There is some clinical evidence that amphotericin B given with either itraconazole, ketoconazole or miconazole may possibly be less effective than amphotericin B given alone, and the adverse effects may be greater.
Despite extensive in vitro and animal data, it is not entirely clear whether or not azoles inhibit the efficacy of amphotericin B. Until more is known combined treatment should be limited to specific cases and the outcome should be very well monitored, being alert for a reduced antifungal response, or increasing LFTs.
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