title: Safety and potential of drug interactions of caspofungin and voriconazole in multimorbid patients.
abstract: Due to their broad antimycotic spectrum and the relatively low rate of side effects, the two antifungals caspofungin and voriconazole are considered as attractive therapeutic alternatives to amphotericin B. However, treatment of severe mycotic infections in patients taking co-medication is associated with the risk of severe adverse drug interactions. The risk of such interactions is increased if voriconazole and, much less pronounced caspofungin, are co-administered with drugs which have an inducing or inhibiting effect on the CYP 450 system, primarily on the isoenzymes CYP2C19, CYP2C9 and CYP3A4. This review provides a comprehensive overview on the potential drug interactions of caspofungin and voriconazole in multimorbid patients.
authors.affiliation: Department of Clinical Pharmacology, Division of Clinical Pharmacokinetics, Medical University of Vienna, Vienna, Austria.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Kulemann
authors.forename: Martin
authors.initials: M
authors.lastname: Bauer
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Graninger
authors.forename: Christian
authors.initials: C
authors.lastname: Joukhadar
mesh_terms: D000900:Anti-Bacterial Agents / Q000493:pharmacokinetics / Q000627:therapeutic use; D000927:Anticonvulsants / Q000493:pharmacokinetics / Q000627:therapeutic use; D000935:Antifungal Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000077336:Caspofungin; D002986:Clinical Trials as Topic; D003428:Cross Infection / Q000517:prevention & control*; D065607:Cytochrome P-450 Enzyme Inhibitors; D003577:Cytochrome P-450 Enzyme System / Q000378:metabolism; D004347:Drug Interactions; D016903:Drug Monitoring; D054714:Echinocandins; D018565:Food-Drug Interactions; D006801:Humans; D016867:Immunocompromised Host; D007362:Intensive Care Units; D055666:Lipopeptides; D008099:Liver / Q000187:drug effects / Q000201:enzymology; D009181:Mycoses / Q000188:drug therapy* / Q000517:prevention & control; D010456:Peptides, Cyclic / Q000009:adverse effects / Q000627:therapeutic use*; D019338:Polypharmacy; D011743:Pyrimidines / Q000009:adverse effects / Q000627:therapeutic use*; D018894:Reverse Transcriptase Inhibitors / Q000493:pharmacokinetics / Q000627:therapeutic use; D014230:Triazoles / Q000009:adverse effects / Q000627:therapeutic use*; D065819:Voriconazole
chemical_list: D000900:Anti-Bacterial Agents; D000927:Anticonvulsants; D000935:Antifungal Agents; D065607:Cytochrome P-450 Enzyme Inhibitors; D054714:Echinocandins; D055666:Lipopeptides; D010456:Peptides, Cyclic; D011743:Pyrimidines; D018894:Reverse Transcriptase Inhibitors; D014230:Triazoles; D003577:Cytochrome P-450 Enzyme System; D000077336:Caspofungin; D065819:Voriconazole