Pharmacological interactions of isavuconazole

The interactions between the various drugs a patient receives at any given time are crucial for justifying treatments, especially considering the often severe adverse effects associated with them. These interactions are particularly significant for azole antifungals, such as voriconazole, fluconazole, posaconazole, and itraconazole. The most recently marketed azole, isavuconazole, stands out due to its lower inhibitory effect on various CYP450 enzymes and transport proteins. While it can induce some isoenzymes of the CYP450 superfamily, its impact is minimal. As a result, we can conclude that its interactions with other drugs are less pronounced, which reduces the need for treatment adjustments or dose modifications. Additionally, isavuconazole boasts high oral bioavailability, an extensive volume of distribution, and a notably long elimination half-life. A significant side effect common to all azoles, but not associated with isavuconazole, is the prolongation of the QTc interval, which can sometimes lead to the risk of Torsades de Pointes. These advantages make isavuconazole the preferred antifungal choice for patients on multiple medications.