Re: Adrenal insufficiency (Fluconazole/Prednisone) was Milk Thistle- Pam

[Guest guest]

Pam:

You have to consider everything your taking, and it looks so far

like prednisone, milk thistle, fluconazole and ibuprofen....

SO, I just looked some stuff up for you.

Fluconazole moderately inhibits CYP3A4 and potently inhibits CYP2C9.

One of the pathways Ibuprofen inhibits is also CYP 2C9...

Prednesone is a CYP3A4 substrate, and there have been cases of

adrenal insufficiency in patients on prednisone and fluconazole that

appeared AFTER the fluconazole was stopped because of increased

prednisone metabolism. I don't know the dosages involved.. but it

doesn't take too much prednisone to get a systemic response.

I would discuss these interactions with your Dr., because it seems

to me you are taking several drugs that are interacting, and it's

possible it's why you feel sick.

Barb

PS

Here's something to print out and give to your DOc.

http://www.mpa.se/spc_pil/pdf/enhumspc/Fluconazol%20ratiopharm%

20capsule%20hard%20ENG.pdf

>Hi Barb

Many thanks for your detailed reply and I rather guessed it might be

something like that. Therefore the past 2 days since I restarted

flucanzole but only at 75mg daily I have stopped the milk thistle.

The only other drugs I take each day is Armour and a small amount of

T4 for my thryoid plus just 2.5mg Prednisolone, possibly they also

use that pathway.

I have also been taking Ibruprofen for my stiff neck and indeed it

does help a bit.

Best Wishes

Pam

[Guest guest]

> Pam:

>

> You have to consider everything your taking, and it looks so

far

> like prednisone, milk thistle, fluconazole and ibuprofen....

>

> SO, I just looked some stuff up for you.

>

> Fluconazole moderately inhibits CYP3A4 and potently inhibits

CYP2C9.

> One of the pathways Ibuprofen inhibits is also CYP 2C9...

>

> Prednesone is a CYP3A4 substrate, and there have been cases of

> adrenal insufficiency in patients on prednisone and fluconazole

that

> appeared AFTER the fluconazole was stopped because of increased

> prednisone metabolism. I don't know the dosages involved.. but

it

> doesn't take too much prednisone to get a systemic response.

>

> I would discuss these interactions with your Dr., because it

seems

> to me you are taking several drugs that are interacting, and it's

> possible it's why you feel sick.

>

>

> Barb

> PS

>

> Here's something to print out and give to your DOc.

>

> http://www.mpa.se/spc_pil/pdf/enhumspc/Fluconazol%20ratiopharm%

> 20capsule%20hard%20ENG.pdf

>

Hi Barb

Thanks again but I couldn't get the link to work. BTW I have

stopped all herbal supplements and have only taken 3 Ibuprofen

today, I don't take it regularly. I will watch carefully what

happens to my adrenals when I stop the flucanzole, I am always very

aware they get badly hit when my health goes downhill and I often

have to add in extra hydrocortisone when this happens.

Because I had stopped all drugs for the past 3 weeks apart from the

thyroid/adrenal meds I have been feeling very well apart from the

stiff neck so it should be easy to tell what goes on as I increase

the dosage of flucanzole (only 75mg yesterday and today so far).

Pam

[Guest guest]

Hey Barb thanks for the info on your last few posts ...another possibility worth considering is the addition of Lactoferrin with Ibuprofen or aspirin ..I haven't tried it , but I think I will...anyone with any experience of it ...

http://www.pdrhealth.com/drug_info/nmdrugprofiles/nutsupdrugs/lac_0314.shtml

http://www.lef.org/magazine/mag2001/apr2001_report_lacto.html

-----Original Message-----From: infections [mailto:infections ]On Behalf Of Barb PeckSent: 20 May 2005 20:00infections Subject: [infections] Re: Adrenal insufficiency (Fluconazole/Prednisone) was Milk Thistle- PamPam: You have to consider everything your taking, and it looks so far like prednisone, milk thistle, fluconazole and ibuprofen....SO, I just looked some stuff up for you.Fluconazole moderately inhibits CYP3A4 and potently inhibits CYP2C9.One of the pathways Ibuprofen inhibits is also CYP 2C9...Prednesone is a CYP3A4 substrate, and there have been cases of adrenal insufficiency in patients on prednisone and fluconazole that appeared AFTER the fluconazole was stopped because of increased prednisone metabolism. I don't know the dosages involved.. but it doesn't take too much prednisone to get a systemic response. I would discuss these interactions with your Dr., because it seems to me you are taking several drugs that are interacting, and it's possible it's why you feel sick.BarbPSHere's something to print out and give to your DOc.http://www.mpa.se/spc_pil/pdf/enhumspc/Fluconazol%20ratiopharm%20capsule%20hard%20ENG.pdf >Hi BarbMany thanks for your detailed reply and I rather guessed it might besomething like that. Therefore the past 2 days since I restartedflucanzole but only at 75mg daily I have stopped the milk thistle.The only other drugs I take each day is Armour and a small amount ofT4 for my thryoid plus just 2.5mg Prednisolone, possibly they alsouse that pathway.I have also been taking Ibruprofen for my stiff neck and indeed itdoes help a bit.Best WishesPam

[Guest guest]

Pam:

Copy and paste in in your web browser.. I guess it's too long for a

direct link.

http://www.mpa.se/spc_pil/pdf/enhumspc/Fluconazol%20ratiopharm%

20capsule%20hard%20ENG.pdf

_________________________________________________________

> > Pam:

> >

> > You have to consider everything your taking, and it looks so

> far

> > like prednisone, milk thistle, fluconazole and ibuprofen....

> >

> > SO, I just looked some stuff up for you.

> >

> > Fluconazole moderately inhibits CYP3A4 and potently inhibits

> CYP2C9.

> > One of the pathways Ibuprofen inhibits is also CYP 2C9...

> >

> > Prednesone is a CYP3A4 substrate, and there have been cases of

> > adrenal insufficiency in patients on prednisone and fluconazole

> that

> > appeared AFTER the fluconazole was stopped because of increased

> > prednisone metabolism. I don't know the dosages involved.. but

> it

> > doesn't take too much prednisone to get a systemic response.

> >

> > I would discuss these interactions with your Dr., because it

> seems

> > to me you are taking several drugs that are interacting, and it's

> > possible it's why you feel sick.

> >

> >

> > Barb

> > PS

> >

> > Here's something to print out and give to your DOc.

> >

> > http://www.mpa.se/spc_pil/pdf/enhumspc/Fluconazol%20ratiopharm%

> > 20capsule%20hard%20ENG.pdf

> >

>

> Hi Barb

>

> Thanks again but I couldn't get the link to work. BTW I have

> stopped all herbal supplements and have only taken 3 Ibuprofen

> today, I don't take it regularly. I will watch carefully what

> happens to my adrenals when I stop the flucanzole, I am always very

> aware they get badly hit when my health goes downhill and I often

> have to add in extra hydrocortisone when this happens.

>

> Because I had stopped all drugs for the past 3 weeks apart from the

> thyroid/adrenal meds I have been feeling very well apart from the

> stiff neck so it should be easy to tell what goes on as I increase

> the dosage of flucanzole (only 75mg yesterday and today so far).

>

> Pam

[Guest guest]

Hi :

Awareness yes, experience no.

Always sounded intriguing to me.

Let us know how it goes if you do.

Barb

> >Hi Barb

>

> Many thanks for your detailed reply and I rather guessed it might

be

> something like that. Therefore the past 2 days since I restarted

> flucanzole but only at 75mg daily I have stopped the milk thistle.

>

> The only other drugs I take each day is Armour and a small amount

of

> T4 for my thryoid plus just 2.5mg Prednisolone, possibly they also

> use that pathway.

>

> I have also been taking Ibruprofen for my stiff neck and indeed it

> does help a bit.

>

> Best Wishes

>

> Pam

>

>

>

>

>

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