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Related Concept Videos

Pharmacokinetics: Drug–Drug Interactions01:25

Pharmacokinetics: Drug–Drug Interactions

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Drug interactions occur when the pharmacological effect of one drug is altered by another substance, either enhancing or diminishing its activity. The drug whose activity is altered is known as the object drug, and the substance causing the alteration is called the agent drug or the precipitant. The net effects of these interactions are mostly undesirable, leading to decreased effectiveness or increased adverse effects. In rare cases, interactions can be beneficial, such as the enhanced...
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A drug interaction occurs when the concurrent use of another drug, food, or an external substance alters the pharmacological activity of a drug. This interaction can modify the action of the original drug, affecting its effectiveness and safety.Drug–food interactions are significant as they impact drug absorption, metabolism, and excretion. For example, grapefruit juice is a well-known disruptor of drug metabolism. It inhibits the cytochrome P450 3A4 enzyme, crucial for the metabolism of...
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Pharmacokinetics is a scientific discipline that focuses on the journey of a drug within the body, encompassing four key stages: absorption, distribution, metabolism, and elimination. The first stage, absorption, involves the drug's transfer into the bloodstream. Several factors dictate the extent and speed of this process. For example, the liver often metabolizes oral drugs before they reach systemic circulation, leading to only partial absorption. In contrast, intravenous (IV)...
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Pharmacokinetic models utilize mathematical analysis to achieve a detailed quantitative understanding of a drug's life cycle within the body. They are instrumental in simulating a drug's pharmacokinetic parameters, predicting drug concentrations over time, optimizing dosage regimens, linking concentrations with pharmacologic activity, and estimating potential toxicity.
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Nonlinear or dose-dependent pharmacokinetics is a phenomenon that occurs when the pharmacokinetic parameters of certain drugs deviate from linear pharmacokinetics at higher doses. These drugs do not follow the expected first-order kinetics, where the rate of drug elimination is directly proportional to the drug concentration. Instead, they exhibit a nonlinear relationship, which can be attributed to several factors.
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Related Experiment Video

Updated: Jan 24, 2026

An Intestine/Liver Microphysiological System for Drug Pharmacokinetic and Toxicological Assessment
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Pharmacokinetic Interaction Between Isavuconazole and Rifabutin in a Real-World Setting.

Sunish Shah1,2, Lloyd Clarke1, Tiffany Lee3

  • 1Antibiotic Management Program, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

Mycoses
|January 23, 2026
PubMed
Summary

Isavuconazole levels remain adequate when taken with rifabutin, a preferred drug due to fewer interactions. Therapeutic drug monitoring is still essential for patients receiving both isavuconazole and rifabutin.

Keywords:
isavuconazolerifabutinrifampintherapeutic drug monitoring

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Area of Science:

  • Pharmacology
  • Infectious Diseases

Background:

  • Rifabutin is preferred over rifampin for concomitant use with azole antifungals due to fewer drug interactions.
  • Limited data exist on the interaction between rifabutin and isavuconazole.

Purpose of the Study:

  • To evaluate isavuconazole trough concentrations in patients receiving concomitant rifabutin.
  • To assess the safety and efficacy of this drug combination.

Main Methods:

  • A single-center study involving hospitalized patients.
  • Isavuconazole was administered at a standard dose with therapeutic drug monitoring.
  • Patients received concomitant isavuconazole and rifabutin.

Main Results:

  • Seven patients were included; 71% were solid organ transplant recipients.
  • Median isavuconazole trough concentration was 2.7 mg/L, with 86% above 1 mg/L.
  • Pharmacokinetic parameters (AUC24, T½, Cl) were determined.

Conclusions:

  • Isavuconazole trough concentrations are often maintained above 1 mg/L when co-administered with rifabutin.
  • Therapeutic drug monitoring is mandatory in this clinical setting.
  • Further research is needed to confirm these findings.