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Fluconazole Oral Suspension and Fluvastatin Capsules

Determining the interaction of Fluconazole Oral Suspension and Fluvastatin Capsules and the possibility of their joint administration.

Check result:
Fluconazole Oral Suspension <> Fluvastatin Capsules
Relevance: 08.11.2023 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 fluvastatin can increase your blood levels of fluvastatin. This may increase your risk of a dangerous side effect on your muscles. If your doctor prescribes these medications together, you may need a dose adjustment or special tests to safely take both medications. You should also watch for muscle symptoms and call the doctor if you have muscle pain, tenderness, or weakness, especially if you also have dark colored urine. 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: Coadministration with fluconazole may significantly increase the plasma concentrations of fluvastatin. The mechanism is fluconazole inhibition of CYP450 2C9, the isoenzyme primarily responsible for the metabolic clearance of fluvastatin. In 12 healthy volunteers, fluconazole (400 mg orally on day 1 and 200 mg on days 2 to 4) increased the mean peak plasma concentration (Cmax), area under the concentration-time curve (AUC) and elimination half-life (t1/2) of fluvastatin (40 mg single oral dose) by 44%, 84% and 80%, respectively, compared to placebo.

MANAGEMENT: Because of the increased risk of musculoskeletal toxicity (e.g., severe myopathy, rhabdomyolysis) associated with high levels of HMG-CoA reductase inhibitory activity in plasma, fluconazole should preferably not be given with fluvastatin. It may be advisable to temporarily discontinue fluvastatin during and for a few days after fluconazole therapy, or consider using another azole antifungal agent such as ketoconazole or itraconazole that is less likely to interfere with CYP450 2C9 metabolism. Alternatively, pravastatin has been shown to lack significant interaction with fluconazole and may be a reasonable substitute for fluvastatin. If fluconazole is used with fluvastatin, patients should be closely monitored for early signs and symptoms of myopathy. All patients treated with HMG-CoA reductase inhibitors should be advised to promptly report any unexplained muscle pain, tenderness, or weakness, particularly if accompanied by malaise or fever. Therapy should be discontinued if creatine kinase is markedly elevated in the absence of strenuous exercise or if myopathy is otherwise suspected or diagnosed.

References
  • Kantola T, Backman JT, Niemi M, Kivisto KT, Neuvonen PJ "Effect of fluconazole on plasma fluvastatin and pravastatin concentrations." Eur J Clin Pharmacol 56 (2000): 225-9
  • "Product Information. Lescol (fluvastatin)." Novartis Pharmaceuticals, East Hanover, NJ.
Fluconazole Oral Suspension

Generic Name: fluconazole

Brand name: Diflucan

Synonyms: Fluconazole

Fluvastatin Capsules

Generic Name: fluvastatin

Brand name: Lescol, Lescol XL

Synonyms: Fluvastatin

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.