Systemic availability of itraconazole in lung transplantation.
Systemic availability of itraconazole in lung transplantation was evaluated by serially measuring the bioactivity of itraconazole in lung transplant patients who received itraconazole for prophylaxis (n = 12) or therapy (n = 5). These patients also received concomitant antacid and H2 blocker therapy. In patients receiving itraconazole at 200 and 400 mg/day, the median concentrations in serum were 0.5 microgram/ml (range, < 0.05 to 2.7) and 3.5 micrograms/ml (< 0.5 to 14), respectively. The concentration following administration of 400 mg/day was > 2.5 micrograms/ml in 56% of samples, while only 4% of samples from patients who were administered 200 mg/day had levels over 2.5 micrograms/ml. This study documents that itraconazole can be absorbed in patients receiving concomitant antacid and H2 blocker therapy. However, the reduced and variable absorption suggests the importance of confirming drug delivery by measurement of concentrations in serum.
Patterson
T F
TF
Department of Medicine, University of Texas Health Science Center at San Antonio 78284, USA.
Peters
J
J
Levine
S M
SM
Anzueto
A
A
Bryan
C L
CL
Sako
E Y
EY
Miller
O L
OL
Calhoon
J H
JH
Rinaldi
M G
MG
D000042:Absorption; D000863:Antacids / Q000494:pharmacology; D000935:Antifungal Agents / Q000493:pharmacokinetics*; D001228:Aspergillosis / Q000382:microbiology / Q000517:prevention & control; D001681:Biological Assay; D001682:Biological Availability; D004347:Drug Interactions; D006635:Histamine H2 Antagonists / Q000494:pharmacology; D006801:Humans; D017964:Itraconazole / Q000493:pharmacokinetics*; D016040:Lung Transplantation / Q000502:physiology*
D000863:Antacids; D000935:Antifungal Agents; D006635:Histamine H2 Antagonists; D017964:Itraconazole