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Axid

Interactions

Slt Azole Antifungals/H-2 Antagonists;Proton Pump Inhibitors

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.

Medical warning:

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:

When these two medicines are taken together, the amount of the antifungal medicine absorbed by your body may decrease.

What might happen:

A decrease in the beneficial effects of your antifungal medicine may occur.

What you should do about this interaction:

Contact your healthcare professionals (e.g. doctor or pharmacist) as soon as possible about taking these two medicines together. They may already be aware of this interaction and may be monitoring you for it. If your doctor prescribes these medicines together, you may need to take another medicine before taking your antifungal. Try to take your antifungal medicine at least 2 hours before taking your H-2 antagonist. Do not start, stop, or change the dosage of any medicine before checking with them first.

References:

1.Prilosec (omeprazole) US prescribing information. AstraZeneca Pharmaceuticals LP March, 2014.

2.Prevacid (lansoprazole) US prescribing information. Takeda Pharmaceuticals America, Inc. September, 2012.

3.Van Der Meer JW, Keuning JJ, Scheijgrond HW, Heykants J, Van Cutsem J, Brugmans J. The influence of gastric acidity on the bio-availability of ketoconazole. J Antimicrob Chemother 1980 Jul;6(4):552-4.

4.Carlson JA, Mann HJ, Canafax DM. Effect of pH on disintegration and dissolution of ketoconazole tablets. Am J Hosp Pharm 1983 Aug; 40(8):1334-6.

5.Jaruratanasirikul S, Sriwiriyajan S. Effect of omeprazole on the pharmacokinetics of itraconazole. Eur J Clin Pharmacol 1998 Apr; 54(2):159-61.

6.Johnson MD, Hamilton CD, Drew RH, Sanders LL, Pennick GJ, Perfect JR. A randomized comparative study to determine the effect of omeprazole on the peak serum concentration of itraconazole oral solution. J Antimicrob Chemother 2003 Feb;51(2):453-7.

7.Chin TW, Loeb M, Fong IW. Effects of an acidic beverage (Coca-Cola) on absorption of ketoconazole. Antimicrob Agents Chemother 1995 Aug; 39(8):1671-5.

8.Walravens J, Brouwers J, Spriet I, Tack J, Annaert P, Augustijns P. Effect of pH and comedication on gastrointestinal absorption of posaconazole: monitoring of intraluminal and plasma drug concentrations. Clin Pharmacokinet 2011 Nov 1;50(11):725-34.

9.Noxafil (posaconazole) UK summary of product characteristics. Schering-Plough Ltd. February 2, 2006.

10.Noxafil (posaconazole) US prescribing information. Merck & Co. Inc March, 2014.

11.Zimmermann T, Yeates RA, Riedel KD, Lach P, Laufen H. The influence of gastric pH on the pharmacokinetics of fluconazole: the effect of omeprazole. Int J Clin Pharmacol Ther 1994 Sep;32(9):491-6.

12.Wood N, Tan K, Purkins L, Layton G, Hamlin J, Kleinermans D, Nichols D. Effect of omeprazole on the steady-state pharmacokinetics of voriconazole. Br J Clin Pharmacol 2003 Dec;56 Suppl 1:56-61.

13.Phansalkar S, van der Sijs H, Tucker AD, Desai AA, Bell DS, Teich JM, Middleton B, Bates DW. Drug-drug interactions that should be non-interruptive in order to reduce alert fatigue in electronic health records. J Am Med Inform Assoc 2012 Sep 25.

14.Lelawongs P, Barone JA, Colaizzi JL, Hsuan AT, Mechlinski W, Legendre R, Guarnieri J. Effect of food and gastric acidity on absorption of orally administered ketoconazole. Clin Pharm 1988 Mar;7(3):228-35.

15.Lazar JD, Wilner KD. Drug interactions with fluconazole. Rev Infect Dis 1990 Mar-Apr;12 Suppl 3:S327-33.

16.Piscitelli SC, Goss TF, Wilton JH, D'Andrea DT, Goldstein H, Schentag JJ. Effects of ranitidine and sucralfate on ketoconazole bioavailability. Antimicrob Agents Chemother 1991 Sep;35(9):1765-71.

17.Lim SG, Sawyerr AM, Hudson M, Sercombe J, Pounder RE. Short report: the absorption of fluconazole and itraconazole under conditions of low intragastric acidity. Aliment Pharmacol Ther 1993 Jun;7(3):317-21.

18.Tagamet (cimetidine) US prescribing information. GlaxoSmithKline December, 2005.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, expect as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

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