Diflucan (Fluconazole Injection Solution) and Tolazamide

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.

Fluconazole may increase the blood levels and effects of TOLAZamide. You may be more likely to experience hypoglycemia, or low blood glucose, during treatment with these medications. Symptoms of hypoglycemia include headache, dizziness, drowsiness, nervousness, confusion, tremor, nausea, hunger, weakness, perspiration, palpitation, and rapid heartbeat. Severe hypoglycemia has occasionally been reported, which may result in coma and even death, especially in the elderly and patients with kidney and/or liver problems. Monitor your blood glucose levels closely. You may need a dose adjustment of TOLAZamide during and after treatment with fluconazole. 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.

MONITOR CLOSELY: Coadministration with inhibitors of CYP450 2C9 including certain azole antifungal agents such as fluconazole, miconazole, and voriconazole may increase the plasma concentrations of sulfonylureas, many of which have been found to be substrates of the isoenzyme. Pharmacokinetic data are available for single-dose administration of chlorpropamide (250 mg), tolbutamide (500 mg), glipizide (2.5 mg), glyburide (5 mg), and glimepiride (0.5 mg) in combination with fluconazole. In healthy study subjects, fluconazole 100 mg daily for 7 days increased the single-dose systemic exposures (AUCs) of various sulfonylureas by an average of nearly 30% (chlorpropamide, tolbutamide) to almost 50% (glipizide, glyburide). Mean changes in blood glucose levels were not statistically significant in these studies, although approximately 48% of patients treated with fluconazole experienced symptoms consistent with hypoglycemia compared to 40% of patients treated with placebo. One in four of the fluconazole-treated patients in the glyburide study also required oral glucose. A higher dosage of fluconazole (400 mg for one day, followed by 200 mg daily for 3 days) increased single-dose glimepiride AUC by 138% and prolonged its half-life from 2.0 to 3.3 hours in healthy volunteers. In another study, low-dose fluconazole (50 mg/day) given to treat vulvovaginal candidiasis in 14 postmenopausal diabetic women receiving gliclazide or glyburide therapy demonstrated no effect on blood glucose control; pharmacokinetic data were not included. Based on available data, fluconazole use does not appear to be associated with a significant risk of severe hypoglycemia at dosages
MANAGEMENT: Caution is advised when sulfonylureas are used concomitantly with azole antifungal agents that inhibit CYP450 2C9. Blood glucose should be closely monitored, and the sulfonylurea dosage adjusted as necessary. Patients should also be apprised of the increased risk of hypoglycemia and be alert to potential signs and symptoms such as headache, dizziness, drowsiness, nervousness, confusion, tremor, hunger, weakness, perspiration, palpitation, and tachycardia. If hypoglycemia occurs, patients should initiate appropriate remedial therapy immediately, discontinue the azole antifungal agent, and contact their physician.

Diflucan (Fluconazole Injection Solution)

Generic Name: fluconazole

Brand name: Diflucan

Synonyms: Diflucan

What is Diflucan (Fluconazole Injection Solution)?

Tolazamide

Generic Name: tolazamide

Brand name: Tolinase

Synonyms: TOLAZamide

What is Tolazamide?