Drug-drug interaction between itraconazole and efavirenz in a patient with AIDS and disseminated histoplasmosis.
Although there is a presumed drug-drug interaction between itraconazole and nonnucleoside reverse-transcriptase inhibitors, the medical literature lacks such documentation. We describe a drug-drug interaction between itraconazole and efavirenz in a patient with disseminated histoplasmosis and acquired immunodeficiency syndrome (AIDS). The drug combination resulted in persistently elevated urinary Histoplasma antigen levels and subtherapeutic plasma itraconazole concentrations. Changing treatment from efavirenz to a protease inhibitor was accompanied by improvements in the desired urinary Histoplasma antigen level and plasma itraconazole concentration.
Koo
Hoonmo L
HL
Section of Infectious Diseases, Baylor College of Medicine, Houston, TX, USA.
Hamill
Richard J
RJ
Andrade
Roberto A
RA
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000188:drug therapy*; D000328:Adult; D000480:Alkynes; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use; D000935:Antifungal Agents / Q000009:adverse effects / Q000627:therapeutic use; D000946:Antigens, Fungal / Q000652:urine; D048588:Benzoxazines / Q000009:adverse effects* / Q000627:therapeutic use; D003521:Cyclopropanes; D004347:Drug Interactions; D006658:Histoplasma / Q000276:immunology; D006660:Histoplasmosis / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D017964:Itraconazole / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male
D000480:Alkynes; D019380:Anti-HIV Agents; D000935:Antifungal Agents; D000946:Antigens, Fungal; D048588:Benzoxazines; D003521:Cyclopropanes; D017964:Itraconazole; C098320:efavirenz