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Dexilant and Ketoconazole (Systemic)

Determining the interaction of Dexilant and Ketoconazole (Systemic) and the possibility of their joint administration.

Check result:

Dexilant <> Ketoconazole (Systemic)

Relevance: 14.06.2022 Reviewer: Shkutko P.M., M.D., in

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:

Talk to your doctor before using ketoconazole together with dexlansoprazole. By reducing stomach acid, dexlansoprazole can decrease the absorption and blood levels of ketoconazole and make the medication less effective against fungal infections. Your doctor or pharmacist may be able to offer suggestions on safer alternatives if you require treatment for stomach acid or ulcer while you are being treated with ketoconazole. However, if your doctor does prescribe these medications together, taking ketoconazole with an acidic beverage such as a cola may help. 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:

GENERALLY AVOID: Proton pump inhibitors may decrease the gastrointestinal absorption of the azole antifungal agents, itraconazole and ketoconazole, both of which require an acidic environment for dissolution. By increasing gastric pH and reducing the acidity, proton pump inhibitors can decrease bioavailability of the azoles by 75% to 80%.

MANAGEMENT: If coadministration is necessary, an acidic pH may be produced with two capsules of glutamic acid hydrochloride administered 15 minutes before the azole dose. Administration with an acidic beverage such as Coca-Cola(R) or Pepsi(R) may also help. However, clinicians should still consider the possibility of a reduced or subtherapeutic antifungal effect. It may be appropriate to switch to an agent like fluconazole or terbinafine whose absorption is not affected by stomach pH.

References

Van der Meer JW, Keuning JJ "The influence of gastric acidity on the bio-availability of ketoconazole." J Antimicrob Chemother 6 (1980): 552-4
Piscitelli SC, Goss TF, Wilton JH, D'Andrea DT, Goldstein H, Schentag JJ "Effects of ranitidine and sucralfate on ketoconazole bioavailability." Antimicrob Agents Chemother 35 (1991): 1765-71
"Product Information. Nexium (esomeprazole)" Astra-Zeneca Pharmaceuticals, Wilmington, DE.
Bottiger Y, Tybring G, Gotharson E, Bertilsson L "Inhibition of the sulfoxidation of omeprazole by ketoconazole in poor and extensive metabolizers of S-mephenytoin." Clin Pharmacol Ther 62 (1997): 384-91
"Product Information. Aciphex (rabeprazole)" Janssen Pharmaceuticals, Titusville, NJ.
"Product Information. Protonix (pantoprazole)" Wyeth-Ayerst Laboratories, Philadelphia, PA.
Chin TWF, Loeb M, Fong IW "Effects of an acidic beverage (coca-cola) on absorption of ketoconazole." Antimicrob Agents Chemother 39 (1995): 1671-5
"Product Information. Prilosec (omeprazole)." Merck & Co, Inc, West Point, PA.
"Product Information. Prevacid (lansoprazole)." TAP Pharmaceuticals Inc, Deerfield, IL.
Jaruratanasirikul S, Sriwiriyajan S "Effect of omeprazole on the pharmacokinetics of itraconazole." Eur J Clin Pharmacol 54 (1998): 159-61
"Product Information. Kapidex (dexlansoprazole)." Takeda Pharmaceuticals America, Lincolnshire, IL.
Carlson JA, Mann HJ, Canafax DM "Effect of pH on disintegration and dissolution of ketoconazole tablets." Am J Hosp Pharm 40 (1983): 1334-6

Dexilant

Generic Name: dexlansoprazole

Brand name: Dexilant, Kapidex

Synonyms: n.a.

What is Dexilant?

Ketoconazole (Systemic)

Generic Name: ketoconazole

Brand name: Nizoral

Synonyms: Ketoconazole

What is Ketoconazole (Systemic)?

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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.

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