Compatibility «Fluconazole» and «Dexamethasone»

• Interactions Fluconazole with Dexamethasone

  • Dangerous interactions
    • ⓘ In addition, in addition to the effects listed below, there is a risk of increased plasma concentrations of other drugs metabolized by CYP2C9, CYP2C19 and CYP3A4 isoenzymes when used concomitantly with fluconazole.
    • ⓘ When fluconazole is co-administered with HMG-CoA reductase inhibitors metabolized by the CYP3A4 isoenzyme (such as atorvastatin and simvastatin) or the CYP2D6 isoenzyme (such as fluvastatin (decreased liver metabolism of statins)), the risk of myopathy and rhabdomyolysis increases (depending on the dose).
    • ⓘ Moderate inhibitors of the CYP3A4 isoenzyme, such as fluconazole, increase the concentration of ibrutinib in plasma and may increase the risk of toxicity.
    • ⓘ Despite the lack of targeted studies, it is assumed that fluconazole may increase the concentration of periwinkle alkaloids (for example, vincristine and vinblastine) in blood plasma and thus lead to neurotoxicity, which may possibly be associated with inhibition of the CYP3A4 isoenzyme.
  • Negative interactions
    • ⓘ Fluconazole increases the plasma concentration of sirolimus presumably due to inhibition of sirolimus metabolism mediated by CYP3A4 and P-glycoprotein (with simultaneous use, dose adjustment of sirolimus may be required).
    • ⓘ Presumably, the end of therapy with fluconazole (a CYP3A4 inhibitor) caused an increase in the activity of this isoenzyme, which led to an increase in prednisone metabolism.
    • ⓘ Moderate inhibitors of the CYP3A4 isoenzyme, such as fluconazole, may increase the concentration of lurazidone in plasma.
    • ⓘ Moderate inhibitors of the CYP3A4 isoenzyme, such as fluconazole, increase the concentration of olaparib in blood plasma.
    • ⓘ Presumably, discontinuation of fluconazole therapy caused an increase in the activity of the CYP3A4 isoenzyme, which led to increased prednisone metabolism.
    • ⓘ Saquinavir: AUC increases by approximately 50%, max'>C_max - by 55%, clearance of saquinavir decreases by approximately 50% due to inhibition of hepatic metabolism of the CYP3A4 isoenzyme and inhibition of P‑glycoprotein.
    • ⓘ An increase in the concentration of sirolimus in blood plasma, presumably due to the inhibition of sirolimus metabolism through inhibition of the CYP3A4 isoenzyme and P‑glycoprotein.
    • ⓘ The simultaneous use of fluconazole and tacrolimus (orally) leads to an increase in serum concentrations of the latter by 5 times due to inhibition of tacrolimus metabolism occurring in the intestine through the CYP3A4 isoenzyme.
    • ⓘ The effect of tofacitinib increases when it is co-administered with drugs that are both moderate inhibitors of CYP3A4 and CYP2C19 isoenzymes (for example, fluconazole).
    • ⓘ Tolvaptan: the effect of tolvaptan is significantly increased (AUC by 200%, max'>C_max by 80%) with the combined use of tolvaptan, a CYP3A4 substrate, and fluconazole, a moderate CYP3A4 inhibitor.
    • ⓘ Voriconazole (inhibitor of CYP2C9, CYP2C19 and CYP3A4 isoenzymes): simultaneous use of voriconazole (400 mg 2 times a day on the first day, then 200 mg twice a day for 2.5 days) and fluconazole (400 mg on the first day, then 200 mg per day for 4 days) In 8 healthy male subjects, it led to an increase in the concentration of max'>C_max and AUC of voriconazole by 57% and 79%, respectively.
    • ⓘ In vitro studies show that GCS inhibit the antifungal activity of econazole against C.
  • No interactions
    • ⓘ Everolimus: Although this interaction has not been studied in vitro or in vivo, fluconazole may increase the concentration of everolimus in blood plasma by inhibiting CYP3A4.
  • Unclear interactions
    • ⓘ Fluconazole may increase the systemic effects of certain BCC (nifedipine, isradipine, amlodipine, felodipine), which are metabolized with the participation of CYP3A4.
    • ⓘ This may be due to the inhibition of the CYP3A4 isoenzyme by fluconazole.
    • ⓘ Some calcium channel antagonists (nifedipine, isradipine, amlodipine, verapamil and felodipine) are metabolized by the CYP3A4 isoenzyme.
    • ⓘ Fluconazole may increase the concentration of halophantrin in blood plasma due to inhibition of the CYP3A4 isoenzyme.
    • ⓘ When the concentration of GCS was equal to or higher than the concentration of econazole in terms of unit body weight, the antifungal activity of econazole was significantly suppressed.
    • ⓘ When the concentration of GCS was one tenth of the concentration of econazole, no inhibition of antifungal activity was observed.

Decoding the colors of interactions and contraindications

Dangerous	—	a pronounced negative interaction or contraindication.
Negative	—	negative interaction or side effect that may reduce effectiveness.
Positive	—	the interaction can SOMETIMES be used as a positive (often a dose adjustment is needed), or it is an indication of the drug.
No	—	the drugs do NOT interact, which is separately indicated in the instructions.
Unclear	—	the system failed to pre-assess the danger.

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Additional information

• Kiberis checks interactions and evaluates drug compatibility for free online right in the instructions thanks to the latest artificial intelligence technologies. The accuracy of finding is more than 95%, the accuracy of the hazard assessment is more than 80%. The online medical service takes into account all the drug groups of the selected drugs and all their components. And since the database contains 25,000 drugs with detailed instructions, not every pharmacologist can compete with our artificial intelligence. List of popular interactions.
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• The use of information about interactions is only possible as an introduction. This information should not be used to adjust therapy without consulting a specialist.
• The article is written: artificial intelligence Kiberis
• Sources: official instructions for medicines and their active substances, as well as inter-group interactions described in medical studies and textbooks.
• Total analyzed: 169,994,378 possible combinations of drugs and their components were found 412,530 interacting combinations.
• Medicine section: Standard evidence-based medicine
• The date of the last update of the interaction database: 2024-12-19

Category - medicine