Six healthy volunteers received terfenadine 60 mg BID for 15 days. Candizol 200 mg was administered daily from days 9 through 15. Candizol did not affect terfenadine plasma concentrations. Terfenadine acid metabolite AUC increased 36% ± 36% (range: 7 to 102%) from Day 8 to Day 15 with the concomitant administration of Candizol. There was no change in cardiac repolarization as measured by Holter QTc intervals. Another study at a 400 mg and 800 mg daily dose of Candizol demonstrated that DIFLUCAN taken in doses of 400 mg/day or greater significantly increases plasma levels of terfenadine when taken concomitantly. (See CONTRAINDICATIONS and PRECAUTIONS.)
Candizol increases the effect of amitriptyline and nortriptyline. 5-Nortriptyline and/or S-amitriptyline may be measured at initiation of the combination therapy and after 1 week. Dosage of amitriptyline/nortriptyline should be adjusted, if necessary.
If you are allergic to Candizol or any of its inactive ingredients, you should not take Candizol.
If you are taking medications that can change the electrical activity in the heart you should not take this drug.
Also, if you have severe kidney problems (kidneys with a creatinine clearance, CrCl, or urine output 50 ml/ minute or less), your body may not be able to eliminate Candizol as quickly as it should.
Your doctor may need to find a special dose that works best for you.
Be sure to let your doctor know that you have kidney problems before taking this medication. People who are on dialysis should receive the full dose of Candizol after they have finished their dialysis procedure.
Talk to your doctor before taking Candizol if you:
- Are taking medications that change heart rhythm or conduction like Ery-tab (erythromycin), Orap (pimozide), or quinidine
- Have kidney problems
- Are pregnant
Additionally, if you are allergic to azoles (the building block of a certain class of antifungal drugs that includes Candizol), you should not take Candizol.
It should also be noted that people with certain sensitivities must be careful with various dosage forms of Candizol.
For example, people who may have inherited certain genetic conditions, including intolerances to certain sugars, such as glucose-galactose, lapp lactase, or sucrose, should avoid Diflucan capsules because they contain lactose.
People with glycerol sensitivities should avoid Candizol syrups because the glycerol may cause unpleasant symptoms like diarrhea, stomach discomfort, or headaches.
One fatal case of possible fentanyl-Candizol interaction was reported. The author judged that the patient died from fentanyl intoxication. Furthermore, in a randomized crossover study with 12 healthy volunteers, it was shown that Candizol delayed the elimination of fentanyl significantly. Elevated fentanyl concentration may lead to respiratory depression.
Candizol increases the AUC of triazolam (single dose) by approximately 50%, Cmax by 20% to 32%, and increases t½ by 25% to 50 % due to the inhibition of metabolism of triazolam. Dosage adjustments of triazolam may be necessary.
DIFLUCAN is generally well tolerated.
In some patients, particularly those with serious underlying diseases such as AIDS and cancer, changes in renal and hematological function test results and hepatic abnormalities have been observed during treatment with Candizol and comparative agents, but the clinical significance and relationship to treatment is uncertain.
The pharmacokinetics of theophylline were determined from a single intravenous dose of aminophylline (6 mg/kg) before and after the oral administration of Candizol 200 mg daily for 14 days in 16 normal male volunteers. There were significant increases in theophylline AUC, Cmax, and half-life with a corresponding decrease in clearance. The mean ± SD theophylline AUC increased 21% ± 16% (range: –5 to 48%). The Cmax increased 13% ± 17% (range: –13 to 40%). Theophylline clearance decreased 16% ± 11% (range: –32 to 5%). The half-life of theophylline increased from 6.6 ± 1.7 hours to 7.9 ± 1.5 hours. (See PRECAUTIONS.)
What is the most important information I should know about Candizol (Diflucan)?
Tell your doctor about all your current medicines and any you start or stop using. Many drugs can interact, and some drugs should not be used together.
Concomitant administration of Candizol with astemizole may decrease the clearance of astemizole. Resulting increased plasma concentrations of astemizole can lead to QT prolongation and rare occurrences of torsade de pointes. Coadministration of Candizol and astemizole is contraindicated.