Nizoral and Prilosec (Omeprazole Powder for Oral 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 ketoconazole together with omeprazole. Combining these medications may interfere with the absorption of ketoconazole and reduce its effectiveness. Your doctor may be able to prescribe alternative medications that do not interact, or you may need a dose adjustment to safely use both medications. Taking ketoconazole with a cola beverage may also help by increasing stomach acid. Contact your doctor if your infection does not improve or gets worse. 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: Proton pump inhibitors may decrease the gastrointestinal absorption of the azole antifungal agents, itraconazole (capsules only) and ketoconazole, both of which require an acidic environment for dissolution. By increasing gastric pH and reducing the acidity, proton pump inhibitors can decrease bioavailability of the azoles by 75% to 80%. Additionally, ketoconazole (a potent CYP450 3A4 inhibitor) may increase serum omeprazole levels. The metabolism of omeprazole includes hydroxylation catalyzed by CYP450 2C19 and, to a minor extent, sulfoxidation by CYP450 3A4. In a study involving ten subjects, ketoconazole 100 mg to 200 mg daily resulted in a marked inhibition of the formation of the omeprazole sulfone in both extensive and poor metabolizers of CYP450 2C19. In poor metabolizers, a doubling of omeprazole levels was observed. No adverse effects were reported by any of the subjects.

MANAGEMENT: In general, the concomitant use of these drugs is not recommended. If coadministration is necessary, an acidic pH may be produced with two capsules of glutamic acid hydrochloride administered 15 minutes before the azole dose. Administration with an acidic beverage such as Coca-Cola(R) may also help. Additionally, an increase of the antifungal dosage may be required. However, clinicians should still consider the possibility of a reduced or subtherapeutic antifungal effect. It may be appropriate to switch to itraconazole oral solution or an agent like fluconazole whose absorption is not affected by stomach pH.

Nizoral

Generic Name: ketoconazole

Brand name: Nizoral

Synonyms: n.a.

What is Nizoral?

Prilosec (Omeprazole Powder for Oral Suspension)

Generic Name: omeprazole

Brand name: FIRST Omeprazole, Omeprazole + SyrSpend SF Alka, Prilosec, Prilosec OTC, Prilosec, Prilosec OTC, Zegerid>

Synonyms: Prilosec

What is Prilosec (Omeprazole Powder for Oral Suspension)?