Interaction of all-trans-retinoic acid with fluconazole in acute promyelocytic leukemia.
All-trans-retinoic acid (ATRA) has a dramatic antitumor effect in patients with acute promyelocytic leukemia (APL). It is hepatically metabolized by cytochrome P-450, and there are known toxicities associated with high levels of this drug. The effects of ATRA can be potentiated by inhibition of cytochrome P-450, which is known to occur with certain drugs. We report a case of a patient with ATRA toxicity thought to be secondary to interaction with fluconazole.
Vanier
Kelly L
KL
School of Medicine, McMaster University, Hamilton, Ontario, Canada.
Mattiussi
Andrea J
AJ
Johnston
Donna L
DL
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003577:Cytochrome P-450 Enzyme System / Q000378:metabolism; D004347:Drug Interactions; D005260:Female; D015725:Fluconazole / Q000009:adverse effects* / Q000627:therapeutic use*; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy* / Q000378:metabolism*; D008297:Male; D014212:Tretinoin / Q000009:adverse effects* / Q000627:therapeutic use*
D014212:Tretinoin; D015725:Fluconazole; D003577:Cytochrome P-450 Enzyme System