Utilization of omeprazole to augment subtherapeutic voriconazole concentrations for treatment of Aspergillus infections

Antimicrob Agents Chemother. 2012 Nov;56(11):6001-2. doi: 10.1128/AAC.00700-12. Epub 2012 Aug 13.

Abstract

Voriconazole is the preferred antifungal agent for Aspergillus infections. Therapeutic drug monitoring is recommended to achieve target concentrations and prevent toxicity. However, variable pharmacokinetics, cytochrome P450 polymorphisms, and extensive drug-drug interactions can contribute to subtherapeutic concentrations. We report a voriconazole "boosting" effect of omeprazole to achieve target concentrations for the treatment of Aspergillus in a patient who had persistently subtherapeutic trough concentrations.

Publication types

  • Case Reports

MeSH terms

  • Antifungal Agents / blood
  • Antifungal Agents / pharmacokinetics*
  • Antifungal Agents / pharmacology
  • Aspergillosis / drug therapy*
  • Aspergillosis / microbiology
  • Aspergillosis / pathology
  • Aspergillus fumigatus / drug effects
  • Aspergillus fumigatus / physiology
  • Brain / drug effects
  • Brain / microbiology
  • Brain / pathology
  • Drug Administration Routes
  • Drug Administration Schedule
  • Drug Monitoring
  • Drug Synergism
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Omeprazole / pharmacology
  • Omeprazole / therapeutic use*
  • Pyrimidines / blood
  • Pyrimidines / pharmacokinetics*
  • Pyrimidines / pharmacology
  • Triazoles / blood
  • Triazoles / pharmacokinetics*
  • Triazoles / pharmacology
  • Voriconazole
  • Young Adult

Substances

  • Antifungal Agents
  • Pyrimidines
  • Triazoles
  • Voriconazole
  • Omeprazole