Ketoconazole Nimodipine

Benzodiazepines alprazolam, clonazepam, diazepam, midazolam, triazolam, zolpidem Calcium channel blockers diltiazem, nifedipine, nimodipine, verapamil Steroids androgens, estrogens, cortisol Others erythromycin, terfenadine, cyclosporine, dapsone, ketoconazole, lovastatin, lidocaine, alfentanil, amiodarone, astemizole, codeine, sildenafil... 

Clinically important, potentially hazardous interactions with amlodipine, anisindione, anticoagulants, aprepitant, atorvastatin, barbiturates, benzodiazepines, butabarbital, carbamazepine, chlordiazepoxide, clarithromycin, clonazepam, dorazepate, corticosteroids, cyclosporine, dexamethasone, diazepam, dicumarol, erythromycin, ethotoin, felodipine, flurazepam, fluvastatin, fosphenytoin, isradipine, itraconazole, ketoconazole, lorazepam, lovastatin, mephenytoin, mephobarbital, midazolam, nicardipine, nifedipine, nimodipine, nisoldipine, oxazepam, pentobarbital, phenobarbital, pimozide, pravastatin, primidone, quazepam, rifampin, secobarbital, simvastatin, St John s wort, temazepam, warfarin... 

The interaction between felodipine and itraconazole would appear to be established and elinieally important. It also seems that isradipine, lercanidipine, nifedipine and nisoldipine ean interaet similarly with fluconazole, itraconazole or ketoconazole and, because they are metabolised by CYP3A4, it is likely that other calcium-channel blockers will behave in the same way. If itraconazole, ketoconazole, or fluconazole is given to a patient on established treatment with any calcium-channel blocker be alert for the need to lower the dosage of the calcium-channel blocker. However, some manufaeturers (e.g. felodipine, lercanidipine ) actually contraindicate concurrent use of itraconazole or ketoconazole, and others (e.g. nisoldipine ) additionally contraindicate fluconazole. In the US the guidance differs slightly and only caution is considered necessary with felodipine. The manufacturers of nimodipine predict that fluconazole, itraconazole and ketoconazole will substantially raise nimodipine levels. They say that concurrent use should be avoided, but, if this is not possible then the patient s blood pressure should be carefully monitored."... 

Phenobarbital and phenytoin reduce the serum levels of tirilazad mesilate whereas ketoconazole increases them. Finasteride inhibits the metabolism of tirilazad to its active metabolite. No pharmacokinetic interaction appears to occur between cimetidine or nimodipine and tirilazad. 

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