Necessity for a Significant Maintenance Dosage Reduction of Voriconazole in Patients with Severe Liver Cirrhosis (Child-Pugh Class C)

Biological & Pharmaceutical Bulletin
Takehiro YamadaKen Iseki

Abstract

Therapeutic drug monitoring for voriconazole, an antifungal agent, is essential for maximizing efficacy and preventing toxicity. The aim of this study was to elucidate the optimal maintenance dose of voriconazole in patients with severe liver cirrhosis (Child-Pugh class C) by reviewing the plasma trough concentrations obtained by therapeutic drug monitoring and daily doses of voriconazole. We retrospectively evaluated 6 patients with Child-Pugh class C cirrhosis who received oral voriconazole treatment and were liver transplant recipients or were awaiting liver transplantation. We compared their voriconazole trough concentrations and daily maintenance doses to those of patients who did not have liver cirrhosis (n=56). We found that plasma voriconazole trough concentrations in all patients with Child-Pugh class C were almost within therapeutic range, and the median plasma trough concentration at steady state was not significantly different from that of patients who did not have liver cirrhosis. In addition, the median daily maintenance dose of voriconazole was significantly lower (2.13 mg/kg/d) than that of the control patients (6.27 mg/kg/d), suggesting that trough voriconazole concentrations are elevated in Child-Pugh class C ...Continue Reading

References

Nov 4, 1998·Journal of Pharmaceutical and Biomedical Analysis·R Gage, D A Stopher
Apr 9, 2002·Journal of Clinical Pharmacology·Hillard M LazarusAlain Romero
Feb 21, 2003·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Leonard B Johnson, Carol A Kauffman
Sep 10, 2003·Drug Metabolism Reviews·Takaharu Mizutani
Jun 20, 2007·Drug Metabolism and Disposition : the Biological Fate of Chemicals·Alison E Aitken, Edward T Morgan
Jul 4, 2007·Antimicrobial Agents and Chemotherapy·Stefan WeilerRomuald Bellmann
Mar 6, 2009·International Journal of Antimicrobial Agents·Kazuaki MatsumotoKatsushi Yamada
Apr 13, 2010·Journal of Critical Care·Joana Pedro da Silva SilvestrePedro Manuel Sarmento Rodrigues Póvoa
Dec 8, 2011·Liver International : Official Journal of the International Association for the Study of the Liver·Maria PappPeter Antal-Szalmas
Jan 11, 2012·Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy·Yukihiro HamadaMasakazu Kuroyama
Jul 4, 2012·Antimicrobial Agents and Chemotherapy·Michael J DoltonAndrew J McLachlan
Jan 9, 2013·Therapeutic Drug Monitoring·Isabel SprietLudo Willems
May 16, 2013·Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy·Yukihiro HamadaYoshio Takesue
Nov 29, 2013·BioMed Research International·Christophe LelubreMichaël Piagnerelli
Oct 29, 2014·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Francesco BarchiesiNina Singh
Jan 15, 2015·The Canadian Journal of Infectious Diseases & Medical Microbiology = Journal Canadien Des Maladies Infectieuses Et De La Microbiologie Médicale·Michel LaverdiereYves Théorêt
Jul 1, 2015·Antimicrobial Agents and Chemotherapy·Krista L NieceKevin S Akers
Oct 31, 2015·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Julius BaloghR Mark Ghobrial
Apr 21, 2016·Journal of Pharmaceutical Health Care and Sciences·Satoshi DoteHirokazu Nakanishi
Jul 2, 2016·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Thomas F PattersonJohn E Bennett
Sep 8, 2016·The Journal of Antimicrobial Chemotherapy·Anette VeringaJan-Willem C Alffenaar
Feb 6, 2017·International Journal of Antimicrobial Agents·Fang QiShasha Liao

❮ Previous
Next ❯

Citations

Jun 20, 2019·Drug Metabolism Reviews·Josefine SchulzCharlotte Kloft
Mar 20, 2020·Psychiatric Services : a Journal of the American Psychiatric Association·Kelly J KelleherKimberly Hoagwood
Dec 14, 2018·Journal of Fungi·Nikolaos Spernovasilis, Diamantis P Kofteridis
Oct 5, 2018·European Journal of Drug Metabolism and Pharmacokinetics·Zorica JovićMarina Kostić
Dec 20, 2021·Therapeutic Drug Monitoring·Benjamin KablyEliane M Billaud

❮ Previous
Next ❯

Related Concepts

Related Feeds

Antifungals

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.

Antifungals (ASM)

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.

Related Papers

Clinica Chimica Acta; International Journal of Clinical Chemistry
Yosuke SuzukiJun-ichi Kadota
European Journal of Clinical Pharmacology
K DalhoffJ Lund
Journal of the Pediatric Infectious Diseases Society
Zachary HoyDamian J Krysan
© 2022 Meta ULC. All rights reserved