AZOLES AND CICLOSPORIN (CYCLOSPORINE) - OTHER AZOLES

Ciclosporin levels may be increased by some azole antifungals. The effects seem variable and may be affected by dose, ethnicity and gender. The azoles implicated are fluconazole (up to 2-fold increase in ciclosporin levels), itraconazole (ciclosporin dose reductions of about 80% needed), ketoconazole (ciclosporin dose reductions of up to 85% needed), and miconazole (65% rise in ciclosporin levels). However, many patients may not be affected.
Ciclosporin levels and/or effects (e.g. on renal function) should be monitored as a matter of routine, but it may be prudent to increase monitoring if these azoles are stopped, started, or if the doses are altered.
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