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Published on: December 28, 2017
Update on drug interactions with azole antifungal agents
1Department of Pharmacy, Albany Medical Center, NY 12208, USA. Blomaestro@ccgateway.amc.edu
The Annals of Pharmacotherapy
|October 8, 1998
Summary
Azole antifungals like itraconazole, ketoconazole, and fluconazole can cause significant drug interactions. Understanding these interactions is crucial for safe and effective patient care.
Area of Science:
- Pharmacology
- Mycology
- Drug Interactions
Background:
- Azole antifungals are increasingly used to treat fungal infections.
- These agents inhibit cytochrome P450 fungal enzyme systems, leading to potential drug interactions.
- The incidence of fungal infections and azole antifungal usage is rising.
Purpose of the Study:
- To review and update the incidence, mechanism, and clinical relevance of drug interactions with itraconazole, ketoconazole, and fluconazole.
- To enhance understanding of drug-drug interactions involving azole antifungals.
Main Methods:
- Literature search of MEDLINE (1990-1997) using antifungal names and "interaction" as MeSH headings.
- Included randomized controlled trials, uncontrolled studies, case reports, and in vitro data.
- Evaluated data for study design, clinical relevance, magnitude, and recommendations.
Main Results:
- Azole antifungals are implicated in numerous drug interactions due to their mechanism of action.
- The severity of these interactions ranges from minor to life-threatening.
- Interaction magnitude varies depending on the specific azole and interacting drug.
Conclusions:
- Azole antifungals are frequently prescribed and possess a wide spectrum of potential drug interactions.
- Recent research has improved the understanding of azole drug-drug interactions.
- Pharmacists play a key role in identifying and managing these interactions to improve patient outcomes.
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