Interaction between flucloxacillin and azoles: Is isavuconazole next?
CYP450
azoles
drug-drug interaction
flucloxacillin
isavuconazole
Journal
Mycoses
ISSN: 1439-0507
Titre abrégé: Mycoses
Pays: Germany
ID NLM: 8805008
Informations de publication
Date de publication:
Dec 2021
Dec 2021
Historique:
received:
26
08
2021
accepted:
13
09
2021
pubmed:
24
9
2021
medline:
7
1
2022
entrez:
23
9
2021
Statut:
ppublish
Résumé
Isavuconazole is a triazole antifungal drug, approved for the treatment of invasive aspergillosis and mucormycosis. It has been previously reported that an interaction between flucloxacillin and voriconazole may lead to subtherapeutic voriconazole exposure, when used concomitantly. Since isavuconazole is also metabolised via cytochrome P450 enzymes, the same interaction may be expected. We aim to document exposure to isavuconazole in patients concomitantly treated with flucloxacillin. We report two patients treated with both isavuconazole and flucloxacillin, in whom we determined isavuconazole concentrations. Low isavuconazole trough concentrations (<1 mg/L) were observed in two patients under concomitant treatment with flucloxacillin. In combination with flucloxacillin, low isavuconazole concentrations were observed but an adequate isavuconazole exposure may be reached with dose augmentation. Therapeutic drug monitoring of isavuconazole is recommended to ensure an adequate exposure.
Sections du résumé
BACKGROUND
BACKGROUND
Isavuconazole is a triazole antifungal drug, approved for the treatment of invasive aspergillosis and mucormycosis. It has been previously reported that an interaction between flucloxacillin and voriconazole may lead to subtherapeutic voriconazole exposure, when used concomitantly. Since isavuconazole is also metabolised via cytochrome P450 enzymes, the same interaction may be expected.
OBJECTIVES
OBJECTIVE
We aim to document exposure to isavuconazole in patients concomitantly treated with flucloxacillin.
PATIENTS
METHODS
We report two patients treated with both isavuconazole and flucloxacillin, in whom we determined isavuconazole concentrations.
RESULTS
RESULTS
Low isavuconazole trough concentrations (<1 mg/L) were observed in two patients under concomitant treatment with flucloxacillin.
CONCLUSIONS
CONCLUSIONS
In combination with flucloxacillin, low isavuconazole concentrations were observed but an adequate isavuconazole exposure may be reached with dose augmentation. Therapeutic drug monitoring of isavuconazole is recommended to ensure an adequate exposure.
Substances chimiques
Antifungal Agents
0
Azoles
0
Nitriles
0
Pyridines
0
Triazoles
0
Floxacillin
43B2M34G2V
isavuconazole
60UTO373KE
Voriconazole
JFU09I87TR
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1508-1511Informations de copyright
© 2021 Wiley-VCH GmbH.
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