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Diflucan (Fluconazole Oral Suspension) and Levofloxacin (Systemic)

Determining the interaction of Diflucan (Fluconazole Oral Suspension) and Levofloxacin (Systemic) and the possibility of their joint administration.

Check result:

Diflucan (Fluconazole Oral Suspension) <> Levofloxacin (Systemic)

Relevance: 27.09.2022 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:

Using fluconazole together with levoFLOXacin can affect the rhythm of your heart. Call your doctor if you have symptoms of irregular heartbeat, chest tightness, dizziness, blurred vision or nausea. 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:

MONITOR: In one case report, coadministration of fluconazole and levofloxacin was suspected in causing QT prolongation and torsade de pointes ventricular arrhythmia. The exact mechanism of interaction is unknown, although both agents have individually been associated with these events on rare occasions. The case patient was a 53-year-old man who was being managed for possible nosocomial pneumonia and received intravenous levofloxacin for 8 doses over 14 days and intravenous fluconazole for 2 doses over 2 days before developing torsade de pointes. His QTc interval was 655 ms and remained prolonged for 12 days after resolution of the arrhythmia, despite discontinuation of both medications and substitution with caspofungin. His medical history includes paroxysmal atrial fibrillation, chronic obstructive pulmonary disease, type I diabetes mellitus, and hemodialysis-dependent diabetic nephropathy. Electrolyte imbalance and prior medications were ruled out as possible causes. However, the patient may have received more fluconazole than intended due to inadvertent administration on a day he did not receive dialysis.

MANAGEMENT: Caution is advised if fluconazole is coadministered with levofloxacin. Patients should be advised to seek medical attention if they experience symptoms that could indicate the occurrence of torsade de pointes such as dizziness, palpitations, or syncope.

References

Frothingham R "Rates of torsades de pointes associated with ciprofloxacin, ofloxacin, levofloxacin, gatifloxacin, and moxifloxacin." Pharmacotherapy 21 (2001): 1468-72
Gandhi PJ, Menezes PA, Vu HT, Rivera AL, Ramaswamy K "Fluconazole- and levofloxacin-induced torsades de pointes in an intensive care unit patient." Am J Health Syst Pharm 60 (2003): 2479-83
Khazan M, Mathis AS "Probable case of torsades de pointes induced by fluconazole." Pharmacotherapy 22 (2002): 1632-7
Wassmann S, Nickenig G, Bohm M "Long QT syndrome and Torsade de Pointes in a patient receiving fluconazole." Ann Intern Med 131 (1999): 797
Tholakanahalli VN, Potti A, Hanley JF, Merliss AD "Fluconazole-induced torsade de pointes." Ann Pharmacother 35 (2001): 432-4
Samaha FF "QTC interval prolongation and polymorphic ventricular tachycardia in association with levofloxacin." Am J Med 107 (1999): 528-9

Diflucan (Fluconazole Oral Suspension)

Generic Name: fluconazole

Brand name: Diflucan

Synonyms: Diflucan

What is Diflucan (Fluconazole Oral Suspension)?

Levofloxacin (Systemic)

Generic Name: levofloxacin

Brand name: Levaquin

Synonyms: Levofloxacin

What is Levofloxacin (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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