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Factors Influencing the Magnitude and Clinical Significance of Drug Interactions Between Azole Antifungals and Select Immunosuppressants

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dc.contributor.author Saad, Aline
dc.date.accessioned 2016-09-23T12:02:36Z
dc.date.available 2016-09-23T12:02:36Z
dc.date.copyright 2006 en_US
dc.identifier.issn 0277-0008 en_US
dc.identifier.uri http://hdl.handle.net/10725/4355
dc.description.abstract The magnitude of drug interactions between azole antifungals and immunosuppressants is drug and patient specific and depends on the potency of the azole inhibitor involved, the resulting plasma concentrations of each drug, the drug formulation, and interpatient variability. Many factors contribute to variability in the magnitude and clinical significance of drug interactions between an immunosuppressant such as cyclosporine, tacrolimus, or sirolimus and an antifungal agent such as ketoconazole, fluconazole, itraconazole, voriconazole, or posaconazole. By bringing similarities and differences among these agents and their potential interactions to clinicians’ attention, they can appreciate and apply these findings in a individualized patient approach rather than follow only the one-size-fits-all dosing recommendations suggested in many tertiary references. Differences in metabolism and in the inhibitory potency of cytochrome P450 3A4 and Pglycoprotein influence the onset, magnitude, and resolution of drug interactions and their potential effect on clinical outcomes. Important issues are the route of administration and the decision to preemptively adjust dosages versus intensive monitoring with subsequent dosage adjustments. We provide recommendations for the concomitant use of these agents, including suggestions regarding contraindicated combinations, those best avoided, and those requiring close monitoring of drug dosages and plasma concentrations. en_US
dc.language.iso en en_US
dc.title Factors Influencing the Magnitude and Clinical Significance of Drug Interactions Between Azole Antifungals and Select Immunosuppressants en_US
dc.type Article en_US
dc.description.version Published en_US
dc.author.school SOP en_US
dc.author.idnumber 200703818 en_US
dc.author.department N/A en_US
dc.description.embargo N/A en_US
dc.relation.journal Pharmacotherapy en_US
dc.journal.volume 26 en_US
dc.journal.issue 12 en_US
dc.article.pages 1730-1744 en_US
dc.keywords Drug interactions en_US
dc.keywords Azole antifungals en_US
dc.keywords Immunosuppressants en_US
dc.keywords Ketoconazole en_US
dc.keywords Itraconazole en_US
dc.keywords Fluconazole en_US
dc.keywords Voriconazole en_US
dc.keywords Cyclosporine en_US
dc.keywords Tacrolimus en_US
dc.keywords Sirolimus en_US
dc.identifier.doi http://dx.doi.org/10.1592/phco.26.12.1730 en_US
dc.identifier.ctation Saad, A. H., DePestel, D. D., & Carver, P. L. (2006). Factors influencing the magnitude and clinical significance of drug interactions between azole antifungals and select immunosuppressants. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, 26(12), 1730-1744. en_US
dc.author.email aline.saad@lau.edu.lb en_US
dc.identifier.tou http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php en_US
dc.identifier.url http://onlinelibrary.wiley.com/doi/10.1592/phco.26.12.1730/abstract en_US


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