Can you take Mitoxantrone with Sporanox?
1 drug interaction and 21 additional warnings found for the following 2 drugs:
- mitoxantrone
- Sporanox (itraconazole)
Drug interactions
Moderate drug interactions
Moderate:
itraconazole mitoXANTRONE
Applies to: Sporanox (itraconazole) and mitoxantrone
Itraconazole may increase the blood levels of mitoXANTRONE. This can increase the risk of side effects such as irregular heartbeat, heart failure, and impaired bone marrow function resulting in low numbers of different types of blood cells. You may also be more likely to develop anemia, bleeding problems, or infections due to low blood cell counts. Contact your doctor if you experience potential signs and symptoms of these conditions such as paleness, fatigue, dizziness, fainting, unusual bleeding or bruising, fever, chills, sore throat, body aches, or other flu-like symptoms. You should seek immediate medical attention if you experience sudden, unexplained weight gain; swelling of the hands, ankles, or feet; chest pain; or difficulty breathing, as these may be indications of heart failure. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. 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
20 potential interactions Applies to: 16 conditions, including COPD, Arrhythmia, Fever, Heart Disease, and Fluid Retention.
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.
Bleeding Disorder
Major:
mitoxantrone
mitoXANTRONE has a major potential interaction with Bleeding Disorder.
Mitoxantrone induces myelosuppression when administered at therapeutic doses indicated for treatment of leukemia. Leukopenia is the most profound hematologic side-effect. Thrombocytopenia is rare, but can be severe and erythrocytes do not appear to be significantly affected. Therapy with mitoxantrone should be withheld in patients whose bone marrow function is severely depressed by prior irradiation or chemotherapy or whose marrow function is recovering from previous cytotoxic therapy. If the need outweighs the risk, extreme caution should be exercised in administering mitoxantrone. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Close clinical monitory of hematopoietic function is recommended.
Bone Marrow Depression/Low Blood Counts
Major:
mitoxantrone
mitoXANTRONE has a major potential interaction with Bone Marrow Depression/Low Blood Counts.
Mitoxantrone induces myelosuppression when administered at therapeutic doses indicated for treatment of leukemia. Leukopenia is the most profound hematologic side-effect. Thrombocytopenia is rare, but can be severe and erythrocytes do not appear to be significantly affected. Therapy with mitoxantrone should be withheld in patients whose bone marrow function is severely depressed by prior irradiation or chemotherapy or whose marrow function is recovering from previous cytotoxic therapy. If the need outweighs the risk, extreme caution should be exercised in administering mitoxantrone. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Close clinical monitory of hematopoietic function is recommended.
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.
Fever
Major:
mitoxantrone
mitoXANTRONE has a major potential interaction with Fever.
Mitoxantrone induces myelosuppression when administered at therapeutic doses indicated for treatment of leukemia. Leukopenia is the most profound hematologic side-effect. Thrombocytopenia is rare, but can be severe and erythrocytes do not appear to be significantly affected. Therapy with mitoxantrone should be withheld in patients whose bone marrow function is severely depressed by prior irradiation or chemotherapy or whose marrow function is recovering from previous cytotoxic therapy. If the need outweighs the risk, extreme caution should be exercised in administering mitoxantrone. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Close clinical monitory of hematopoietic function is recommended.
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.
Heart Disease
Major:
mitoxantrone
mitoXANTRONE has a major potential interaction with Heart Disease.
Mitoxantrone can cause myocardial toxicity leading to congestive heart failure (CHF). Patients with preexisting heart disease, prior irradiation, previous therapy with related compounds such as daunorubicin, idarubicin or doxorubicin, or of advanced age are at increased risk of cardiotoxicity at a lower cumulative dose. The incidence of drug-induced congestive heart failure in adults is increased when the total cumulative dose of mitoxantrone exceeds 140 mg/m2. Close clinical monitoring of cardiac function, such as determination of left ventricular ejection fraction, prior to each course of therapy is recommended.
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.
Hyperuricemia Secondary to Chemotherapy
Moderate:
mitoxantrone
mitoXANTRONE has a moderate potential interaction with Hyperuricemia Secondary to Chemotherapy.
Treatment with mitoxantrone may cause hyperuricemia as a result of rapid lysis of tumor cells. Levels of serum uric acid should be monitored and appropriate therapy should be initiated before starting 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.
Infection
Major:
mitoxantrone
mitoXANTRONE has a major potential interaction with Infection.
Mitoxantrone induces myelosuppression when administered at therapeutic doses indicated for treatment of leukemia. Leukopenia is the most profound hematologic side-effect. Thrombocytopenia is rare, but can be severe and erythrocytes do not appear to be significantly affected. Therapy with mitoxantrone should be withheld in patients whose bone marrow function is severely depressed by prior irradiation or chemotherapy or whose marrow function is recovering from previous cytotoxic therapy. If the need outweighs the risk, extreme caution should be exercised in administering mitoxantrone. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Close clinical monitory of hematopoietic function is recommended.
Major:
mitoxantrone
mitoXANTRONE has a major potential interaction with Infection.
Because of their cytotoxic effects on rapidly proliferating tissues, antineoplastic agents frequently can, to varying extent, induce myelosuppression. The use of these drugs may be contraindicated in patients with known infectious diseases. All patients should be instructed to immediately report any signs or symptoms suggesting infection such as fever, sore throat, or local infection during antineoplastic therapy. Close clinical monitoring of hematopoietic function is recommended.
Liver Disease
Major:
mitoxantrone
mitoXANTRONE has a major potential interaction with Liver Disease.
Hepatic impairment reduces mitoxantrone clearance. Patients with severe hepatic dysfunction (bilirubin > 3.4 mg/dL) have an AUC more than three times greater than that of patients with normal hepatic function receiving the same dose. Therapy with mitoxantrone should be administered cautiously to patients with significantly compromised hepatic function.
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
mitoxantrone
A total of 385 drugs are known to interact with mitoxantrone.
- Mitoxantrone is in the drug class antibiotics/antineoplastics.
- Mitoxantrone 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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