Orapred/Ketoconozole interaction!

[Stephanie2]

So, I have been banging my head against the wall all day trying to wrap my mind around what the HECK is going on with my son!! I started to think that this was really starting to resemble a previous problem we had when we combined singulair and zyrtec. My son lost his mind for 2 months and I couldnt' understand what was wrong...we were in total crisis. I finally did a google search and found that the meds were probably the cause. I stopped the meds and voila...24 hours he was acting completely NORMAL!!!!!

 

So, it just popped into my head to do a google search of orapred and cytochrome p470 system (liver enzyme pathway that clears out drugs...former drug rep here...don't throw tomatoes). Here is the link that popped up!!!!!!:

 

http://www.webmd.com/drugs/drug-20260-Orapred+Oral.aspx?drugid=20260&drugname=Orapred+Oral&dmid=1503&dmtitle=SELECTED%20CORTICOSTEROIDS/ITRACONAZOLE;%20KETOCONAZOLE&intrtype=DRUG&pagenumber=9

 

Giving these two together can dramatically raise the level of orapred in the system. My son has been on ketoconozole (antifungal) for over a month. There ya go, I'm willing to bet my life on the fact that this has been our problem. And here I go adding on 2 more drugs: tenex and risperdal. I'm sure his liver is just lovin' it.

 

I'm stopping keto in the morning, I'm also stopping risperdal and tenex and tapering the orapred. But now I have to wonder if I have to SLOW the taper down b/c it will be too dramatic of a drop!

 

When do I get to take my detective hat off...I'm so tired!

[thereishope]

Good find! Think this through, though. So, it's been taking longer for the body to process the steroid,hence he has more built up in his system. Thinking out loud here....if you stop the keto, how long does that take to fully get out of his system? You may not want to lower the steroid taper right now. By stopping the keto, that is like part of the taper. Follow me? You can continue with tapering down the steroid once the keto is fully out of his system. You actually may want to discuss this with the doctor that gave the steroid and see what's the right couse of action.

[kimballot]

Stephanie - I can see you are racking your brains out trying to make sense of this and it looks like you may have found it. But... it would be good for you to get an outside opinion from someone who can look at this objectively and who is not exhausted (not that I am doubting your abilities.. just thinking you must be in sleep deprivation mode by now)

 

I agree with Vickie (as I often do )... discussing this with the doc or even with a pharmacist who might be able to help you would be good.

[Stephanie2]

That's exactly my thinking, Vickie. Only problem is we are going into the weekend! But I will not taper this weekend and will try to get in touch with someone on Monday just to confirm that I should taper as planned or slow it down. I am leaning toward slowing it down, but that depends on if anyone is willing to give me some more orapred, i don't think I have any extra.

[AmberM]

So, I have been banging my head against the wall all day trying to wrap my mind around what the HECK is going on with my son!! I started to think that this was really starting to resemble a previous problem we had when we combined singulair and zyrtec. My son lost his mind for 2 months and I couldnt' understand what was wrong...we were in total crisis. I finally did a google search and found that the meds were probably the cause. I stopped the meds and voila...24 hours he was acting completely NORMAL!!!!!

 

So, it just popped into my head to do a google search of orapred and cytochrome p470 system (liver enzyme pathway that clears out drugs...former drug rep here...don't throw tomatoes). Here is the link that popped up!!!!!!:

 

http://www.webmd.com/drugs/drug-20260-Orapred+Oral.aspx?drugid=20260&drugname=Orapred+Oral&dmid=1503&dmtitle=SELECTED%20CORTICOSTEROIDS/ITRACONAZOLE;%20KETOCONAZOLE&intrtype=DRUG&pagenumber=9

 

Giving these two together can dramatically raise the level of orapred in the system. My son has been on ketoconozole (antifungal) for over a month. There ya go, I'm willing to bet my life on the fact that this has been our problem. And here I go adding on 2 more drugs: tenex and risperdal. I'm sure his liver is just lovin' it.

 

I'm stopping keto in the morning, I'm also stopping risperdal and tenex and tapering the orapred. But now I have to wonder if I have to SLOW the taper down b/c it will be too dramatic of a drop!

 

When do I get to take my detective hat off...I'm so tired!