Itraconazole Oral Solution and Methadone Injection Solution
Determining the interaction of Itraconazole Oral Solution and Methadone Injection Solution 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 methadone together with itraconazole is not recommended. Combining these medications may significantly increase the blood levels and effects of methadone. This may increase the risk of an irregular heart rhythm that may be serious, as well as other side effects of methadone such as dizziness, drowsiness, nervousness, confusion, nausea, dry mouth, constipation, weakness, and difficult or shallow breathing. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or fast or pounding heartbeats during treatment with methadone. 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 itraconazole may significantly increase the plasma concentrations of methadone. The mechanism is itraconazole inhibition of methadone metabolism via CYP450 3A4. The use of methadone has been associated with dose-related prolongation of the QT interval, thus elevated plasma levels of the drug may potentiate the risk of ventricular arrhythmias such as ventricular tachycardia and torsades de pointes as well as cardiac arrest and sudden death. The interaction was suspected in a case report of a heroin-dependent patient receiving methadone substitution therapy who developed a life-threatening cardiac arrhythmia shortly after starting itraconazole for vaginal thrush. The patient presented to the emergency department for chest discomfort and an episode of syncope following two 200 mg doses of itraconazole. Electrocardiogram monitoring showed a prolonged QTc interval, which led to torsades de pointes. The patient was admitted for cardiac monitoring, and electrocardiogram returned to normal upon discontinuation of methadone.
MANAGEMENT: Given the potential for severe central nervous system and respiratory depression as well as life-threatening adverse cardiac events associated with increased plasma levels of methadone, concomitant use with itraconazole is considered contraindicated.
- "Product Information. Sporanox (itraconazole)." Janssen Pharmaceutica, Titusville, NJ.
- NoorZurani MH, Vicknasingam B, Narayanan S "Itraconazole-induced torsade de pointes in a patient receiving methadone substitution therapy." Drug Alcohol Rev 28 (2009): 688-90
Generic Name: itraconazole
Brand name: Onmel, Sporanox, Sporanox PulsePak, Tolsura
Synonyms: Itraconazole
Generic Name: methadone
Brand name: Dolophine, Methadose, Methadose Sugar-Free, Diskets
Synonyms: Methadone
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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