Treatment
Table 3. Commonly Encountered Drug-Drug Interactions
During Treatment of Aspergillosis (cont'd)
Agent/Class Interaction Comment
Agents which cause QTc
interval prolongation
(fluoroquinolone and
macrolide antimicrobials,
quinine, quinidine,
digoxin, amiodarone and
other antiarrhythmic
drugs, calcium channel
blockers, psychiatric drugs,
antihistamines, cocaine
and other agents)
QT interval prolongation,
torsades de pointes and
other cardiac arrhythmias
have been observed with
azoles in combination
with other agents or
preexisting conditions that
have these effects.
Assess risk benefit and
administer with caution
to patients with cardiac
disorders that increase the
risk of arrhythmias.
Vincristine and other
vinca alkaloid agents
• Neurotoxicity
including peripheral
neuropathy and seizures
in combination with
azoles.
• Azole levels also
increased.
• Given the potential for
serious toxicity, vincristine
and other vinca alkaloids
should generally not be
co-administered with
mold-active azoles.
• Alternative
antifungal therapy
(e.g., amphotericin
B formulation or
echinocandin) should
be used.
Cyclophosphamide Increased levels with
co-administration of some
azoles.
Increased renal, hepatic or
GU dysfunction.
21
