Voriconazole Corticosteroids

AZOLES - FLUCONAZOLE, ITRACONAZOLE, KETOCONAZOLE, POSACONAZOLE, VORICONAZOLE CORTICOSTEROIDS t adrenal suppressive effects of corticosteroids, which may T risk of infections and produce an inadequate response to stress scenarios Due to inhibition of CYP3A4-mediated metabolism of corticosteroids and inhibition of P-gp (t bioavailability of corticosteroids) Monitor cortisol levels and warn patients to report symptoms such as fever and sore throat... 

Caspofungin, itraconazole, ketoconazole, posaconazole Systemic corticosteroids, caspofungin, itraconazole, voriconazole, ketoconazole, fluconazole, erythromycins... 

Clinically important, potentially hazardous interactions with amiodarone, anisindione, anticoagulants, azithromycin, corticosteroids, cyclosporine, dapsone, delavirdine, dicumarol, fosamprenavir, lapatinib, lopinavir, midazolam, oral contraceptives, ritonavir, solifenacin, tacrolimus, temsirolimus, tolvaptan, voriconazole... 

Clinically important, potentially hazardous interactions with amiodarone, amprenavir, anisindione, antacids, anticoagulants, aprepitant, atazanavir, atovaquone, beclomethasone, buprenorphine, corticosteroids, cortisone, cyclosporine, cyproterone, dabigatran, dapsone, darunavir, delavirdine, dexamethasone, dicumarol, digoxin, eszopiclone, flunisolide, fosamprenavir, gadoxetate, gestrinone, halothane, imatinib, isoniazid, itraconazole, ketoconazole, lapatinib, lorcainide, methylprednisolone, midazolam, nelfinavir, nifedipine, oral contraceptives, phenylbutazone, prednisone, protease inhibitors, pyrazinamide, ramelteon, ritonavir, saquinavir, solifenacin, sunitinib, tacrolimus, telithromycin, temsirolimus, tipranavir, tolvaptan, trabectedin, triamcinolone, triazolam, voriconazole, warfarin, zaleplon... 

Voriconazole is an inhihitor of the cytochrome P450 isoenzyme CYP3A4, hirt its inhihitory effects are much less than those of itraconazole. Therefore voriconazole is less likely than itraconazole , (p.l050), or ketoconazole , (p.l051) to affect the pharmacokinetics of the corticosteroids. 

No dosage adjustment of the corticosteroid is said to be necessary if voriconazole is given with prednisolone, and this also appears to be the case if voriconazole is given with hydrocortisone. ... 

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