Skip to main content

Can you take Pegaspargase with Sporanox?

1 drug interaction and 19 additional warnings found for the following 2 drugs:

Add/remove drugs

Drug interactions

Moderate drug interactions

Moderate:

itraconazole pegaspargase

Applies to: Sporanox (itraconazole) and pegaspargase

Talk to your doctor before using itraconazole together with pegaspargase. Combining these medications may increase the risk of side effects such as liver damage. You may need more frequent monitoring by your doctor to safely use both medications. Let your doctor know immediately if you develop right upper quadrant pain, increasing abdominal size, fever, swelling, rash, itching, loss of appetite, fatigue, nausea, vomiting, dark urine, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. 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

18 potential interactions Applies to: 16 conditions, including COPD, Arrhythmia, Heart Disease, Diabetes Mellitus, and Thrombotic/Thromboembolic Disorder.

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:

pegaspargase

Pegaspargase has a major potential interaction with Bleeding Disorder.

The use of pegaspargase is contraindicated in patients who developed significant bleeding with previous L-asparaginase therapy. Pegaspargase interferes with coagulation factors, and both thrombosis and hemorrhage have been observed. Therapy with pegaspargase should be administered with extreme caution to patients with or predisposed to coagulopathies. Patients should be instructed to immediately report any signs or symptoms of thrombosis or bleeding. Close clinical monitoring of hematopoetic function and coagulation profiles 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.

Diabetes Mellitus

Moderate:

pegaspargase

Pegaspargase has a moderate potential interaction with Diabetes Mellitus.

Hyperglycemia requiring insulin therapy has been reported during pegaspargase therapy. Therapy with pegaspargase should be administered cautiously to patients with diabetes mellitus.

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:

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.

History, Thrombotic/Thromboembolic Disorder

Major:

pegaspargase

Pegaspargase has a major potential interaction with History, Thrombotic/Thromboembolic Disorder.

The use of pegaspargase is contraindicated in patients who developed significant bleeding with previous L-asparaginase therapy. Pegaspargase interferes with coagulation factors, and both thrombosis and hemorrhage have been observed. Therapy with pegaspargase should be administered with extreme caution to patients with or predisposed to coagulopathies. Patients should be instructed to immediately report any signs or symptoms of thrombosis or bleeding. Close clinical monitoring of hematopoetic function and coagulation profiles is recommended.

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.

Moderate:

pegaspargase

Pegaspargase has a moderate potential interaction with Liver Disease.

Reversible liver abnormalities such as elevated liver transaminase and bilirubin levels and decreased albumin synthesis have been reported during pegaspargase therapy. Fatty changes and liver failure have occurred. Patients should be instructed to immediately report any sign or symptoms of hepatic dysfunction such as jaundice, dark urine, right upper quadrant pain, or anorexia. Therapy with pegaspargase should be administered cautiously to patients with or predisposed to compromised hepatic function. Clinical monitoring of hepatic function is recommended.

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.

Pancreatitis

Major:

pegaspargase

Pegaspargase has a major potential interaction with Pancreatitis.

The use of pegaspargase is contraindicated in patients with or a history of pancreatitis. Pegaspargase can cause decreased insulin synthesis or inflammation and/or necrosis of cells of the pancreas. Fulminant and fatal pancreatitis has occurred. Clinical monitoring of pancreatic function, including serum amylase levels, is recommended.

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.

Thrombotic/Thromboembolic Disorder

Major:

pegaspargase

Pegaspargase has a major potential interaction with Thrombotic/Thromboembolic Disorder.

The use of pegaspargase is contraindicated in patients who developed significant bleeding with previous L-asparaginase therapy. Pegaspargase interferes with coagulation factors, and both thrombosis and hemorrhage have been observed. Therapy with pegaspargase should be administered with extreme caution to patients with or predisposed to coagulopathies. Patients should be instructed to immediately report any signs or symptoms of thrombosis or bleeding. Close clinical monitoring of hematopoetic function and coagulation profiles is recommended.

More resources

pegaspargase

A total of 556 drugs are known to interact with pegaspargase.

Sporanox

A total of 597 drugs are known to interact with Sporanox.

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.