Accelerated metabolism of voriconazole and its partial reversal by cimetidine

Antimicrob Agents Chemother. 2009 Apr;53(4):1712-4. doi: 10.1128/AAC.01221-08. Epub 2009 Jan 26.

Abstract

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.

Publication types

  • Case Reports
  • Research Support, N.I.H., Intramural

MeSH terms

  • Antifungal Agents / metabolism*
  • Cimetidine / pharmacology*
  • Cytochrome P-450 CYP3A / biosynthesis
  • Drug Interactions
  • Hemofiltration
  • Humans
  • Male
  • Middle Aged
  • Pyrimidines / metabolism*
  • Triazoles / metabolism*
  • Voriconazole

Substances

  • Antifungal Agents
  • Pyrimidines
  • Triazoles
  • Cimetidine
  • Cytochrome P-450 CYP3A
  • CYP3A4 protein, human
  • Voriconazole