Drug General Information (ID: DDIICJTV02)
Drug Name			Itraconazole		Drug Info		Sodium bicarbonate		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antifungal Agents				Antidiarrheals
Structure

Mechanism of Itraconazole-Sodium bicarbonate Interaction (Severity Level: Moderate)
Altered gastric pH Click to Show/Hide Mechanism Graph
Drug Name		Itraconazole				Sodium bicarbonate
Mechanism		Gastric pH sensitive				Gastric alkalinizer
Key Mechanism Factor 1
		Factor Name		Gastric pH
		Factor Description		The normal pH range of gastric acid is between 1.5 and 3.5 and is highly acidic, consisting mainly of hydrochloric acid. Changes in the pH of the stomach can alter the absorption of drugs.
Mechanism Description		Decreased absorption of Itraconazole due to altered gastric pH caused by Sodium bicarbonate

Recommended Action
Management		Separation of doses by two or more hours is recommended.

References
1	Brass C, Galgiani JN, Blaschke TF, et al "Disposition of ketoconazole, an oral antifungal, in humans." Antimicrob Agents Chemother 21 (1982): 151-8. [PMID: 6282204]
2	Carlson JA, Mann HJ, Canafax DM "Effect of pH on disintegration and dissolution of ketoconazole tablets." Am J Hosp Pharm 40 (1983): 1334-6. [PMID: 6310994]
3	Katz HI "Drug interactions of the newer oral antifungal agents." Br J Dermatol 141 (1999): 26-32. [PMID: 10730911]
4	Product Information. Sporanox (itraconazole). Janssen Pharmaceutica, Titusville, NJ.
5	Van der Meer JW, Keuning JJ "The influence of gastric acidity on the bio-availability of ketoconazole." J Antimicrob Chemother 6 (1980): 552-4. [PMID: 6253434]