Factors Influencing the Magnitude and Clinical Significance of Drug Interactions Between Azole Antifungals and Select Immunosuppressants

The magnitude of drug interactions between azole antifungals and immunosuppressants is drug and patient specific and depends on the potency of the azole inhibitor involved, the resulting plasma concentrations of each drug, the drug formulation, and interpatient variability. Many factors contribute t...

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محفوظ في:
التفاصيل البيبلوغرافية
المؤلف الرئيسي: Saad, Aline (author)
التنسيق: article
منشور في: 2006
الوصول للمادة أونلاين:http://hdl.handle.net/10725/4355
http://dx.doi.org/10.1592/phco.26.12.1730
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
http://onlinelibrary.wiley.com/doi/10.1592/phco.26.12.1730/abstract
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author Saad, Aline
author_facet Saad, Aline
author_role author
dc.creator.none.fl_str_mv Saad, Aline
dc.date.none.fl_str_mv 2006
2016-09-23T12:02:36Z
2016-09-23T12:02:36Z
2016-09-23
dc.identifier.none.fl_str_mv 0277-0008
http://hdl.handle.net/10725/4355
http://dx.doi.org/10.1592/phco.26.12.1730
Saad, A. H., DePestel, D. D., & Carver, P. L. (2006). Factors influencing the magnitude and clinical significance of drug interactions between azole antifungals and select immunosuppressants. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, 26(12), 1730-1744.
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
http://onlinelibrary.wiley.com/doi/10.1592/phco.26.12.1730/abstract
dc.language.none.fl_str_mv en
dc.relation.none.fl_str_mv Pharmacotherapy
dc.rights.*.fl_str_mv info:eu-repo/semantics/openAccess
dc.title.none.fl_str_mv Factors Influencing the Magnitude and Clinical Significance of Drug Interactions Between Azole Antifungals and Select Immunosuppressants
dc.type.none.fl_str_mv Article
info:eu-repo/semantics/publishedVersion
info:eu-repo/semantics/article
description The magnitude of drug interactions between azole antifungals and immunosuppressants is drug and patient specific and depends on the potency of the azole inhibitor involved, the resulting plasma concentrations of each drug, the drug formulation, and interpatient variability. Many factors contribute to variability in the magnitude and clinical significance of drug interactions between an immunosuppressant such as cyclosporine, tacrolimus, or sirolimus and an antifungal agent such as ketoconazole, fluconazole, itraconazole, voriconazole, or posaconazole. By bringing similarities and differences among these agents and their potential interactions to clinicians’ attention, they can appreciate and apply these findings in a individualized patient approach rather than follow only the one-size-fits-all dosing recommendations suggested in many tertiary references. Differences in metabolism and in the inhibitory potency of cytochrome P450 3A4 and Pglycoprotein influence the onset, magnitude, and resolution of drug interactions and their potential effect on clinical outcomes. Important issues are the route of administration and the decision to preemptively adjust dosages versus intensive monitoring with subsequent dosage adjustments. We provide recommendations for the concomitant use of these agents, including suggestions regarding contraindicated combinations, those best avoided, and those requiring close monitoring of drug dosages and plasma concentrations.
eu_rights_str_mv openAccess
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id LAURepo_a628109d10e49581bedd10065f563bdf
identifier_str_mv 0277-0008
Saad, A. H., DePestel, D. D., & Carver, P. L. (2006). Factors influencing the magnitude and clinical significance of drug interactions between azole antifungals and select immunosuppressants. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, 26(12), 1730-1744.
language_invalid_str_mv en
network_acronym_str LAURepo
network_name_str Lebanese American University repository
oai_identifier_str oai:laur.lau.edu.lb:10725/4355
publishDate 2006
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spelling Factors Influencing the Magnitude and Clinical Significance of Drug Interactions Between Azole Antifungals and Select ImmunosuppressantsSaad, AlineThe magnitude of drug interactions between azole antifungals and immunosuppressants is drug and patient specific and depends on the potency of the azole inhibitor involved, the resulting plasma concentrations of each drug, the drug formulation, and interpatient variability. Many factors contribute to variability in the magnitude and clinical significance of drug interactions between an immunosuppressant such as cyclosporine, tacrolimus, or sirolimus and an antifungal agent such as ketoconazole, fluconazole, itraconazole, voriconazole, or posaconazole. By bringing similarities and differences among these agents and their potential interactions to clinicians’ attention, they can appreciate and apply these findings in a individualized patient approach rather than follow only the one-size-fits-all dosing recommendations suggested in many tertiary references. Differences in metabolism and in the inhibitory potency of cytochrome P450 3A4 and Pglycoprotein influence the onset, magnitude, and resolution of drug interactions and their potential effect on clinical outcomes. Important issues are the route of administration and the decision to preemptively adjust dosages versus intensive monitoring with subsequent dosage adjustments. We provide recommendations for the concomitant use of these agents, including suggestions regarding contraindicated combinations, those best avoided, and those requiring close monitoring of drug dosages and plasma concentrations.PublishedN/A2016-09-23T12:02:36Z2016-09-23T12:02:36Z20062016-09-23Articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article0277-0008http://hdl.handle.net/10725/4355http://dx.doi.org/10.1592/phco.26.12.1730Saad, A. H., DePestel, D. D., & Carver, P. L. (2006). Factors influencing the magnitude and clinical significance of drug interactions between azole antifungals and select immunosuppressants. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, 26(12), 1730-1744.http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.phphttp://onlinelibrary.wiley.com/doi/10.1592/phco.26.12.1730/abstractenPharmacotherapyinfo:eu-repo/semantics/openAccessoai:laur.lau.edu.lb:10725/43552021-03-19T10:00:55Z
spellingShingle Factors Influencing the Magnitude and Clinical Significance of Drug Interactions Between Azole Antifungals and Select Immunosuppressants
Saad, Aline
status_str publishedVersion
title Factors Influencing the Magnitude and Clinical Significance of Drug Interactions Between Azole Antifungals and Select Immunosuppressants
title_full Factors Influencing the Magnitude and Clinical Significance of Drug Interactions Between Azole Antifungals and Select Immunosuppressants
title_fullStr Factors Influencing the Magnitude and Clinical Significance of Drug Interactions Between Azole Antifungals and Select Immunosuppressants
title_full_unstemmed Factors Influencing the Magnitude and Clinical Significance of Drug Interactions Between Azole Antifungals and Select Immunosuppressants
title_short Factors Influencing the Magnitude and Clinical Significance of Drug Interactions Between Azole Antifungals and Select Immunosuppressants
title_sort Factors Influencing the Magnitude and Clinical Significance of Drug Interactions Between Azole Antifungals and Select Immunosuppressants
url http://hdl.handle.net/10725/4355
http://dx.doi.org/10.1592/phco.26.12.1730
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
http://onlinelibrary.wiley.com/doi/10.1592/phco.26.12.1730/abstract