Miconazole oral buccal and Propulsid (Cisapride Suspension)

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.

Talk to your doctor before using cisapride together with miconazole. Combining these medications may significantly increase the blood levels and effects of cisapride in rare cases. High blood levels of cisapride can occasionally cause an irregular heart rhythm that may be serious. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, or fast or pounding heartbeats during treatment with cisapride. 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. **Cisapride (Propulsid) is no longer marketed in the United States. You should only be taking cisapride if you are obtaining the medication from your doctor though a Limited Access Program developed jointly by the manufacturer and the FDA.**

GENERALLY AVOID: Coadministration with potent inhibitors of CYP450 3A4 including azole antifungal agents may significantly increase the plasma concentrations of cisapride, which is primarily metabolized by the isoenzyme. The use of cisapride 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 torsade de pointes as well as cardiac arrest and sudden death. In humans, coadministration with oral ketoconazole resulted in a mean 8-fold increase in cisapride systemic exposure (AUC). Fluconazole 200 mg daily for 7 days increased the peak plasma concentration (Cmax) and AUC of cisapride (20 mg four times a day) by 153% and 192%, respectively. Prolongation of the QT interval has been reported with both combinations. The interaction has not been studied with clotrimazole troches or miconazole buccal tablets. Although systemic absorption following mucous membrane exposure is limited, the potential for interaction with drugs metabolized by CYP450 3A4 such as cisapride cannot be ruled out.

MANAGEMENT: Given the potential for serious and life-threatening adverse cardiac events associated with increased plasma levels of cisapride, the concomitant use with clotrimazole or miconazole mucous membrane preparations should be avoided if possible. Otherwise, patients should be cautioned about the potential for interaction and advised to seek medical attention if they experience symptoms that could indicate the occurrence of torsade de pointes such as dizziness, palpitations, or syncope.

Miconazole oral buccal

Generic Name: miconazole

Brand name: Oravig, Monistat IV, Oravig

Synonyms: Miconazole oral (buccal), Miconazole (Oral)

What is Miconazole oral buccal?

Propulsid (Cisapride Suspension)

Generic Name: cisapride

Brand name: Propulsid

Synonyms: Propulsid (Suspension), Propulsid

What is Propulsid (Cisapride Suspension)?