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Fluconazole-induced convulsions at serum trough concentrations of approximately 80 microg/mL
K Matsumoto1, K Ueno, H Yoshimura
1Department of Pharmacy, National Cardiovascular Center, Suita-city, Osaka, Japan.
Therapeutic Drug Monitoring
|October 18, 2000
Abstract:
On the basis of two case reports it is suggested that serious convulsions may occur in patients treated with flucoazole when serum trough concentrations exceed 80 microg/mL. The authors recommend monitoring fluconazole concentrations during high-dose therapy in patients with poor kidney function.
Insights
Serious convulsions may occur in patients receiving high-dose fluconazole if serum trough concentrations exceed 80 microg/mL. Monitoring is recommended for patients with impaired kidney function during high-dose fluconazole therapy.
Area of Science:
- Pharmacology
- Clinical Neurology
Background:
- Fluconazole is a widely used antifungal medication.
- High-dose therapy is sometimes necessary for severe fungal infections.
Observation:
- Two case reports suggest a link between fluconazole and serious convulsions.
- This association was observed when serum trough concentrations surpassed 80 microg/mL.
Findings:
- Elevated serum trough concentrations of fluconazole ( > 80 microg/mL) may precipitate serious convulsions.
- Patient factors, such as impaired kidney function, might influence fluconazole accumulation.
Implications:
- Clinicians should consider monitoring fluconazole serum levels in patients receiving high-dose treatment, especially those with renal impairment.
- This monitoring may help prevent adverse neurological events like seizures.
- Further research is warranted to confirm this association and establish clear therapeutic drug monitoring guidelines.