Immunodeficiency.
The oral bioavailability of itraconazole 100-mg capsules may be decreased in some immunocompromised patients (e.g., neutropenic patients, AIDS patients, organ transplant recipients); in addition, since hypochlorhydria has been reported in HIV-infected patients, the absorption of itraconazole may be reduced in these patients. The dose of itraconazole 100-mg capsules should be adjusted based on the clinical response of such patients.
Itraconazole oral solution is not recommended for initial treatment in severely neutropenic patients at immediate risk of systemic candidiasis.
Liver Disease
Major:
Sporanox
The itraconazole in Sporanox has a major potential interaction with Liver Disease.
Limited data are available on the use of oral itraconazole in patients with liver dysfunction. Itraconazole has been associated with rare cases of serious hepatotoxicity (including liver failure and death). Caution is recommended when this drug is used in patients with liver dysfunction; such patients should be carefully monitored during therapy. Treatment with itraconazole is strongly discouraged in patients with elevated or abnormal liver enzymes, with active liver disease, or who had liver toxicity with other drugs unless the situation is serious or life-threatening and the expected benefit exceeds the risk. Liver function monitoring is recommended for patients with preexisting hepatic function abnormalities or those who had liver toxicity with other drugs.
Neutropenia
Moderate:
Sporanox
The itraconazole in Sporanox has a moderate potential interaction with Neutropenia.
The oral bioavailability of itraconazole 100-mg capsules may be decreased in some immunocompromised patients (e.g., neutropenic patients, AIDS patients, organ transplant recipients); in addition, since hypochlorhydria has been reported in HIV-infected patients, the absorption of itraconazole may be reduced in these patients. The dose of itraconazole 100-mg capsules should be adjusted based on the clinical response of such patients.
Itraconazole oral solution is not recommended for initial treatment in severely neutropenic patients at immediate risk of systemic candidiasis.
Organ Transplant
Moderate:
Sporanox
The itraconazole in Sporanox has a moderate potential interaction with Organ Transplant.
The oral bioavailability of itraconazole 100-mg capsules may be decreased in some immunocompromised patients (e.g., neutropenic patients, AIDS patients, organ transplant recipients); in addition, since hypochlorhydria has been reported in HIV-infected patients, the absorption of itraconazole may be reduced in these patients. The dose of itraconazole 100-mg capsules should be adjusted based on the clinical response of such patients.
Itraconazole oral solution is not recommended for initial treatment in severely neutropenic patients at immediate risk of systemic candidiasis.
Renal Dysfunction
Major:
Sporanox
The itraconazole in Sporanox has a major potential interaction with Renal Dysfunction.
Itraconazole may possess a dose-related negative inotropic effect. Transient, asymptomatic decreases in left ventricular ejection fraction were observed with IV administration in healthy volunteers; these resolved before the next infusion. Additionally, cases of congestive heart failure (CHF), peripheral edema, and pulmonary edema have been reported during postmarketing experience in patients treated for onychomycosis and/or systemic fungal infections. Itraconazole should not be used to treat onychomycosis in patients with evidence of ventricular dysfunction such as CHF or history of CHF; itraconazole should not be used for other indications in such patients unless the benefit clearly outweighs the risk. The risks and benefits of itraconazole therapy should be reviewed carefully in patients with risk factors for CHF (including cardiac disease [e.g., ischemic and valvular disease], significant pulmonary disease [e.g., chronic obstructive pulmonary disease], renal failure and other edematous disorders). Patients with risk factors for CHF should be advised of the signs/symptoms of CHF, treated with caution, and monitored for signs/symptoms of CHF during therapy.
Moderate:
Sporanox
The itraconazole in Sporanox has a moderate potential interaction with Renal Dysfunction.
Limited data are available on the use of oral itraconazole in patients with renal dysfunction; itraconazole exposure may be lower in some of these patients. Caution is advised when using itraconazole in patients with renal dysfunction and dose adjustment may be needed. Patients with renal dysfunction should be carefully monitored when using the 65-mg capsule formulation.
More resources
loteprednol ophthalmic
A total of 147 drugs are known to interact with loteprednol ophthalmic.
- Loteprednol ophthalmic is in the drug class ophthalmic steroids.
- Loteprednol ophthalmic is used to treat the following conditions:
Sporanox
A total of 597 drugs are known to interact with Sporanox.
- Sporanox is in the drug class azole antifungals.
-
Sporanox is used to treat the following conditions:
- Aspergillosis, Aspergilloma
- Aspergillosis, Invasive
- Blastomycosis
- Candida Urinary Tract Infection
- Candidemia
- Coccidioidomycosis
- Cryptococcal Meningitis, Immunosuppressed Host
- Cryptococcosis
- Dermatophytosis
- Esophageal Candidiasis
- Febrile Neutropenia
- Fungal Infection Prophylaxis
- Histoplasmosis
- Microsporidiosis
- Onychomycosis, Fingernail
- Onychomycosis, Toenail
- Oral Thrush
- Paracoccidioidomycosis
- Sporotrichosis
- Systemic Fungal Infection
- Tinea Capitis
- Tinea Versicolor
- Vaginal Yeast Infection
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
Further information
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