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Itraconazole Capsules (Tolsura) and Valium

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

Check result:

Itraconazole Capsules (Tolsura) <> Valium

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:

Itraconazole may increase the blood levels of diazePAM, particularly in the elderly and patients with liver disease. This can increase the risk and/or severity of side effects such as dizziness, drowsiness, and breathing difficulties. You may need a dose adjustment or more frequent monitoring by your doctor to safely use 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.

Professional:

MONITOR: Coadministration with azole antifungal agents may increase the plasma concentrations of diazepam. The proposed mechanism is inhibition of diazepam metabolism via CYP450 3A4. In 10 healthy volunteers, administration of a single 5 mg oral dose of diazepam following pretreatment with itraconazole 200 mg daily for 4 days resulted in a 15% increase in diazepam systemic exposure (AUC) compared to administration following placebo. A clinically significant effect on psychomotor performance tests was not observed. These results are consistent with the fact that diazepam is metabolized by multiple enzymatic pathways, thus inhibition of a single isoenzyme would not be expected to substantially alter its pharmacokinetics in most patients.

MANAGEMENT: Patients receiving diazepam with azole antifungal agents may need to be monitored for potentially excessive or prolonged central nervous system-depressant effects, and the diazepam dosage adjusted as necessary.

References

"Product Information. VFEND (voriconazole)." Pfizer U.S. Pharmaceuticals, New York, NY.
"Product Information. Noxafil (posaconazole)." Schering-Plough Corporation, Kenilworth, NJ.
"Product Information. Nizoral (ketoconazole)." Janssen Pharmaceutica, Titusville, NJ. (1992):
"Product Information. Diflucan (fluconazole)." Roerig Division, New York, NY.
Ahonen J, Olkkola KT, Neuvonen PJ "The effect of the antimycotic itraconazole on the pharmacokinetics and pharmacodynamics of diazepam." Fundam Clin Pharmacol 10 (1996): 314-8
"Product Information. Cresemba (isavuconazonium)." Astellas Pharma US, Inc, Deerfield, IL.
Andersson T, Miners JO, Veronese ME, Birkett DJ "Diazepam metabolism by human liver microsomes is mediated by both S-mephenytoin hydroxylase and CYP3A isoforms." Br J Clin Pharmacol 38(2) (1994): 131-7
"Product Information. Sporanox (itraconazole)." Janssen Pharmaceutica, Titusville, NJ.
"Product Information. Valium (diazepam)." Roche Laboratories, Nutley, NJ.

Itraconazole Capsules (Tolsura)

Generic Name: itraconazole

Brand name: Onmel, Sporanox, Sporanox PulsePak, Tolsura

Synonyms: Itraconazole

What is Itraconazole Capsules (Tolsura)?

Valium

Generic Name: diazepam

Brand name: Valium, Diastat, Diastat AcuDial, Diastat Pediatric, Diazepam Intensol, Zetran

Synonyms: n.a.

What is Valium?

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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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