Antimicrobial Use Guidelines (AMUG) version 21 - UW Health

• Donepezil • Pioglitazone• Dronaderone • Praziquantel• Dutasteride • Ramelteon• Efavirenz • Ranolazine• Eplerenone • Reboxetine• Ergot derivatives • Repaglinide* - Drug is contraindicated to administer concurrently with ketoconazoleOther drugs that interact with ketoconazole include:• Amprenavir – increases ketoconazole levels• Clopidogrel – has decreased efficacy due to reduced metabolism to active moiety• Digoxin – has its levels increased by ketoconazole• Efavirenz – increases ketoconazole levels• Erythromycin – increases ketoconazole levels• Escitalopram – decreases ketoconazole levels• Etravirine – decreases ketoconazole levels• Isoniazid – decreases ketoconazole levels• Lopinavir – increases ketoconazole levels• Nevirapine – decreases ketoconazole levels• Phenytoin/fosphenytoin – decreases ketoconazole levels; variable effects on phenytoin levels• Rifampin – decreases ketoconazole levels• Rifapentane – decreases ketoconazole levels• Ritonavir – increases ketoconazole levels• Tipranivir – increases ketoconazole levelsKetonazole may prolong the QT interval, an effect that may be additive with the QT-prolonging effects of many drugsincluding the following:• Amiodarone • Iloperidone• Artemether/lumefantrine • Levomethadyl• Astemizole (contraindicated) • Mefloquine• Bretylium • Methadone• Cisapride (contraindicated) • Quinidine• Dofetilide • Ranolazine• Halofantrine • Sotalol• Ibutilide • Terfenadine (contraindicated)LAMIVUDINEAlso a component of the combination products Combivir ® , Epzicom ® , and Trizivir ®1. For up-to-date information on the use of antiretrovirals, consult an HIV expert or www.aidsinfo.nih.gov/2. Also used in chronic hepatitis B at a daily dose of 100 mg, with adjustments for renal insufficiency. (UWHC cost/day$11.01)LEVOFLOXACINInfectious Disease approval required for use of levofloxacin except for concurrent pneumonia and UTI or forsusceptible Stenotrophomonas maltophiliaUsual DoseAdult 250-750 mg IV/PO Q24H (UWHC cost/day PO $15.06-29.40; IV $17.64-46.84)Safety and efficacy in children have not been established.Indications1. Community-acquired pneumonia in patients with penicillin-resistant pneumococcal infections or penicillin allergy.2. Complicated and uncomplicated urinary tract infections with susceptible organisms.