Methylprednisolone with Voriconazole Interaction Details
Brand Names Associated with Methylprednisolone
- Medrol®
- Methylprednisolone
Brand Names Associated with Voriconazole
- Vfend®
- Voriconazole
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Dec 03, 2023
Interaction Effect
Increased methylprednisolone exposure
Interaction Summary
Coadministration of corticosteroids, such as methylprednisolone, with voriconazole may lead to corticosteroid excess and adrenal suppression. If concomitant use is required, reduce the dosage and closely monitor for adverse drug reactions both during and after completion of therapy .
Severity
Major
Onset
Unspecified
Evidence
Probable
How To Manage Interaction
Coadministration of corticosteroids, such as methylprednisolone, with voriconazole may lead to corticosteroid excess and adrenal suppression. If concomitant use is required, reduce the dosage of methylprednisone and closely monitor for adverse drug reactions both during and after completion of therapy .
Mechanism Of Interaction
Inhibition of CYP3A-mediated metabolism of methylprednisolone
Literature Reports
A) In a pharmacokinetic simulation study in virtual healthy 30-year-old male subjects, methylprednisolone Cmax and AUC(0 to infinity) were increased by 1.56-fold and 2.23-fold when combined with voriconazole. Doses in the simulation were methylprednisolone 80 mg IV 3 times daily (days 1 to 3) and voriconazole 400 mg orally twice daily for 1 day (loading dose) followed by 200 mg orally twice daily (days 2 and 3). The Cmax of methylprednisolone increased from 1.18 mcg/mL at baseline to 1.84 mcg/mL after voriconazole; similarly, the AUC increased from 35.7 mcg x hr/mL to 79.6 mcg x hr/mL. A dose reduction of methylprednisolone should be employed to reduce the risk of adverse reactions, and the patient should be monitored closely .
Methylprednisolone Overview
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Methylprednisolone, a corticosteroid, is similar to a natural hormone produced by your adrenal glands. It is often used to replace this chemical when your body does not make enough of it. It relieves inflammation (swelling, heat, redness, and pain) and is used to treat certain forms of arthritis; skin, blood, kidney, eye, thyroid, and intestinal disorders (e.g., colitis); severe allergies; and asthma. Methylprednisolone is also used to treat certain types of cancer.
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This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
Voriconazole Overview
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Voriconazole is used in adults and children 2 years of age and older to treat serious fungal infections such as invasive aspergillosis (a fungal infection that begins in the lungs and spreads through the bloodstream to other organs), esophageal candidiasis (a yeast [a type of fungus] infection that may cause white patching in the mouth and throat), and candidemia (a fungal infection in the blood). It is also used to treat certain other fungal infections when other medications will not work for certain patients. Voriconazole is in a class of antifungal medications called triazoles. It works by slowing the growth of the fungi that cause infection.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.