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.