Clinical significance of interactions with antifungal agents
Breckenridge, A.
British Journal of Dermatology 126(Suppl): 19-22
1992
ISSN/ISBN: 0007-0963 PMID: 1311944 Document Number: 397814
The clinical importance of drug interactions involving antifungal agents is considered. Agents such as substituent imidazoles and triazoles, which act by inhibiting the fungal cytochrome P-450-dependent enzyme lanosterol N-demethylase, have the potential to inhibit host cytochrome P-450-dependent drug metabolism. This is discussed with respect to ketoconazole, fluconazole and itraconazole. In contrast, allylamines such as terbinafine, which have a different mode of action and a weaker ability to bind to cytochrome P-450, are not expected to inhibit clinical drug oxidation. Inducers of drug metabolism, especially rifampicin, phenobarbitone and phenytoin, may lower plasma (and tissue) concn of those antifungals metabolized by mixed function oxidases, with therapeutic consequences.