Felodipine; Nisoldipine/Itraconazole; Ketoconazole
Severe. These medicines may interact and cause very harmful effects and are usually not taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
Your antifungal may decrease the ability of your liver to remove felodipine and nisoldipine from your body.
What might happen:
The amount of felodipine or nisoldipine in your body may cause your blood pressure to decrease too much. Symptoms of low blood pressure include: dizziness, light-headedness, irregular heartbeat, nausea, drowsiness, confusion, and slurred speech. You may also notice a headache or swelling in your legs and/or feet.
What you should do about this interaction:
Let your healthcare professionals (e.g. doctor or pharmacist) know right away that you are taking these medicines together. Your doctor may want to decrease the dose of your felodipine or nisoldipine, change to a different blood pressure medicine, or change your antifungal medicine. Let your doctor know right away if you develop any signs of low blood pressure, a decreased heart rate, or swelling of the legs.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.Sporanox (itraconazole) US prescribing information. Janssen Pharmaceutica Products, L.P. April, 2012.
2.Nizoral (ketoconazole oral) US prescribing information. Janssen Pharmaceuticals February, 2014.
3.Sular (nisoldipine) US prescribing information. Shionogi, Inc. December, 2012.
4.US Food and Drug Administration (FDA). Drug Development and Drug Interactions: Table of Substrates, Inhibitors and Inducers. Available at: http://www.fda.gov/Drugs/DevelopmentApprovalProcess/DevelopmentResources/D rugInteractionsLabeling/ucm093664.htm. Updated 08/05/2011.
5.This information is based on or an extract from the UW Metabolism and Transport Drug Interaction Database (DIDB) Platform, Copyright University of Washington 1999-2014..
6.Sporanox (itraconazole) UK summary of product characteristics. Janssen-Cilag Ltd November, 2008.
7.Sporanox (itraconazole) Canadian prescribing information. Janssen-Ortho May 20, 2008.
8.Nizoral (ketoconazole) UK summary of product characteristics. Janssen-Cilag Ltd October, 2008.
9.Jalava KM, Olkkola KT, Neuvonen PJ. Itraconazole greatly increases plasma concentrations and effects of felodipine. Clin Pharmacol Ther 1997 Apr; 61(4):410-5.
10.Neuvonen PJ, Suhonen R. Itraconazole interacts with felodipine. J Am Acad Dermatol 1995 Jul;33(1):134-5.
11.Heinig R, Adelmann HG, Ahr G. The effect of ketoconazole on the pharmacokinetics, pharmacodynamics and safety of nisoldipine. Eur J Clin Pharmacol 1999 Mar;55(1):57-60.