Can you take Sporanox with Toremifene?
1 drug interaction and 22 additional warnings found for the following 2 drugs:
- Sporanox (itraconazole)
- toremifene
Drug interactions
Major drug interactions
Major:
itraconazole toremifene
Applies to: Sporanox (itraconazole) and toremifene
Talk to your doctor before using toremifene together with itraconazole. Combining these medications may significantly increase the blood levels of toremifene. This can make you more likely to develop side effects such as vaginal bleeding, blood clots, or an irregular heart rhythm that may be serious or life-threatening. You may not be able to take toremifene during treatment with itraconazole, or you may need a dose adjustment and/or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if you experience potential signs and symptoms of blood clots such as chest pain, shortness of breath, sudden loss of vision, and pain, redness or swelling your arms or legs. You should also seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, or fast or pounding heartbeats during treatment with toremifene. 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.
Moderate:
toremifene Food/Lifestyle
Applies to: toremifene
You should avoid drinking grapefruit juice during treatment with toremifene. Grapefruit juice may increase the blood levels of toremifene. This can make you more likely to develop side effects such as vaginal bleeding, blood clots, or an irregular heart rhythm that may be serious or life-threatening. Contact your doctor if you experience potential signs and symptoms of blood clots such as chest pain, shortness of breath, sudden loss of vision, and pain, redness or swelling your arms or legs. You should also seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, or fast or pounding heartbeats during treatment with toremifene.
Talk to your doctor before using toremifene with soy products. There is some evidence that substances present in soy may stimulate breast tumor growth and interfere with the action of toremifene, although this has not been proven. Whether soy products are effective for hot flashes is also uncertain. 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.
Disease interactions
20 potential interactions Applies to: 18 conditions, including Heart Failure, COPD, Arrhythmia, Hypokalemia, and Heart Disease.
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.
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.
Endometrial Dysplasia
Moderate:
toremifene
Toremifene has a moderate potential interaction with Endometrial Dysplasia.
Endometrial cancer, endometrial hyperplasia, hypertrophy, and uterine polyps have been reported in some patients treated with toremifene. Long-term use of toremifene has not been established in patients with preexisting endometrial hyperplasia. All patients should have baseline and annual gynecological examinations. In particular, patients at high risk of endometrial cancer should be closely monitored.
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.
Heart Failure
Major:
toremifene
Toremifene has a major potential interaction with Heart Failure.
Toremifene has shown to prolong the QTc interval in a dose and concentration related manner, which can result in Torsade de Pointes (ventricular tachycardia), syncope, seizure, and/or death. Toremifene should not be prescribed to patients with congenital or acquired QT prolongation, uncorrected hypokalemia or uncorrected hypomagnesemia. Caution is advised in patients with congestive heart failure, and patients taking other drugs that can prolong the QT interval.
History, Thrombotic/Thromboembolic Disorder
Moderate:
toremifene
Toremifene has a moderate potential interaction with History, Thrombotic/Thromboembolic Disorder.
Thromboembolic events such as thrombophlebitis and pulmonary embolism have been noted during toremifene therapy. Patients with an active or past history of thromboembolic events should generally not be administered toremifene.
Hypokalemia
Major:
toremifene
Toremifene has a major potential interaction with Hypokalemia.
Toremifene has shown to prolong the QTc interval in a dose and concentration related manner, which can result in Torsade de Pointes (ventricular tachycardia), syncope, seizure, and/or death. Toremifene should not be prescribed to patients with congenital or acquired QT prolongation, uncorrected hypokalemia or uncorrected hypomagnesemia. Caution is advised in patients with congestive heart failure, and patients taking other drugs that can prolong the QT interval.
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:
toremifene
Toremifene has a moderate potential interaction with Liver Disease.
Hepatotoxicity, hepatitis, and non-alcoholic fatty liver disease have been reported in clinical trials and postmarketing with toremifene. Liver function tests should be performed periodically. Caution is advised in patients with any hepatic impairment.
Long QT Syndrome
Major:
toremifene
Toremifene has a major potential interaction with Long QT Syndrome.
Toremifene has shown to prolong the QTc interval in a dose and concentration related manner, which can result in Torsade de Pointes (ventricular tachycardia), syncope, seizure, and/or death. Toremifene should not be prescribed to patients with congenital or acquired QT prolongation, uncorrected hypokalemia or uncorrected hypomagnesemia. Caution is advised in patients with congestive heart failure, and patients taking other drugs that can prolong the QT interval.
Magnesium Imbalance
Major:
toremifene
Toremifene has a major potential interaction with Magnesium Imbalance.
Toremifene has shown to prolong the QTc interval in a dose and concentration related manner, which can result in Torsade de Pointes (ventricular tachycardia), syncope, seizure, and/or death. Toremifene should not be prescribed to patients with congenital or acquired QT prolongation, uncorrected hypokalemia or uncorrected hypomagnesemia. Caution is advised in patients with congestive heart failure, and patients taking other drugs that can prolong the QT interval.
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.
Thrombotic/Thromboembolic Disorder
Moderate:
toremifene
Toremifene has a moderate potential interaction with Thrombotic/Thromboembolic Disorder.
Thromboembolic events such as thrombophlebitis and pulmonary embolism have been noted during toremifene therapy. Patients with an active or past history of thromboembolic events should generally not be administered toremifene.
More resources
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
toremifene
A total of 432 drugs are known to interact with toremifene.
- Toremifene is in the following drug classes: hormones/antineoplastics, selective estrogen receptor modulators.
- Toremifene is used to treat the following conditions:
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
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.