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The Implications and Management of Drug Interactions with Itraconazole, Fluconazole and Terbinafine
Neil Shear^a,b, Lynn Drake^c, Aditya K. Gupta^b, Julien Lambert^d, Ron Yaniv<sup>e

a</sup>Departments of Medicine and Pharmacology,
^bUniversity of Toronto, Canada;
^cHarvard University School of Medicine, Boston, Mass., USA;
^dDepartment of Dermatology, Edegem, Belgium;
^eDepartment of Dermatology, C.Sheba Medical Center, Tel-Hashomer, Israel

Address of Corresponding Author

Dermatology 2000;201:196-203 (DOI: 10.1159/000018488)

  Key Words

• Drug interactions
• Itraconazole
• Fluconazole
• Terbinafine
• Safety

  Abstract

The efficacy and safety of many pharmacological agents can be adversely affected by drug interactions. However, an appreciation of the mechanisms and incidence of these interactions, together with a knowledge of the patient's medical history, means that the majority are predictable and can be managed successfully. Drug interactions involving oral antifungal agents such as itraconazole, fluconazole and terbinafine have been studied extensively and are well understood. When problems are known to arise, they can often be overcome or minimised by varying the dosage regimens, or by drug monitoring. Where certain drugs are definitely contraindicated with antifungal agents, suitable alternatives can usually be found. Clinical trials and surveillance monitoring have demonstrated that when viewed in a wider context, drug interactions do not represent a particular safety problem for the newer oral antifungal agents. An improved understanding of the drug interaction processes and appropriate control measures mean that the high benefit-to-risk ratio of these medications can be maintained.

Copyright © 2000 S. Karger AG, Basel

  Author Contacts

Prof. Neil Shear
Sunnybrook Health Science Centre
2075 Bayview Avenue
Toronto, Ont. M4N 3M5 (Canada)
Tel. +1 416 480 4078, Fax +1 416 480 6025, E-Mail neil.shear@sunnybrook.on.ca

  Article Information

Received: Received: May 11, 2000
Accepted: May 21, 2000
Number of Print Pages : 8
Number of Figures : 0, Number of Tables : 6, Number of References : 45