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Updated: Feb 1, 2026

Human Liver Microphysiological System for Assessing Drug-Induced Liver Toxicity In Vitro
Published on: January 31, 2022
Pre-Existing Liver Disease and Toxicity of Antifungals
Nikolaos Spernovasilis1, Diamantis P Kofteridis2,3
1Department of Internal Medicine and Infectious Diseases, University Hospital of Heraklion, P.O. Box 1352, 71110 Heraklion, Crete, Greece. nikspe@hotmail.com.
Abstract:
Pre-existing liver disease in patients with invasive fungal infections further complicates their management. Altered pharmacokinetics and tolerance issues of antifungal drugs are important concerns. Adjustment of the dosage of antifungal agents in these cases can be challenging given that current evidence to guide decision-making is limited. This comprehensive review aims to evaluate the existing evidence related to antifungal treatment in individuals with liver dysfunction. This article also provides suggestions for dosage adjustment of antifungal drugs in patients with varying degrees of hepatic impairment, after accounting for established or emerging pharmacokinetic⁻pharmacodynamic relationships with regard to antifungal drug efficacy in vivo.
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