Journal Article

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

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

in Journal of Antimicrobial Chemotherapy

Published on behalf of British Society for Antimicrobial Chemotherapy

Volume 53, issue 1, pages 113-114
Published in print January 2004 | ISSN: 0305-7453
Published online January 2004 | e-ISSN: 1460-2091 | DOI: http://dx.doi.org/10.1093/jac/dkh022
Pharmacokinetic interaction between voriconazole and ciclosporin A following allogeneic bone marrow transplantation

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  • Medical Oncology
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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.

Keywords: Keywords: antifungals, CYP450 isoenzymes, graft-versus-host disease

Journal Article.  939 words.  Illustrated.

Subjects: Medical Oncology ; Critical Care

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