Accelerated metabolism of voriconazole and its partial reversal by cimetidine.
We report a case of accelerated metabolism of voriconazole during therapy for invasive pulmonary aspergillosis, resulting in subtherapeutic levels. Target voriconazole levels were restored with high dosages of voriconazole (up to 40 mg/kg of body weight/day) and the addition of cimetidine as a cytochrome P450 enzyme inhibitor.
Moriyama
Brad
B
NIH Clinical Center Pharmacy Dept., Bethesda, Maryland, USA.
Elinoff
Jason
J
Danner
Robert L
RL
Gea-Banacloche
Juan
J
Pennick
Gennethel
G
Rinaldi
Michael G
MG
Walsh
Thomas J
TJ
D000935:Antifungal Agents / Q000378:metabolism*; D002927:Cimetidine / Q000494:pharmacology*; D051544:Cytochrome P-450 CYP3A / Q000096:biosynthesis; D004347:Drug Interactions; D006440:Hemofiltration; D006801:Humans; D008297:Male; D008875:Middle Aged; D011743:Pyrimidines / Q000378:metabolism*; D014230:Triazoles / Q000378:metabolism*; D065819:Voriconazole
D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D002927:Cimetidine; D051544:Cytochrome P-450 CYP3A; C510163:CYP3A4 protein, human; D065819:Voriconazole