Doxorubicin Liposomal: (Main) Avoid coadministration of ketoconazole with doxorubicin on account of increased systemic publicity of doxorubicin leading to elevated remedy-associated hostile reactions. Ketoconazole is a potent CYP3A4 inhibitor, and a P-glycoprotein (P-gp) inhibitor; doxorubicin is a major substrate of CYP3A4 and P-gp. Concurrent use of CYP3A4 or P-gp inhibitors with doxorubicin has resulted in clinically important interactions.
Tisotumab Vedotin: (Moderate) Monitor for tisotumab vedotin-associated adversarial reactions if concomitant use with ketoconazole is critical on account of increased monomethyl auristatin E (MMAE) publicity which may enhance the incidence and severity of antagonistic reactions. MMAE, the energetic part of tisotumab vedotin, is a CYP3A substrate and ketoconazole is a robust CYP3A inhibitor. Clinical drug interaction studies have not been conducted for tisotumab vedotin. However, coadministration of another antibody-drug conjugate that accommodates MMAE with ketoconazole increased unconjugated MMAE exposure by 34%.
Codeine; Promethazine: (Main) Concomitant use of codeine with barbiturates may cause respiratory depression, hypotension, profound sedation, and loss of life. Limit using opioid pain medications with barbiturates to only patients for buy dihydrocodeine online whom different therapy choices are inadequate. It’s endorsed to avoid this combination when codeine is being used for cough. If concurrent use is critical, cut back initial dosage and titrate to clinical response; use the lowest efficient doses and minimum remedy durations. Educate patients concerning the dangers and symptoms of respiratory depression and sedation. Additionally, concomitant use of codeine with a barbiturate can lower codeine concentrations, resulting in less metabolism by CYP2D6 and decreased morphine concentrations; this may lead to decreased efficacy or onset of a withdrawal syndrome in patients who have developed physical dependence. Monitor for decreased efficacy of codeine and indicators of opioid withdrawal. Discontinuation of a barbiturate may enhance the risk of opioid-related adversarial reactions, resembling fatal respiratory depression. Barbiturates induce CYP3A4. Codeine is primarily metabolized by CYP2D6 to morphine, and by CYP3A4 to norcodeine; norcodeine does not have analgesic properties.
Paclitaxel: (Average) Monitor for an increase in paclitaxel-related opposed reactions if coadministration of paclitaxel with ketoconazole is necessary attributable to the risk of increased plasma concentrations of paclitaxel. Paclitaxel is a CYP3A4 substrate and ketoconazole is a robust CYP3A4 inhibitor. In vitro, coadministration with each sturdy and reasonable CYP3A4 inhibitors increased paclitaxel publicity; nevertheless, the concentrations used exceeded these found in vivo following normal therapeutic doses. The pharmacokinetics of paclitaxel might even be altered in vivo because of interactions with CYP3A4 inhibitors.
Taking hydroxyzine with alcohol could make you too drowsy. Hydroxyzine may cause some side effects. Name your doctor if any aspect effect turns into worse or does not go away. In addition to drowsiness, hydroxyzine can also cause the following negative effects: Nausea and dizziness. Dryness in your mouth, nostril, or throat. Headache.