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Ketoconazole (Systemic) 与 Vincristine

Ketoconazole (Systemic) 与 Vincristine互相作用以及同时服用的可能性。

检测结果:

Ketoconazole (Systemic) <> Vincristine

现实性: 05.01.2023 评论家: 医学副博士Shkutko P.M., in

在该服务的官方手册中，已注明相关研究结果统计规定的互相作用。该互相作用或对患者健康引起不良后果，或起到良好效果。具体联合用药问题，需遵从医嘱。

用户:

谈谈你的医生之前使用的药物一起酮康唑。结合这些药物可以大大增加，血液水平和效果的药. 你的医生可以规定替代品，不进行互动，或者可能需要一剂量的调整或更频繁的监测安全地使用这两种药物。你应该寻求医疗照顾，如果你的经验增加副作用的药物，例如便秘、腹部疼痛或膨胀、排尿困难，麻木或刺痛的手和脚，肌肉软弱，行走困难，听力损失、惊厥、不寻常或过量出血，容易青肿，脸色苍白、疲劳昏厥、感染、发热、冷、喉咙疼痛、或其他类似流感的症状。重要的是要告诉你的医生关于所有其他药物的使用，包括维生素和草药。不停止使用任何药物，没有第一个说你的医生。

医界专家:

一般避免：共同给予有效抑制剂的CYP450 3A4和/或P-糖蛋白质可能会显着增加的等离子浓度的长春花生物碱，这是底两者的肝脏微粒体酶同工酶和细胞内外的转运。虽然药物动力学的数据不可用的互动已经与严重和危及生命的毒性成人和儿童癌症患者。麻痹性肠梗阻、肠梗阻的和穿孔，喉神经麻痹需要的机械通风、神经性膀胱感觉异常、瘫痪，低血压、高血压、心脏衰竭、低钠血次要SIADH、癫痫、深刻骨髓抑制和化粪池的冲击的报道。大多数情况下都涉及药或长春组合与康唑. 但是，互动也已经报告了与其他已知的有效抑制剂，如甲红霉素、红霉素、环孢菌素、泊沙康唑、伏立康和利托那韦、以及较少的强有力的，如硝苯地平和异烟肼。在成年人的急性淋巴细胞性白血病的接收药物作为部分其化学治疗方案，神经毒性(感觉异常、肌肉软弱的，并且麻痹肠梗阻的)更为严重，并发生的早期和更频繁地在14患者加服康唑400毫克/日的对抗真菌药物预防于在460以前的病人没有得到康唑(29％和6％). 同样，在回顾队列研究组成的25患者接受59课程的长春瑞含化疗，发生率的档3或4中性白细胞减少症是63.2%的患者是加服克拉，相比27.5％，在那些没有收到克拉霉素。发生率的4年级的中性白细胞减少症是也较高，在克拉组，31.6％和2.5%. 四个病人已经收到长春瑞具有和不具有克拉低嗜中性白细胞计数在克拉共同给予. 回顾性研究，以评估药物剂量和毒性的结合与唑类发现，新碱的配量的修改(即剂量削减剂量的延误，治疗中断)的发生在58.6%的患者接收到的伴随唑治疗(n=29)相比，23.8%的患者没有(n=21). 这意味着减少剂量的新碱当结合一个唑是46.5%. 症状减少蠕动也更常见的唑组，65.5%和28.6%. 个人的发病率为50%、75%和66.6%的患者接受氟康唑、种药物，并泊沙康唑。此外，患者在唑组更有可能有一个不完整的课程的长春新碱、48.3%和9.5%. 大多数报告的情况下的毒性已经可逆转的以下中止CYP450 3A4抑制剂，许多患者容忍他们的化学疗法在不存在的抑制剂或之后的剂量调整。在一次事件中，然而，一个病人已经康唑真菌性肺炎的发展便秘、粘膜炎，粒细胞后一个星期内第一次剂量的诺和顺，和死了12天后。没有其他细节。

管理：伴随使用的长春花生物碱的有效CYP450 3A4和/或P-糖蛋白抑制剂应该可以避免的，如果可能的。否则，保守剂量的抗肿瘤应被认为与病人密切监视毒性。根据已知的半衰期的长春花生物碱(24至48小时)中，时间当然的相互作用，预计大约为5至7天。病人应被告知寻求医疗注意，如果他们遇到的症状可能表明神经或骨髓抑制，包括便秘、腹部疼痛或膨胀、尿潴留，感觉异常、瘫痪、肌肉乏力、听力丧失、惊厥、不稳定的血压变化，不寻常或过量出血，容易青肿，脸色苍白、疲劳、眩晕、头晕、发热、冷和喉咙痛。以下中止的有效CYP450 3A4抑制剂、清洗周期的大约一个星期应允许之前的抗肿瘤药物剂量向上调整到以前的剂量。

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