Darunavir, Cobicistat, Emtricitabine, and Tenofovir Alafenamide and Itraconazole Capsules (Sporanox)
Determining the interaction of Darunavir, Cobicistat, Emtricitabine, and Tenofovir Alafenamide and Itraconazole Capsules (Sporanox) and the possibility of their joint administration.
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.
Consumer:Using itraconazole together with darunavir can increase the effects of both medications and cause serious side effects that may affect your liver. Call your doctor immediately if you experience a fever, chills, joint pain or swelling, excessive tiredness or weakness, unusual bleeding or bruising, skin rash or itching, loss of appetite, nausea, vomiting, or yellowing of the skin or the whites of your eyes. If your doctor does prescribe these medications together, you may need a dose adjustment or special tests to safely take both medications. 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.
Professional:ADJUST DOSE: Coadministration of ketoconazole or itraconazole with ritonavir- or cobicistat-boosted darunavir may result in increased plasma concentrations of both the azole antifungal agent and darunavir. The proposed mechanism is inhibition of CYP450 3A4, as all of these medicines are known substrates and inhibitors of the CYP450 3A4 isoenzyme. In 15 study subjects, administration of ketoconazole (200 mg twice a day) with darunavir/ritonavir (400 mg/100 mg twice a day) increased the peak plasma concentration (Cmax), area under the concentration-time curve (AUC) and trough plasma concentration (Cmin) of ketoconazole by over 2-, 3- and 9-fold, respectively, compared to administration without darunavir/ritonavir. Darunavir Cmax, AUC, and Cmin also increased by 21%, 42%, and 73%, respectively, compared to administration without ketoconazole. A similar interaction is expected to occur with itraconazole and ritonavir- or cobicistat-boosted darunavir; however, no data are currently available.
MANAGEMENT: During coadministration with ritonavir- or cobicistat-boosted darunavir, the dosage of ketoconazole should generally not exceed 200 mg/day so as to avoid excessive plasma drug levels, which may be associated with impairment of testosterone and cortisol production and possibly an increased risk of hepatotoxicity. Some authorities recommend that the dosage of itraconazole should also be limited to 200 mg per day when prescribed with ritonavir- or cobicistat-boosted darunavir.
- "Product Information. Prezista (darunavir)." Ortho Biotech Inc, Bridgewater, NJ.
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- Cerner Multum, Inc. "Australian Product Information." O 0
Generic Name: cobicistat / darunavir / emtricitabine / tenofovir alafenamide
Brand name: Symtuza
Synonyms: Cobicistat, darunavir, emtricitabine, and tenofovir
Generic Name: itraconazole
Brand name: Onmel, Sporanox, Sporanox PulsePak, Tolsura
Synonyms: Itraconazole
In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.
- Darunavir, Cobicistat, Emtricitabine, and Tenofovir Alafenamide-Itraconazole Capsules (Tolsura)
- Darunavir, Cobicistat, Emtricitabine, and Tenofovir Alafenamide-Itraconazole Oral Solution
- Darunavir, Cobicistat, Emtricitabine, and Tenofovir Alafenamide-Itraconazole Tablets
- Darunavir, Cobicistat, Emtricitabine, and Tenofovir Alafenamide-Ivabradine
- Darunavir, Cobicistat, Emtricitabine, and Tenofovir Alafenamide-Ivabradine Hydrochloride
- Darunavir, Cobicistat, Emtricitabine, and Tenofovir Alafenamide-Ivabradine Oral Solution
- Itraconazole Capsules (Sporanox)-Darunavir, Cobicistat, Emtricitabine, and Tenofovir Alafenamide Fumarate
- Itraconazole Capsules (Sporanox)-Darvocet
- Itraconazole Capsules (Sporanox)-Darvocet A500
- Itraconazole Capsules (Sporanox)-Darvocet-N
- Itraconazole Capsules (Sporanox)-Darvon
- Itraconazole Capsules (Sporanox)-Darzalex