Atorvastatin and ezetimibe and Vfend

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Voriconazole may significantly increase the blood levels of atorvastatin. This can increase the risk of side effects such as liver damage and a rare but serious condition called rhabdomyolysis that involves the breakdown of skeletal muscle tissue. In some cases, rhabdomyolysis can cause kidney damage and even death. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need to stop taking atorvastatin while you are being treated with voriconazole. Let your doctor know immediately if you have unexplained muscle pain, tenderness, or weakness while taking atorvastatin or similar medications, especially if these symptoms are accompanied by fever or dark colored urine. You should also seek immediate medical attention if you develop fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

ADJUST DOSE: Coadministration with potent inhibitors of CYP450 3A4 including azole antifungal agents may significantly increase the plasma concentrations of HMG-CoA reductase inhibitors (statins) that are substrates of the isoenzyme. High levels of HMG-CoA reductase inhibitory activity in plasma is associated with an increased risk of musculoskeletal toxicity. Myopathy manifested as muscle pain and/or weakness associated with grossly elevated creatine kinase exceeding ten times the upper limit of normal has been reported occasionally. Rhabdomyolysis has also occurred rarely, which may be accompanied by acute renal failure secondary to myoglobinuria and may result in death. Within the azole class, ketoconazole and itraconazole are considered the most potent inhibitors, while fluconazole is comparatively weak and generally causes clinically significant interactions with CYP450 3A4 substrates only at dosages of 200 mg/day or more.

MANAGEMENT: The benefits of using azole antifungal agents with statins that are substrates of CYP450 3A4 should be carefully weighed against the potentially increased risk of myopathy including rhabdomyolysis. If coadministration is required, a lower initial and maintenance dosage of the statin should be considered. Close monitoring for musculoskeletal toxicity is recommended, particularly during the initial months of therapy and following a dosage increase of either drug. Pitavastatin, pravastatin, and rosuvastatin may be safer alternatives, since they are not metabolized by CYP450 3A4. Fluvastatin may also be used with azole antifungal agents except fluconazole and voriconazole, both of which can inhibit fluvastatin metabolism via CYP450 2C9. Alternatively, an interruption of the statin may be considered during treatment with an azole antifungal agent. All patients receiving statin therapy should be advised to promptly report any unexplained muscle pain, tenderness or weakness, particularly if accompanied by fever, malaise and/or dark colored urine. Therapy should be discontinued if creatine kinase is markedly elevated in the absence of strenuous exercise or if myopathy is otherwise suspected or diagnosed.

Atorvastatin and ezetimibe

Generic Name: atorvastatin / ezetimibe

Brand name: Liptruzet

Synonyms: Atorvastatin and ezetimibe (Oral)

What is Atorvastatin and ezetimibe?

Vfend

Generic Name: voriconazole

Brand name: Vfend, Vfend

Synonyms: Vfend Injection

What is Vfend?