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Itraconazole Capsules (Tolsura) and Tolazamide

Determining the interaction of Itraconazole Capsules (Tolsura) and Tolazamide and the possibility of their joint administration.

Check result:

Itraconazole Capsules (Tolsura) <> Tolazamide

Relevance: 27.07.2022 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:

Consumer information for this minor interaction is not currently available. Some minor drug interactions may not be clinically relevant in all patients. Minor drug interactions do not usually cause harm or require a change in therapy. However, your healthcare provider can determine if adjustments to your medications are needed.

Professional:

Itraconazole, a potent inhibitor of CYP450 3A4, does not appear to significantly affect the pharmacokinetics of available oral hypoglycemic agents, most of which are primarily metabolized by CYP450 2C8 (pioglitazone, rosiglitazone, repaglinide) or 2C9 (nateglinide, sulfonylureas). Modest increases in systemic exposure (AUC) have been reported for repaglinide and nateglinide, which are partially metabolized by CYP450 3A4. A retrospective analysis of pharmacokinetic and safety data from postmarketing surveillance and clinical trials over a 10-year period suggests that itraconazole is generally safe for use in diabetic patients. Specifically, a review of all postmarketing adverse event reports in patients receiving itraconazole concomitantly with insulin or an oral antidiabetic agent revealed 15 reports suggestive of hyperglycemia and 9 reports suggestive of hypoglycemia. In most patients, no change in antidiabetic effect was reported. From clinical trials including a total of 189 diabetic patients treated with itraconazole for various infections, only one itraconazole-related adverse event was recorded: a case of aggravated diabetes in a renal transplant recipient who was also receiving cyclosporine. No specific precautions should be necessary during coadministration of most oral hypoglycemic agents with itraconazole. However, dosage adjustments may be necessary if an interaction is suspected.

References

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Niemi M, Backman JT, Juntti-Patinen L, Neuvonen M, Neuvonen PJ "Coadministration of gemfibrozil and itraconazole has only a minor effect on the pharmacokinetics of the CYP2C9 and CYP3A4 substrate nateglinide." Br J Clin Pharmacol 60 (2005): 208-17
Bidstrup TB, Bjornsdottir I, Sidelmann UG, Thomsen MS, Hansen KT "CYP2C8 and CYP3A4 are the principal enzymes involved in the human in vitro biotransformation of the insulin secretagogue repaglinide." Br J Clin Pharmacol 56 (2003): 305-14
Komatsu K, Ito K, Nakajima Y, Kanamitsu S, Imaoka S, Funae Y, Green CE, Tyson CA, Shimada N, Sugiyama Y "Prediction of in vivo drug-drug interactions between tolbutamide and various sulfonamides in humans based on in vitro experiments." Drug Metab Disposition 28 (2000): 475-81
"Product Information. Sporanox (itraconazole)." Janssen Pharmaceutica, Titusville, NJ.
Hatorp V, Hansen KT, Thomsen MS "Influence of drugs interacting with CYP3A4 on the pharmacokinetics, pharmacodynamics, and safety of the prandial glucose regulator repaglinide." J Clin Pharmacol 43 (2003): 649-60
Shon JH, Yoon YR, Kim MJ, et al. "Chlorpropamide 2-hydroxylation is catalysed by CYP2C9 and CYP2C19 in vitro: chlorpropamide disposition is influenced by CYP2C9, but not by CYP2C19 genetic polymorphism." Br J Clin Pharmacol 59 (2005): 552-63
Venkatakrishnan K, von Moltke LL, Greenblatt DJ "Effects of the antifungal agents on oxidative drug metabolism: clinical relevance." Clin Pharmacokinet 38 (2000): 111-80
Niemi M, Cascorbi I, Timm R, Kroemer HK, Neuvonen PJ, Kivisto KT "Glyburide and glimepiride pharmacokinetics in subjects with different CYP2C9 genotypes." Clin Pharmacol Ther 72 (2002): 326-32
Verspeelt J, Marynissen G, Gupta AK, De Doncker P "Safety of itraconazole in diabetic patients." Dermatology 198 (1999): 382-4
Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
Niemi M, Backman JT, Neuvonen M, Neuvonen PJ "Effects of gemfibrozil, itraconazole, and their combination on the pharmacokinetics and pharmacodynamics of repaglinide: potentially hazardous interaction between gemfibrozil and repaglinide." Diabetologia 46 (2003): 347-51
Miners JO, Birkett DJ "Cytochrome P4502C9: an enzyme of major importance in human drug metabolism." Br J Clin Pharmacol 45 (1998): 525-38

Itraconazole Capsules (Tolsura)

Generic Name: itraconazole

Brand name: Onmel, Sporanox, Sporanox PulsePak, Tolsura

Synonyms: Itraconazole

What is Itraconazole Capsules (Tolsura)?

Tolazamide

Generic Name: tolazamide

Brand name: Tolinase

Synonyms: TOLAZamide

What is Tolazamide?

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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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