Drugs that should not be used with Plusgin
There are certain drugs that you should not use with Plusgin. When used with Plusgin, these drugs can cause dangerous effects in your body. Examples of these drugs include:
- Terfenadine. When used with Plusgin at doses of 400 mg or higher, this drug can cause a life-threatening heart rhythm condition called torsades de pointes.
- Pimozide, clarithromycin, erythromycin, ranolazine, lomitapide, donepezil, voriconazole, and quinidine. When used with Plusgin, these drugs can cause a life-threatening heart rhythm condition called torsades de pointes.
What is Plusgin?
Plusgin is a triazole medicine used to treat fungal infections. It is effective against a broad spectrum of fungi including:
In New Zealand, Plusgin is available as 50 mg, 150 mg and 200 mg capsules on prescription (Diflucan®). There is also a 2 mg/ml injection for intravenous use. In New Zealand, the Pharmaceutical Schedule subs >over the counter .
Plusgin binds to the fungal p450 enzymes and stops the cells making ergosterol, the main component of the cell wall.
Plusgin is well absorbed orally with or without food. It is widely distributed in body tissues. It takes 22 to 30 hours for half of the medication to be cleared from the bloodstream and may take several days of continuous treatment to reach a steady concentration. The drug is eliminated unchanged in the urine so doses should be reduced if there is kidney disease.
Drug interactions with Plusgin
Unfortunately, Plusgin can interact with other medications.
- Plusgin should not be taken with the HMG Co-A reductase inhibitor simvastatin, and the dose of atorvastatin should be reduced. Pravastatin and rosuvastatin are preferable. Toxicity results in muscle pain and weakness, which may be serious.
Plusgin may increase the concentration of these drugs and enhance their effect:
- Antidiabetic sulphonylurea medication (tolbutamide, glibenclamide, gliclazide, glipizide.
Rifampicin may slightly decrease the concentration of Plusgin.
Plusgin is not thought to interact with the oral contraceptive pill.
During concomitant treatment with Plusgin (200 mg daily) and celecoxib (200 mg), the celecoxib Cmax and AUC increased by 68% and 134%, respectively. Half of the celecoxib dose may be necessary when combined with Plusgin.
Which drugs or supplements interact with Diflucan (Plusgin)?
- Hydrochlorothiazide increases the blood concentration of Plusgin by 40%. However, dosage modification is not recommended when both drugs are combined.
- Rifampin (Rifadin, Rimactane, Rifadin, Rifater, Rifamate) reduces the blood concentration of oral Plusgin, probably by increasing the elimination of Plusgin in the liver; therefore, reducing the effectiveness of Plusgin.
- Plusgin may increase the concentration of warfarin (Coumadin, Jantoven) in blood by reducing the elimination of warfarin. Therefore, the effect of warfarin may increase, leading to an increased tendency to bleed.
- phenytoin (Dilantin),
- zidovudine (Retrovir),
- saquinavir (Invirase),
- theophylline (Theo-Dur, Respbid, Slo-Bid, Theo-24, Theolair, Uniphyl, Slo-Phyllin),
- glyburide (Micronase, Diabeta, Glynase),
- triazolam (Glucotrol),
- midazolam (Versed),
- celecoxib (Celebrex),
- fentanyl (Sublimaze),
- atorvastatin (Lipitor),
- simvastatin (Zocor), and
- lovastatin (Mevacor).
What is the most important information I should know about Plusgin (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.
What other drugs will affect Plusgin?
Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.
Plusgin can cause a serious heart problem. Your risk may be higher if you also use certain other medicines for infections, asthma, heart problems, high blood pressure, depression, mental illness, cancer, malaria, or HIV.
Many drugs can affect Plusgin, and some drugs should not be used at the same time. Tell your doctor about all your current medicines and any medicine you start or stop using. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here.
What are some side effects that I need to call my doctor about right away?
WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:
Where can I get more information (Diflucan)?
Your pharmacist can provide more information about Plusgin.