Nizoral and Telithromycin

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.

Ketoconazole may increase the blood levels of telithromycin, particularly if you are elderly or have liver or kidney problems. This may increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these 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.

MONITOR CLOSELY: Coadministration with itraconazole or ketoconazole may increase the plasma concentrations of telithromycin. The proposed mechanism is inhibition of telithromycin metabolism via CYP450 3A4. In multiple-dose interaction studies, telithromycin peak plasma concentration (Cmax) and systemic exposure (AUC) increased 22% and 54%, respectively, with itraconazole, and 51% and 95%, respectively, with ketoconazole. Elevated plasma levels of telithromycin may increase the risk of QT interval prolongation, which has been associated with ventricular arrhythmias including torsade de pointes and sudden death. Azole antifungal agents can also prolong the QT interval, thus an additive pharmacodynamic effect with telithromycin may occur as well.

MANAGEMENT: Caution is advised if telithromycin is prescribed with itraconazole or ketoconazole. Patients should be advised to seek prompt medical attention if they experience symptoms that could indicate the occurrence of torsade de pointes such as dizziness, lightheadedness, fainting, palpitation, irregular heart rhythm, shortness of breath, or syncope. The product labeling for itraconazole states that concomitant use with telithromycin is contraindicated in patients with severe renal or hepatic impairment.

Nizoral

Generic Name: ketoconazole

Brand name: Nizoral

Synonyms: n.a.

What is Nizoral?

Telithromycin

Generic Name: telithromycin

Brand name: Ketek

Synonyms: n.a.

What is Telithromycin?