Novel insights into the complex pharmacokinetics of voriconazole: a review of its metabolism.

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ID: 2065
2019
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Abstract
Voriconazole, a second-generation triazole frequently used for the prophylaxis and treatment of invasive fungal infections, undergoes complex metabolism mainly involving various (polymorphic) cytochrome P450 enzymes in humans. Although high inter- and intraindividual variability in voriconazole pharmacokinetics have been observed and the therapeutic range for this compound is relatively narrow, the metabolism of voriconazole has not been fully elucidated yet. The available literature data investigating the multiple different pathways and metabolites are extremely unbalanced and thus the absolute or relative contribution of the different pathways and enzymes involved in the metabolism of voriconazole remains uncertain. Furthermore, other factors such as nonlinear pharmacokinetics caused by auto-inhibition or -induction and polymorphisms of the metabolizing enzymes hinder safe and effective voriconazole dosing in clinical practice and have not yet been studied sufficiently. This review aimed at amalgamating the available literature on the pharmacokinetics of voriconazole and , with a special focus on metabolism in adults and children, in order to congregate an overall landscape of the current body of knowledge and identify knowledge gaps, opening the way towards further research in order to foster the understanding, towards better therapeutic dosing decisions.
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schulz2019noveldrug Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Schulz, Josefine;Kluwe, Franziska;Mikus, Gerd;Michelet, Robin;Kloft, Charlotte;
Journal drug metabolism reviews
Year 2019
DOI
10.1080/03602532.2019.1632888
URL
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