Fluconazole Intravenous and Hydrochlorothiazide and losartan

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.

Using fluconazole together with a losartan can alter the affects of losartan. Talk to you doctor before using these medications together. You may need a dose adjustment or need your blood pressure checked more often if you 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.

MONITOR: Coadministration with fluconazole may increase the plasma concentration of losartan but decrease that of its active carboxylic acid metabolite. The mechanism is fluconazole inhibition of CYP450 2C9, the isoenzyme that mediates the conversion of losartan to the metabolite. In healthy volunteers, fluconazole (200 mg once a day for 10 days) increased the steady-state peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of losartan (100 mg once daily) by 31% and 69%, respectively, compared to administration of losartan alone. In contrast, the Cmax and AUC of the active metabolite decreased 54% and 41%, respectively. Changes in pharmacodynamic effects, if any, were not evaluated in the study. However, since the active metabolite is 10 to 40 times more potent by weight than losartan and is responsible for most of the angiotensin II receptor antagonism that follows losartan treatment, the potential for diminished pharmacologic effect should be considered. Fluconazole had no effect on the pharmacokinetics of eprosartan, another angiotensin II receptor antagonist.

MANAGEMENT: If fluconazole is to be given for more than a few doses, patients should consider having blood pressure monitored more closely following initiation, discontinuation or change of dosage of fluconazole. Use of an alternative antifungal agent which does not inhibit CYP450 2C9 (e.g., itraconazole, ketoconazole, terbinafine) or another angiotensin II receptor antagonist such as eprosartan may be considered.

Fluconazole Intravenous

Generic Name: fluconazole

Brand name: Diflucan

Synonyms: Fluconazole

What is Fluconazole Intravenous?

Hydrochlorothiazide and losartan

Generic Name: hydrochlorothiazide / losartan

Brand name: Hyzaar

Synonyms: Losartan and Hydrochlorothiazide

What is Hydrochlorothiazide and losartan?