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 language | English |
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Pages (from-to) | 113-4 |
Number of pages | 2 |
Journal | The Journal of antimicrobial chemotherapy |
Volume | 53 |
Issue number | 1 |
DOIs | |
Publication status | Published - Jan 2004 |
Externally published | Yes |
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