This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.
Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
Some azole antifungal medicines may slow down how quickly your liver processes vinca alkaloids.
What might happen:
The levels of vinca alkaloids in your blood may increase and you may experience more chemotherapy-related toxicity than normally expected.
What you should do about this interaction:
Make sure that your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together, or if you have recently (in the past few weeks) undergone chemotherapy with a vinca alkaloid. Your doctor may need to monitor you more closely. Let your doctor know right away if you have any muscle weakness, numbness or loss of feeling, abdominal pain, constipation, seizures, or swelling, or if any side effects are worse than in previous chemotherapy cycles.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.
1.Zhou-Pan XR, Seree E, Zhou XJ, Placidi M, Maurel P, Barra Y, Rahmani R. Involvement of human liver cytochrome P450 3A in vinblastine metabolism: drug interactions. Cancer Res 1993 Nov 1;53(21):5121-6.
2.Noxafil (posaconazole) UK summary of product characteristics. Schering-Plough Ltd. February 2, 2006.
3.Noxafil (posaconazole) US prescribing information. Merck & Co. Inc March, 2014.
4.Vfend (voriconazole) US prescribing information. Pfizer Inc. November, 2011.
5.Nizoral (ketoconazole oral) US prescribing information. Janssen Pharmaceuticals February, 2014.
6.Javlor (vinflunine ditartrate) UK Summary of Product Characteristics. Pierre Fabre Limited September 21, 2009.
7.Gillies J, Hung KA, Fitzsimons E, Soutar R. Severe vincristine toxicity in combination with itraconazole. Clin Lab Haematol 1998 Apr;20(2):123-4.
8.Jeng MR, Feusner J. Itraconazole-enhanced vincristine neurotoxicity in a child with acute lymphoblastic leukemia. Pediatr Hematol Oncol 2001 Mar; 18(2):137-42.
9.Bohme A, Ganser A, Hoelzer D. Aggravation of vincristine-induced neurotoxicity by itraconazole in the treatment of adult ALL. Ann Hematol 1995 Dec;71(6):311-2.
10.Murphy JA, Ross LM, Gibson BE. Vincristine toxicity in five children with acute lymphoblastic leukaemia. Lancet 1995 Aug 12;346(8972):443.
11.Sathiapalan RK, El-Solh H. Enhanced vincristine neurotoxicity from drug interactions: case report and review of literature. Pediatr Hematol Oncol 2001 Dec;18(8):543-6.
12.Kamaluddin M, McNally P, Breatnach F, O'Marcaigh A, Webb D, O'Dell E, Scanlon P, Butler K, O'Meara A. Potentiation of vincristine toxicity by itraconazole in children with lymphoid malignancies. Acta Paediatr 2001 Oct;90(10):1204-7.
13.Eiden C, Palenzuela G, Hillaire-Buys D, Margueritte G, Cociglio M, Hansel-Esteller S, Peyriere H. Posaconazole-increased vincristine neurotoxicity in a child: a case report. J Pediatr Hematol Oncol 2009 Apr;31(4):292-5.
14.Harnicar S, Adel N, Jurcic J. Modification of vincristine dosing during concomitant azole therapy in adult acute lymphoblastic leukemia patients. J Oncol Pharm Pract 2009 Mar 12.