Triazolam fluconazole

Varhe A, Olkkola KT, Neuvonen PJ. Effect of fluconazole dose on the extent of fluconazole-triazolam interaction. Br J Clin Pharmacol 1996 42(4) 465-70. 

Fluconazole increased blood concentrations of midazolam (77) and triazolam (78). 

Clinically important, potentially hazardous interactions with alfentanil, aminophylline, amisulpride, amoxicillin, ampicillin, anticonvulsants, astemizole, atorvastatin, benzodiazepines, bromocriptine, buprenorphine, bupropion, carbamazepine, cilostazol, ciprofloxacin, cisapride, clindamycin, colchicine, cyclosporine, dasatinib, digoxin, dihydroergotamine, diltiazem, disopyramide, enoxacin, eplerenone, ergotamine, eszopiclone, everolimus, fluconazole, fluoxetine, fluvastatin, gatifloxacin, HMG-CoA reductase inhibitors, imatinib, itraconazole, ketoconazole, lomefloxacin, lorazepam, lovastatin, methadone, methylprednisolone, methysergide, midazolam, mizolastine, moxifloxacin, nitrazepam, norfloxacin, ofloxacin, paroxetine, pimozide, pravastatin, quinolones, ranolazine, repaglinide, rupatadine, sertraline, sildenafil, simvastatin, sparfloxacin, sulpiride, tacrolimus, terfenadine, triazolam, troleandomycin, vardenafil, verapamil, vinblastine, warfarin, zaleplon, zolpidem, zuclopenthixol... 

In vitro studies have shown that the cytochrome P450 isoenzyme CYP3A4 is the principal enzyme involved in the metabolism of zonisamide. Based on in vitro data, it is predicted that ketoconazole, ciclosporin, miconazole and fluconazole may cause a modest to minor decrease in the clearance of zonisamide. Conversely, itraconazole and triazolam are not predicted to have an effect. In vitro predictions do not always mirror what happens in clinical use, therefore, further study is needed. 

Fluconazole, itraconazole and ketoconazole very markedly increase the serum levels of midazolam and triazolam, thereby increasing and prolonging their sedative and amnesic effects. Similar but smaller effects are seen with itraconazole or ketoconazole and alprazolam and with itraconazole and brotizolam. Even less effect is seen with etizolam and itraconazole and no important interaction occurs between estazolam and itraconazole. Small effects are found with the non-benzodiazepine hypnotic, zolpidem, with ketoconazole and even less effects with zopiclone and itraconazole. 

Fluconazole. Eight healthy subjects were given fluconazole or a placebo daily for 4 days, with a single 250-microgram oral dose of triazolam on day 4. The AUC of triazolam was increased by 1.6-fold, 2.1 -fold, and 4.4-fold by 50,100, and 200 mg fluconazole, respectively, and the maximum plasma triazolam levels were more than doubled by the 200-mg fluconazole dose. The 100- and 200-mg fluconazole doses both produced significant changes in the psychomotor tests of triazolam, but the 50-mg dose did not. ... 

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