Selected Azole Antifungals/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.
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. Do not start, stop, or change the dosage of any medicine before checking with them first.
1.Prilosec (omeprazole) US prescribing information. AstraZeneca Pharmaceuticals LP October, 2012.
2.Prevacid (lansoprazole) US prescribing information. Takeda Pharmaceuticals America, Inc. September, 2012.
3.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.
4.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.
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. Schering Corporation June, 2012.
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.