Pharmacokinetics of itraconazole oral solution in allogeneic bone marrow transplant patients receiving total body irradiation.
A prospective study of the pharmacokinetics of itraconazole solution was performed in 11 patients who underwent allogeneic BMT (day of BMT = day 0) after a conditioning regimen including total body irradiation (TBI). Itraconazole solution (400 mg once a day) was given 7 days before BMT and continued up to the end of neutropenia unless another antifungal treatment was necessary. Blood samples were collected before itraconazole intake (Cmin) and 4 h later (Cmax) every other day for assays of itraconazole (ITRA) and its active metabolite hydroxy-itraconazole (OH-ITRA). The mean values of Cmin ITRA and OH-ITRA, respectively, were 287 +/- 109 ng/ml and 629 +/- 227 ng/ml at day -1 and 378 +/- 147 ng/ml and 725 +/- 242 ng/ml at day +1. The maximum Cmin values were observed at day +3. Six patients at day -1 (54%) and 8 at day +1 (72%) had satisfactory residual plasma concentrations of at least 250 ng/ml of unchanged ITRA. From day +1 to day +9, eight patients discontinued the itraconazole treatment, five of them had satisfactory plasma residual concentrations at this time. This work shows a good bioavailability of itraconazole oral solution during the early phase after allogeneic BMT, but more data are needed for the late phases.
Michallet
M
M
Unité de Greffe de Moëlle Osseuse, Service d'Hematologie, Hôpital E Herriot, Lyon, France.
Persat
F
F
Kranzhöfer
N
N
Levron
J C
JC
Prat
C
C
Belhabri
A
A
Chwetzoff
E
E
Le Moing
J P
JP
Fiere
D
D
Piens
M A
MA
D000284:Administration, Oral; D000328:Adult; D000935:Antifungal Agents / Q000493:pharmacokinetics*; D016026:Bone Marrow Transplantation; D005260:Female; D006801:Humans; D017964:Itraconazole / Q000008:administration & dosage / Q000493:pharmacokinetics*; D008297:Male; D008875:Middle Aged; D012996:Solutions; D014184:Transplantation, Homologous; D014916:Whole-Body Irradiation
D000935:Antifungal Agents; D012996:Solutions; D017964:Itraconazole