6 replies to this topic

[AlexCanada]

I am frustrated and don't know how to deal with this.  She says the 1mg valium I am taking has a serious interaction with Sporanox (itraconazole). I checked. And basically all it does is increase valium's level of effect. I can't quit the valium cold turkey. I am withdrawing from it for past few years.  

 

I need to treat this fungal infection inside of me because I been feeling seriously ill.  And now this insane roadblock.

 

 

Any advice?

 

The interaction with valium is it really incredibly severe to the point where I am warranted to suffer without anti-fungal treatment?    My skin is bit yellow, I look like a ghoul with intense dark circles under my eyes, and I have fungas on my back, my shoulder and my toes.    I obviously need treatment.

 

 

Just how much of a level of effect increase would the Sporanox cause towards valium?   50%? 100%? 200%?    What should I expect.    Should 1mg of Valium with 50-100mg of Sporanox be relatively safe? 

Edited by AlexCanada, 05 June 2015 - 10:13 PM.

[AlexCanada]

If there is any alternative anti-fungal that doesn't interact w Valium please let me know but I know a few I checked all appear to. 

[niner]

Wow, that's different.  My pharmacists don't seem to give a crap that I get drugs from them that have interactions.   Your pharmacist is excessively paranoid.
 
Sporanox (itraconazole) is mostly a p450-3A4 inhibitor, as is grapefruit and a million other things.  Valium (diazepam) is metabolized by at least 4 different enzymes, one of which is p450-3A4.  With three other routes of disposal, I wouldn't expect a big effect.  In fact, it's been looked at, and there appears to be little or no danger.  Show this abstract to your pharmacist, or ask for your prescription back and find a pharmacist who is less of a nanny.  I suppose it's conceivable that you could mess up your taper schedule, although I doubt there would be a problem.  You could shave 20% off each diazepam tablet until you're done with the sporanox, if you want.  Even if you shut metabolism down completely, at only 1mg a day, you aren't going to die, given that you are an experienced user.  If you start to feel too chill, just take less valium.
 

Fundam Clin Pharmacol. 1996;10(3):314-8.
The effect of the antimycotic itraconazole on the pharmacokinetics and pharmacodynamics of diazepam.
Ahonen J1, Olkkola KT, Neuvonen PJ.

The azole antimycotic itraconazole is a potent and relatively unspecific inhibitor of cytochrome P450 enzymes and has a potentially dangerous interaction with midazolam and triazolam. The possible interaction between itraconazole and diazepam was investigated in a double-blind, randomized, cross-over study. Ten healthy volunteers were given orally placebo or itraconazole 200 mg a day for 4 days. The challenge dose of 5 mg of diazepam was ingested on the fourth day, after which plasma samples were collected and psychomotor performance tests were carried out for 42 h. Despite a statistically significant small increase in the area under the plasma diazepam concentration-time curve and the elimination half-life of diazepam, there was no clinically significant interaction as determined by the psychomotor performance tests. The lack of significant first-pass metabolism and the different metabolic pathways of diazepam explain the smaller interaction potential of diazepam compared with midazolam and triazolam. Diazepam, unlike midazolam and triazolam, can be prescribed in usual doses for patients receiving itraconazole and probably other inhibitors of P4503A4, at least when diazepam is used as single doses.

PMID: 8836707

[AlexCanada]

Thank you so much for the information! It means a lot to me.  Good advice on the slightly lower valium.

 

The pharmacist was still preventing me from getting it today. The stress of it all nearly had me lose my mind. I am going through a lot and if I had to keep waiting again and again to treat this I'd go mad.

 

Luckily it turns out Fluconazole is available over the counter in Canada and has indications for most forms of systemic candida aside from other fungal infections.  I will get some later today and hope for the best. To be limited to just skin cream when it's something clearly inside of my body would be just insane.  I use the cream and more fungus appears elsewhere. It just keeps coming. I will not attempt to wait however many weeks to see a specialist. Finally I can take matters into my own hands.   I have had too many debilitating neurological symptoms that have been wrecking my life. 

 

Doctors just kept giving me the run around and so many refuse to even believe in Candida infections despite it even being stated on the CDC website. I think the health care system will have to play catch up with this for the next few decades just like with major depression and countless other illnesses through out history.  A real shame really.

 

I fear die off symptoms because caprylic acid, oil of oregano and other non-pharma treatments have caused such intense reactions such as powerful irritability, anger, mood swings, immense fatigue and headaches when I tried them some months ago.   We'll see what happens I guess. 

Edited by AlexCanada, 06 June 2015 - 05:27 PM.

[niner]

There are a couple things that don't make sense...  Your doctors are giving you a runaround (they don't think you have a fungal infection?), but someone gave you a prescription for Sporanox?  Fungus on your toes is a very common condition (athlete's foot).  But on your back and shoulders?  Those are pretty unusual sites for a fungal infection.  Are you sure it's not something else?  What was the diagnosis that led a doctor to write you a prescription for an oral antifungal?  If the doctor is not a quack and really thought an oral drug was warranted, then 1 mg of valium shouldn't be standing in the way.  Why can't you just go to a different pharmacy? 

[AlexCanada]

There are a couple things that don't make sense...  Your doctors are giving you a runaround (they don't think you have a fungal infection?), but someone gave you a prescription for Sporanox?  Fungus on your toes is a very common condition (athlete's foot).  But on your back and shoulders?  Those are pretty unusual sites for a fungal infection.  Are you sure it's not something else?  What was the diagnosis that led a doctor to write you a prescription for an oral antifungal?  If the doctor is not a quack and really thought an oral drug was warranted, then 1 mg of valium shouldn't be standing in the way.  Why can't you just go to a different pharmacy? 

 

They know I have a fungal infection but they keep wanting to only prescribe creams when the problem I am having is clearly beyond surface level. These are not brilliant doctors mind you and outright incompetent from my past history. Just a few walk-in clinic docs. At first I didn't even know what it was on my back. It looked like different colored spots all over and they kept getting more severe. I had no clue this was fungas until the doctor told me.  I wish it wasn't the case but it started to get pretty out of control a few weeks ago and new small spots keep emerging.      edit-  also some Whiteish rashes on my thighs,

 

I change my sheets every week. And I try to maintain proper hygene. Shower every 2 days. Wash my back every day. I am certainly not going to bed sweaty at all.             **Looking back a lot of this may have been exacerbated by a corticosteroid my pdoc gave me a month ago in order to test my cortisol response and ''supress'' my cortisol and test for cushings which I felt was an absolute waste. Low adrenals is my issue, not the other way around. Not sure what he was thinking with that one. 

 

I do have what strongly resembles athletes foot on the bottom of my feet but my actual toe nails have very obvious fungus on at least 8 of them (and I had this for at least few years).  Lamasil cream has been helping a bit over past 3 days I noticed for both toes, back, and shoulder. 

 

The actual diagnosis? ''That's fungas" was what my family doctor said.  What kind? That would be beyond her scope. Walk-in clinic doc didn't specify anything either. She just gave cream + pill prescription.

 

I couldn't take the prescription to a dif pharmacy because this first pharmacy took it. I handed over the paper and expected to get everything the next day. That didn't happen unfortunately.  Now I'm stuck paying for the overpriced over the counter Fluconazole. Maybe next week I go to a dif walk-in clinic and get the sporanox or fluconazole prescription (should be cheaper that way for a 7 day supply). 

Edited by AlexCanada, 07 June 2015 - 10:55 AM.

[niner]

I was going to ask if you were immunosuppressed-- a large dose of corticosteroids can cause trouble.  Which one did you use, and how much of it?  I'd at least ask for the prescription back, since it's not a controlled substance.  (If they thought you were trying to scam the system to get opiates, they can legally keep the prescription, at least in the US)  You could also show the pharmacist that abstract and try to convince her that what you're doing isn't dangerous.   Sorry to see you getting caught up in such a Kafka-esque web...