Prednisolone Ketoconazole

Prednisolone [Corticosteroid] [See Steroids and Table VI-1] Interactions T Effects W/ clarithromycin, erythromycin, estrogen, ketoconazole, OCPs, troleandomycin X effects W/ antacids, aminoglutethimide, barbiturates, cholestyramine, colestipol, phenytoin, rifampin X effects OF anticoagulants, hypoglycemics, INH, salicylates, vaccine toxoids EMS Infxns may be masked OD May cause wt gain, T hair growth, acne, HTN, peripheral edema, and sore muscles symptomatic and supportive... 

Clinically important, potentially hazardous interactions with amiloride, aminoglycosides, amphotericin B, ampicillin, anisindione, anticoagulants, armodafinil, atorvastatin, azathioprine, azithromycin, bacampicillin, basiliximab, bezafibrate, bosentan, bupropion, carbenicillin, caspofungin, cholestyramine, clarithromycin, cloxacillin, co-trimoxazole, corticosteroids, cyclophosphamide, daclizumab, danazol, dicloxacillin, dicumarol, digoxin, diltiazem, disulfiram, echinacea, erythromycin, ethotoin, etoposide, ezetimibe, flunisolide, fluoxymesterone, fluvastatin, foscarnet, fosphenytoin, gemfibrozil, hemophilus B vaccine, HMG-CoA reductase inhibitors, imatinib, imipenem/cilastatin, influenza vaccines, ketoconazole, lanreotide, lopinavir, lovastatin, mephenytoin, methicillin, methoxsalen, methylphenidate, methylprednisolone, methyltestosterone, mezlocillin, mizolastine, mycophenolate, nafcillin, nisoldipine, NSAIDs, orlistat, oxacillin, penicillins, phellodendron, phenytoin, pravastatin, prednisolone, prednisone, pristinamycin, ranolazine, red rice yeast, rifabutin, rifampin, rifapentine, ritonavir, rosuvastatin, simvastatin, sirolimus, spironolactone, St John s wort, sulfacetamide, sulfadiazine, sulfamethoxazole, sulfisoxazole, sulfonamides, tacrolimus, telithromycin, tenoxicam, testosterone, ticarcillin, tolvaptan, trabectedin, triamterene, troleandomycin, ursodeoxycholic acid, vaccines, vecuronium, warfarin, zofenopril... 

Ulrich, B. Frey, F.J. Speck, R.F. Frey, B.M. Pharmacokinetics/pharmacodynamics of ketoconazole-prednisolone interaction. J.Pharmacol.Exp.Ther, 1992, 260, 487-490 [mouse plasma dexamethasone (IS) LOD 10 ng/mL extracted prednisolone]... 

Ketalgin Ketoprofen Ketalgin Methadone HCI Ketaman Propantheline bromide Ketanest - Ketamine HCI Ketawrift - Allopurinol Ketazol Ketoconazole Ketazon - Kebuzone Ketazone Kebuzone Keteocort Prednisone Keteocort H Prednisolone Kethamed Pemoline Keto Ketoprofen Ketobun A Allopurinol Ketobutan Kebuzone Ketobutane Kebuzone Ketobutazone Kebuzone Ketocef Cefuroxime Ketofen Kebuzone Ketofen Ketoprofen Keton Ketoprofen Ketonal - Ketoprofen Ketophezon Kebuzone Ketopron Ketoprofen Ketoprosil Ketoprofen Ketoscillium Fentonium bromide Ketoval - Ketoprofen Kevadon - Ketoprofen Key-Pred Prednisolone acetate Key-Pred S.P. Prednisolone phosphate sodium... 

In vitro studies using human liver microsomes show that ketoconazole, prednisolone, troleandomycin, verapamil and vincristine can inhibit... 

Ketoconazole reduces the metabolism and clearance of methylprednisolone. Ketoconazole may increase levels of the active metabolite of ciclesonide. Ketoconazole modestly increases the systemic effect of inhaled budesonide and possibly fluticasone, and markedly increases the AUC of oral budesonide. The situation with prednisone and prednisolone is uncertain studies have shown some moderate pharmacokinetic effects, but this does not appear to alter the action of either drug. 

In 10 healthy subjects ketoconazole 200 mg daily for 6 to 7 days caused a 50% rise in the levels of both total and unbound prednisolone, following a dose of either oral prednisone or intravenous prednisolone. In contrast, two other studies found that ketoconazole 200 mg daily for 6 days did not affect either the pharmacokinetics or the pharmacodynamics of prednisolone, as measured by the suppressive effects on serum cortisol, blood basophil and helper T-lymphocyte values of prednisolone. ... 

Ziircher RM, Frey BM,Frey FJ. Impact of ketoconazole on the metabolism of prednisolone. Clin Pharmacol Ther (1989) 45, 366-72. 

Yamashita SK, Ludwig EA Middleton E, Jusko WJ. Lack of pharmacokinetic and pharmacodynamic interactions between ketoconazole and prednisolone. Clin Pharmacol Ther (1991)49,558-70. 

Ludwig EA, Slaughter RL, Savliwala M, Brass C, Jusko WJ. Steroid-specific effects of ketoconazole disposition unaltered prednisolone elim ination. Drug Intell Clin Pharm (1989) 23, 858-61. 

Ketoconazole can lead to reduced clearance of CS and a mild increase in levels (62,66,67). In addition, patients with significant liver or renal failure, age older than 65 years (68), or women receiving exogenous estrogen have increased unbound concentrations of prednisolone (69). Conversely, hyperthyroid patients have lower levels (70). There is one case report of an increased prothrombin time occurring in a patient on a stable dose of coumadin who subsequently received prednisone (71). This interaction seems rare and may be overshadowed by other drugs and events in the patient. Troleandomycin, a macrolide, has been shown to reduce clearance of methylprednisolone, but not prednisone (72). 

Ulrich B, Frey FJ, Speck RF, et al. Pharmacokinetics/pharmacodynantics of ketoconazole-prednisolone interaction. J Pharmacol Exp Ther 1992 260 487 90. 

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