Irinotecan Intravenous and Itraconazole Capsules (Tolsura)
Determining the interaction of Irinotecan Intravenous and Itraconazole Capsules (Tolsura) and the possibility of their joint administration.
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 irinotecan together with itraconazole is not recommended. Studies have shown that itraconazole can interfere with the normal clearance of irinotecan from the body. This may increase side effects such as nausea, vomiting, abdominal pain, diarrhea (which can lead to dehydration and kidney failure if severe), mouth sores, lung or breathing problems, and impaired bone marrow function resulting in low numbers of different types of blood cells. You may also be more likely to develop anemia, bleeding problems, or infections due to low blood cell counts. You should seek medical attention if you develop paleness, fatigue, dizziness, fainting, unusual bruising or bleeding, fever, chills, diarrhea, sore throat, muscle aches, shortness of breath, blood in phlegm, weight loss, red or inflamed skin, body sores, and pain or burning during urination. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact. 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:CONTRAINDICATED: Coadministration with certain azole antifungal agents may significantly increase the plasma concentrations of irinotecan and its active metabolite, SN-38. CYP450 3A4 is the isoenzyme responsible for the metabolic conversion of irinotecan to its inactive metabolite, APC. Inhibition of APC formation results in more irinotecan metabolism to SN-38, an active and toxic metabolite. High plasma levels of irinotecan and SN-38 may increase the risk of potentially fatal toxicities such as severe diarrhea, neutropenia, sepsis, and thromboembolism. In cancer patients, coadministration of ketoconazole, a potent CYP450 3A4 inhibitor, resulted in a 100% increase in the relative exposure to SN-38 and an 87% reduction in the exposure to APC. Itraconazole is predicted to interact similarly.
MANAGEMENT: Concomitant use of irinotecan with ketoconazole or itraconazole is considered contraindicated. Ketoconazole should be discontinued for at least one week before initiation of treatment with irinotecan, and itraconazole should be discontinued for up to two weeks before.
- Canadian Pharmacists Association "e-CPS. Available from: URL: http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink."
- "Product Information. Nizoral (ketoconazole)." Janssen Pharmaceutica, Titusville, NJ. (1992):
- "Product Information. Camptosar (irinotecan)." Pharmacia and Upjohn, Kalamazoo, MI.
- "Product Information. Onivyde (irinotecan liposomal)." Merrimack Pharmaceuticals, Cambridge, MA.
- Phansalker S, Desai AA, Bell D, et al "High-priority drug-drug interactions for use in electronic health records." J Am Med Inform Assoc 19 (2012): 735-43
- Cerner Multum, Inc. "Australian Product Information." O 0
- "Product Information. Sporanox (itraconazole)." Janssen Pharmaceutica, Titusville, NJ.
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
Generic Name: irinotecan
Brand name: Camptosar
Synonyms: Irinotecan, Irinotecan (Conventional)
Generic Name: itraconazole
Brand name: Onmel, Sporanox, Sporanox PulsePak, Tolsura
Synonyms: Itraconazole
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.
- Irinotecan Intravenous-Itraconazole Oral Solution
- Irinotecan Intravenous-Itraconazole Tablets
- Irinotecan Intravenous-Ivabradine
- Irinotecan Intravenous-Ivabradine Hydrochloride
- Irinotecan Intravenous-Ivabradine Oral Solution
- Irinotecan Intravenous-Ivabradine Tablets
- Itraconazole Capsules (Tolsura)-Irinotecan liposomal
- Itraconazole Capsules (Tolsura)-Irinotecan liposome Intravenous
- Itraconazole Capsules (Tolsura)-Iron 100/C
- Itraconazole Capsules (Tolsura)-Iron 21/7
- Itraconazole Capsules (Tolsura)-Iron and Docusate
- Itraconazole Capsules (Tolsura)-Iron and Folic Acid