Drug interaction between oral solution itraconazole and calcineurin inhibitors in allogeneic hematopoietic stem cell transplantation recipients

An association with bioavailability of oral solution itraconazole

Takehiko Mori, Yoshinobu Aisa, Jun Kato, Yukinori Nakamura, Yasuo Ikeda, Shinichiro Okamoto

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19 Citations (Scopus)

Abstract

To assess the drug interaction between oral solution itraconazole and calcineurin inhibitors, 10 recipients of allogeneic hematopoietic stem cell transplantation (HSCT), in whom oral solution itraconazole was started when they had been on a steady dose of calcineurin inhibitors (cyclosporine A or tacrolimus), were retrospectively evaluated. The concentration/dose [C/D; (ng/mL)/(mg/kg)] ratio of calcineurin inhibitors significantly increased after initiating oral solution itraconazole, and the increase at 7-10 days after initiating itraconazole was 93.7%, ranging from 37.3 to 328.2%. The plasma level of itraconazole/hydroxyitraconazole was significantly correlated with the increase in the C/D ratio of calcineurin inhibitors (correlation coefficient, 0.65; P < 0.05). These results suggest that oral solution itraconazole significantly interacts with calcineurin inhibitors with a wide interindividual variability in allogeneic HSCT recipients, which could partly be explained by the variable bioavailability of oral solution itraconazole.

Original languageEnglish
Pages (from-to)103-107
Number of pages5
JournalInternational Journal of Hematology
Volume90
Issue number1
DOIs
Publication statusPublished - 2009 Jul

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Itraconazole
Hematopoietic Stem Cell Transplantation
Drug Interactions
Biological Availability
Tacrolimus
Calcineurin Inhibitors
Cyclosporine

Keywords

  • Calcineurin inhibitors
  • Drug interaction
  • Hematopoietic stem cell transplantation
  • Oral solution itraconazole

ASJC Scopus subject areas

  • Hematology

Cite this

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abstract = "To assess the drug interaction between oral solution itraconazole and calcineurin inhibitors, 10 recipients of allogeneic hematopoietic stem cell transplantation (HSCT), in whom oral solution itraconazole was started when they had been on a steady dose of calcineurin inhibitors (cyclosporine A or tacrolimus), were retrospectively evaluated. The concentration/dose [C/D; (ng/mL)/(mg/kg)] ratio of calcineurin inhibitors significantly increased after initiating oral solution itraconazole, and the increase at 7-10 days after initiating itraconazole was 93.7{\%}, ranging from 37.3 to 328.2{\%}. The plasma level of itraconazole/hydroxyitraconazole was significantly correlated with the increase in the C/D ratio of calcineurin inhibitors (correlation coefficient, 0.65; P < 0.05). These results suggest that oral solution itraconazole significantly interacts with calcineurin inhibitors with a wide interindividual variability in allogeneic HSCT recipients, which could partly be explained by the variable bioavailability of oral solution itraconazole.",
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AU - Kato, Jun

AU - Nakamura, Yukinori

AU - Ikeda, Yasuo

AU - Okamoto, Shinichiro

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