Mycelex Troche and Xanax

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 ALPRAZolam together with clotrimazole. Combining these medications may significantly increase the blood levels and effects of ALPRAZolam in rare cases. This can lead to increased 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.

GENERALLY AVOID: Coadministration with potent inhibitors of CYP450 3A4 including azole antifungal agents may significantly increase the plasma concentrations of benzodiazepines that are primarily metabolized by the isoenzyme. In pharmacokinetic studies, itraconazole (200 mg/day) and ketoconazole (400 mg/day) individually increased the systemic exposure (AUC) of a single 0.25 mg oral dose of triazolam and a 7.5 mg oral dose of midazolam by more than 22-fold and 10-fold, respectively, compared to placebo. The AUC of a single 2 mg IV dose of midazolam increased 5-fold after pretreatment with ketoconazole. Itraconazole and ketoconazole increased the AUC of alprazolam (0.8 and 1 mg single oral dose) 2.5- and 4-fold, respectively, compared to placebo. Fluconazole, a weaker CYP450 3A4 inhibitor, increased the AUC of a single 0.25 mg oral dose of triazolam by 1.6-, 2.1- and 4.4-fold at dosages of 50 mg, 100 mg and 200 mg once a day, respectively, relative to placebo. A single oral dose of fluconazole 150 mg plus midazolam 10 mg resulted in only modest increases in midazolam plasma concentrations and pharmacologic effects. Overall, pharmacodynamic changes associated with the interaction include increased and prolonged sedation, enhanced benzodiazepine-related EEG effects, and increased impairment of psychomotor performance. 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 triazolam, midazolam, and alprazolam cannot be ruled out.

MANAGEMENT: Given the potential for significant interaction, the concomitant use of triazolam with clotrimazole or miconazole mucous membrane preparations should be avoided if possible. The same precaution probably applies also to oral midazolam and high dosages of intravenous midazolam. Caution is advised during coadministration with alprazolam. Patients should be monitored for potentially excessive or prolonged CNS and respiratory depression if these agents are used together. Alternatively, benzodiazepines that are not metabolized by CYP450 3A4 (e.g., lorazepam, oxazepam, temazepam) may be considered in patients requiring treatment with azole antifungal agents.

Mycelex Troche

Generic Name: clotrimazole

Brand name: Mycelex Troche

Synonyms: n.a.

What is Mycelex Troche?

Xanax

Generic Name: alprazolam

Brand name: Niravam, Xanax, Xanax XR, Alprazolam Intensol

Synonyms: n.a.

What is Xanax?