Overdosing Symptoms: nausea, vomiting, dizziness and headache, paresthesia and cramps. Treatment: an overdose during the first hour after ingestion it is necessary: to cancel the drug to gastric lavage, activated charcoal to appoint. Needed: dianabol review monitoring the patient’s condition and conduct symptomatic treatment.
Interaction with other medicinal products
1. Drugs that reduce gastric acidity (antacids, H2 blockers, histamine receptors, proton pump inhibitors) reduce the absorption of ketoconazole. Therefore, the reception of these drugs is recommended for at least 2 hours before or 2 hours after administration of ketoconazole.
2. Drugs affecting the metabolism of ketoconazole:
A) significantly reduce the bioavailability of ketoconazole: drugs Inductors microsomal oxidation, such as rifampicin, rifabutin, carbamazepine, nevirapine, phenytoin and isoniazid. The use of ketoconazole concurrently with such drugs is not recommended; B) increasing the bioavailability of ketoconazole, such as ritonavir (therefore while taking necessary to reduce the dose of ketoconazole).
3. Effect of ketoconazole on the metabolism of other drugs:
A) ketoconazole may inhibit the metabolism of drugs metabolized of CYP3A: astemizole, terfenadine, bepridil, halofantrine, disopyramide, cisapride, dofetilide, levacetylmethadol, mizolastine, pimozide, quinidine and sertindole, domperidone. As a result, the concentration of these drugs are increased, which leads to an increase in the frequency and / or duration of the effects, including adverse (for example, the duration of QT interval on the ECG -. Risk of ventricular tachycardia type «torsade de pointe» should not use these drugs concurrently with ketoconazole. B) similar interaction with inhibitors of HMG-CoA reductase metabolised CYP3A4, such as lovastatin and simvastatin. Do not use these drugs simultaneously with ketoconazole.
Dianabol reviewpossible interaction with ergot alkaloids such as dihydroergotamine, ergometrine, ergotamine, metilergometrina (metilergonovinom); nisoldipine; eplerenone. Do not use these drugs simultaneously with ketoconazole. It is also possible interaction with triazolam, and midazolam (increased duration of action of midazolam sedation). Therefore, should not be used simultaneously with ketoconazole midazolam in a dosage form for oral administration, while intravenous midazolam is only permitted when adequate control of the patient. 4. Formulations in which assignment must monitor their concentrations in plasma, therapeutic effects and severity of side effects. Their dosage while receiving ketoconazole should be reduced if necessary:
- Some immunosuppressants: cyclosporin, tacrolimus, sirolimus;
- some steroids, such as budesonide, dexamethasone, and methylprednisolone;
- HIV protease inhibitors such as indinavir, saquinavir;
- Some anticancer drugs such as vinca alkaloids, busulfan and docetaxel;
- metabolized via \ CYP3A4 isoenzyme blockers «slow calcium channels’ dihydropyridine and possibly verapamil.
- Some HMG-CoA reductase inhibitors, such as atorvastatin;
- other drugs: digoxin, buspirone, alfentanil, alprazolam, brotizolam, trimetrexate, ebastine, reboxetine, cilostazol, eletriptan, fentanyl, repaglinide, sildenafil, tolterodine.In rare cases, when taken with alcohol disulfiramopodobnye observed reactions, characterized by redness of the skin, rash, peripheral edema, nausea and headache.These symptoms resolved spontaneously within a few hours.Cautions
When taken Oronazol tablets there is a risk of serious hepatotoxic effects. Therefore, you should Oronazol use in the following cases: when the potential benefits outweigh the potential risks, with the ineffectiveness of the local dosage forms of ketoconazole, with resistance to fluconazole, terbinafine or itraconazole or intolerance.
Hepatotoxicity. In women older than 50 years, in the presence of liver disease in history, with drug intolerance, while taking hepatotoxic drugs the risk of the toxic effect of the drug on the liver increases.
When pronounced weakness with fever, pruritus, dark urine and discolored stools, jaundice and pain the stomach should immediately stop taking the drug, seek medical attention and to assess liver function.
Monitoring of liver function. When the duration of ketoconazole therapy for more than 2 weeks, it is necessary to conduct a study of liver function before treatment, after 2 and 4 dianabol review weeks of treatment and then monthly. If any of the indicators of liver function is increased to values three times the upper limit of normal, the use of ketoconazole should be discontinued.
Monitoring of adrenal function. Patients with adrenal insufficiency and in patients undergoing prolonged and significant stress factors (extensive surgery, resuscitation, etc.) In the appointment of the drug should monitor adrenal function, as ketoconazole decreases cortisol response to stimulation by adrenocorticotropic hormone (ACTH).
In in-vitro studies, ketoconazole is considered to be unsafe in patients with porphyria, so the use of ketoconazole with porphyria should be avoided as much as possible. On the application of data Oronazol drug in children weighing less than 15 kg is very limited. Therefore, this category of patients the drug is not recommended. Oronazol contains lactose, therefore patients with hereditary galactose intolerance, Lapp lactase deficiency or malabsorption of glucose-galactose should not take the drug.