Itraconazole: (Average) Ciprofloxacin must be used with warning in patients receiving itraconazole as concurrent use may increase the danger of QT prolongation. Uncommon cases of QT prolongation and torsade de pointes (TdP) have been reported with ciprofloxacin during postmarketing surveillance. Itraconazole has been associated with prolongation of the QT interval.
Ranolazine: (Contraindicated) Keep away from concomitant use of ketoconazole and ranolazine resulting from an elevated danger for torsade de pointes (TdP) and QT/QTc prolongation. Concomitant use may additionally enhance the exposure of ranolazine, further increasing the danger for antagonistic results. Ranolazine is a CYP3A4 substrate and ketoconazole is a robust CYP3A4 inhibitor. Coadministration with ketoconazole increased ranolazine exposure by 220%.
Enzalutamide: (Major) Keep away from enzalutamide for two weeks previous to and through treatment with ketoconazole. Concomitant use could decrease exposure of ketoconazole and reduce its efficacy. If coadministration cannot be averted, monitor for decreased efficacy of ketoconazole; a ketoconazole dose increase may be crucial. Ketoconazole is a CYP3A substrate and enzalutamide is a strong CYP3A inducer.
Suvorexant: (Reasonable) Monitor for decreased efficacy of suvorexant if coadministration with a barbiturate is important. Suvorexant is a CYP3A4 substrate and barbiturates are robust CYP3A4 inducers. Coadministration with another robust CYP3A inducer decreased suvorexant exposure by 77% to 88%. Additive CNS results, comparable to sedation and psychomotor impairment, are additionally possible. Dosage adjustments of suvorexant and of concomitant CNS depressants may be needed when administered collectively due to potentially additive effects. Using suvorexant with other drugs to treat insomnia is just not beneficial. The danger of next-day impairment, together with impaired driving, is increased if suvorexant is taken with different CNS depressants. Patients needs to be cautioned towards driving and other activities requiring full psychological alertness. (Minor) Caffeine is a central nervous system (CNS) stimulant. Patients taking medications for sleep, corresponding to suvorexant, eszopiclone, zaleplon, or zolpidem should avoid caffeine-containing medications, dietary supplements, foods, and drinks near bedtime. Patients should be inspired to avoid excessive complete day by day caffeine intake, as a part of correct sleep hygiene, since caffeine intake can interfere with correct sleep.
Ketoconazole: (Major) Avoid barbiturates for two weeks previous to and through treatment with ketoconazole. Concomitant use might lower publicity of ketoconazole and Buy Subutex Online uk reduce its efficacy. If coadministration cannot be avoided, monitor for decreased efficacy of ketoconazole; a ketoconazole dose enhance could also be needed. Ketoconazole is a CYP3A substrate and barbiturates are strong CYP3A inducers. (Average) Ketoconazole has been proven to inhibit the clearance of caffeine by eleven percent. The clinical significance of these interactions has not been determined.
