Pharmacokinetic interaction between voriconazole and ciclosporin A following allogeneic bone marrow transplantation

Andreas H Groll, Hedwig Kolve, Karoline Ehlert, Michael Paulussen, Josef Vormoor

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Voriconazole is a novel antifungal triazole that undergoes extensive oxidative metabolization involving several CYP450 isoenzymes. We report the case of a 14-year-old patient who received voriconazole concomitant with ciclosporin A as secondary antifungal prophylaxis after bone marrow transplantation. Temporary discontinuation of voriconazole due to worsening liver function tests (LFTs) resulted in a sudden drop of ciclosporin A trough levels in blood. Ciclosporin A trough levels returned to baseline following normalization of LFTs and re-institution of voriconazole. This report emphasizes the need for careful monitoring and dose adjustments of ciclosporin A in patients receiving concomitant voriconazole, and in whom voriconazole is discontinued in order to prevent subtherapeutic ciclosporin A levels with the potential consequence of graft-versus-host disease.

Original languageEnglish
Pages (from-to)113-4
Number of pages2
JournalThe Journal of antimicrobial chemotherapy
Volume53
Issue number1
DOIs
Publication statusPublished - Jan 2004
Externally publishedYes

Keywords

  • Adolescent
  • Antifungal Agents/administration & dosage
  • Bone Marrow Transplantation
  • Cyclosporine/administration & dosage
  • Drug Interactions
  • Female
  • Humans
  • Leukemia, Myeloid, Acute/therapy
  • Mycoses/prevention & control
  • Pyrimidines/administration & dosage
  • Triazoles/administration & dosage
  • Voriconazole

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