2013
DOI: 10.1093/jac/dkt229
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Steady-state pharmacokinetics and metabolism of voriconazole in patients

Abstract: Objectives: Voriconazole exhibits non-linear pharmacokinetics in adults and is said to be mainly metabolized by CYP2C19 and CYP3A4 to voriconazole-N-oxide. The aim of this study was to obtain data on steady-state pharmacokinetics after dosing for at least 14 days in patients taking additional medication and in vivo data on metabolites other than voriconazole-N-oxide.Patients and methods: Thirty-one patients receiving voriconazole as regular therapeutic drug treatment during hospitalization participated in this… Show more

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Cited by 56 publications
(49 citation statements)
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“…This hypothesis is supported by a recent study that envisioned a more dominant pathway involving CYP3A4 rather than CYP2C19 (8,9). It is debatable whether an interaction with PXR (fully) explains the observed phenomenon for three reasons.…”
mentioning
confidence: 75%
“…This hypothesis is supported by a recent study that envisioned a more dominant pathway involving CYP3A4 rather than CYP2C19 (8,9). It is debatable whether an interaction with PXR (fully) explains the observed phenomenon for three reasons.…”
mentioning
confidence: 75%
“…N-oxidation of voriconazole into its major circulating metabolite is performed mainly by the cytochrome CYP2C19 [8,16]. It has been demonstrated that the variability of plasma voriconazole concentrations is related to the presence of CYP2C19 polymorphisms, and that the most common defective alleles are CYP2C19*2, CYP2C19*3, CYP2C19*4, and CYP2C19*17.…”
Section: Introductionmentioning
confidence: 99%
“…Trough concentrations between 1 and 5.5 g/ml have correlated with improved clinical responses as well as decreased incidences of adverse events (4,5,(10)(11)(12)(13)(14)(15). Therapeutic drug monitoring (TDM) is therefore recommended to ensure optimal systemic voriconazole exposure (5,16,17).…”
mentioning
confidence: 99%