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Drug Interactions between Mycobutin and voriconazole

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

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Interactions between your drugs

Major

rifabutin voriconazole

Applies to: Mycobutin (rifabutin) and voriconazole

CONTRAINDICATED: Coadministration with rifabutin may significantly reduce the plasma concentrations of voriconazole. The mechanism is rifabutin induction of CYP450 isoenzymes that are responsible for the metabolic clearance of voriconazole. According to the manufacturer, rifabutin (300 mg once daily) decreased the peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of voriconazole (200 mg every 12 hours) by an average of 67% and 79%, respectively, in healthy subjects. Doubling the dose of voriconazole with the same dosage of rifabutin resulted in Cmax and AUC that were on average approximately 2 times higher compared with voriconazole alone at 200 mg twice daily. Coadministration of voriconazole at 400 mg twice daily with rifabutin at 300 mg twice daily increased the Cmax and AUC of rifabutin by an average of 3- and 4-fold, respectively, compared to rifabutin given alone.

MANAGEMENT: The use of voriconazole with rifabutin is considered contraindicated.

References (1)
  1. (2002) "Product Information. VFEND (voriconazole)." Pfizer U.S. Pharmaceuticals

Drug and food interactions

Moderate

voriconazole food

Applies to: voriconazole

ADJUST DOSING INTERVAL: Food reduces the oral absorption and bioavailability of voriconazole. According to the product labeling, administration of multiple doses of voriconazole with high-fat meals decreased the mean peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) by 34% and 24%, respectively, when the drug is administered as a tablet, and by 58% and 37%, respectively, when administered as the oral suspension.

MANAGEMENT: To ensure maximal oral absorption, voriconazole tablets and oral suspension should be taken at least one hour before or after a meal.

References (2)
  1. (2002) "Product Information. VFEND (voriconazole)." Pfizer U.S. Pharmaceuticals
  2. Wohlt PD, Zheng L, Gunderson S, Balzar SA, Johnson BD, Fish JT (2009) "Recommendations for the use of medications with continuous enteral nutrition." Am J Health Syst Pharm, 66, p. 1438-67

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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