Prolonged half-life of voriconazole in a CYP2C19 homozygous poor metabolizer receiving vincristine chemotherapy: avoiding a serious adverse drug interaction

Mycoses. 2011 Nov;54(6):e877-9. doi: 10.1111/j.1439-0507.2011.02016.x. Epub 2011 May 25.

Abstract

We report a case of prolonged half-life of voriconazole due to CYP2C19*2/*2 poor metabolizer genotype in a patient receiving vincristine chemotherapy. Voriconazole was discontinued three days before start of vincristine to avoid a serious drug interaction. Therapeutic drug monitoring and genotyping are valuable tools in managing patients receiving voriconazole and vincristine.

Publication types

  • Case Reports
  • Letter
  • Research Support, N.I.H., Intramural

MeSH terms

  • Adult
  • Antifungal Agents / administration & dosage
  • Antifungal Agents / adverse effects
  • Antifungal Agents / pharmacokinetics*
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / pharmacokinetics*
  • Aryl Hydrocarbon Hydroxylases / genetics*
  • Cytochrome P-450 CYP2C19
  • Drug Interactions
  • Genotype
  • Half-Life
  • Humans
  • Male
  • Metabolic Clearance Rate
  • Pyrimidines / administration & dosage
  • Pyrimidines / adverse effects
  • Pyrimidines / pharmacokinetics*
  • Triazoles / administration & dosage
  • Triazoles / adverse effects
  • Triazoles / pharmacokinetics*
  • Vincristine / administration & dosage
  • Vincristine / adverse effects
  • Vincristine / pharmacokinetics*
  • Voriconazole

Substances

  • Antifungal Agents
  • Antineoplastic Agents
  • Pyrimidines
  • Triazoles
  • Vincristine
  • Aryl Hydrocarbon Hydroxylases
  • CYP2C19 protein, human
  • Cytochrome P-450 CYP2C19
  • Voriconazole