We must carefully monitor patients while receiving rifabutin and fluconazole. The four testosterone ester mix increases. Saquinavir clearance is reduced by about 50% due to the inhibition of hepatic metabolism isoenzyme . You may need dose adjustment of saquinavir. Sirolimus. Increasing the concentration of sirolimus in the plasma presumably due to the metabolism of sirolimus ingibirovainem through inhibition of isozyme . This combination can be used with an appropriate dose of sirolimus adjusted depending on the effect / concentration.
Oral hypoglycemic agents.Fluconazole increases the plasma half-life of oral hypoglycemic agents – sulfonylureas (chlorpropamide, glibenclamide, glipizide, tolbutamide). The combined use of fluconazole and oral hypoglycemic agents may be, but the physician should bear in mind the possibility of hypoglycemia. Requires regular monitoring of blood glucose and, if necessary, correction sulfonylurea dose. Tacrolimus. Use of fluconazole and tacrolimus (oral) leads to increased serum levels of the last 5 times by inhibiting the metabolism of tacrolimus occurring in the intestines by isoenzyme . No significant changes in the pharmacokinetics of drugs are not mentioned in the application of tacrolimus intravenously. Cases of nephrotoxicity. Patients concurrently receiving fluconazole and tacrolimus inside, should be carefully monitored. Tacrolimus dose should be adjusted according to the degree of increase of its concentration in the blood.
Theophylline. When using fluconazole 200 mg for 14 days at the same time (or in combination) with the average speed of plasma theophylline klierensa tsofillina reduced by 18%. In the appointment of fluconazole patients receiving theophylline in high doses, or in patients with an increased risk of toxic effect of theophylline should be monitored for the appearance of symptoms of theophylline overdose and, if necessary, adjust the treatment accordingly. Vinca alkaloids. , Assumed Despite the lack of targeted research that fluconazole can increase the concentration of vinca alkaloids (e.g., vincristine and vinblastine) in blood plasma and, thus, lead to neurotoxicity, which may possibly be associated with inhibition of isozyme four testosterone ester mix. It has been reported one case of undesirable side reactions central nervous system as a pseudotumor of the brain, while the application is fully transretinoevoy acid and fluconazole, who disappeared after the abolition of fluconazole. The use of this combination is possible, but should be aware of the possibility of adverse reactions from the central nervous system.
In patients receiving the combination of fluconazole and zidovudine, there is increase of zidovudine by 84% and 74%, respectively, which is caused by a decrease in the metabolism of the latter to its main metabolite. Before and after treatment with Fluconazole, 200 mg / day for 15 days in patients , a significant increase in set zidovudine (20%). Patients receiving such a combination should be monitored in order to identify side effects of zidovudine.
Simultaneous voriconazole (400 mg, 2 times a day on the first day followed by 200 mg twice a day for 2.5 days) and fluconazole (400 mg on the first day followed by 200 mg daily for 4 days), increases concentration and voriconazole and 79% respectively. It has been shown that this effect is maintained while reducing the dose and / or dosing frequency of any of the drugs. Concomitant use of voriconazole and fluconazole is not recommended. Tofacitinib: tofacitinib exposure is increased by combining it with drugs that are both moderate inhibitors of Cfour testosterone ester mixisoenzyme and potent inhibitors (eg, fluconazole). May possibly need a dose tofacitinib correction. Studies of the interaction of oral formulations of fluconazole during its simultaneous administration with food, cimetidine, antacids, and after total body irradiation in preparation for bone marrow transplantation has shown that these factors do not have a clinically meaningful effect on the absorption of fluconazole. These interactions are installed with repeated application of fluconazole; Interactions with other drugs as a result of a single dose of fluconazole is not known. Doctors should take into account the interaction with other drugs not specifically been studied, but it is possible.