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Journal of Infection and Chemotherapy
Published in: Journal of Infection and Chemotherapy 3/2013

Open Access 01-06-2013 | Guideline

Practice guidelines for therapeutic drug monitoring of voriconazole: a consensus review of the Japanese Society of Chemotherapy and the Japanese Society of Therapeutic Drug Monitoring

Authors: Yukihiro Hamada, Issei Tokimatsu, Hiroshige Mikamo, Masao Kimura, Masafumi Seki, Shunji Takakura, Norio Ohmagari, Yoshiko Takahashi, Kei Kasahara, Kazuaki Matsumoto, Kenji Okada, Masahiro Igarashi, Masahiro Kobayashi, Takahiro Mochizuki, Yoshifumi Nishi, Yusuke Tanigawara, Toshimi Kimura, Yoshio Takesue

Published in: Journal of Infection and Chemotherapy | Issue 3/2013

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Excerpt

Voriconazole (VRCZ) is a triazole antifungal developed for the treatment of fungal infectious disease and is available for both oral and intravenous administration. It has potent activity against a broad spectrum of clinically significant pathogens, including Aspergillus, Candida, Cryptococcus, Fusarium, and Scedosporium [1]. VRCZ has a nonlinear pharmacokinetic profile with wide inter- and intraindividual variability [2]. This variability is caused by many factors, such as sex, age, race, genotypic variation, liver dysfunction, and the presence of food. Another important factor influencing the VRCZ pharmacokinetic profile is drug–drug interactions with CYP450 inhibitors as well as inducers. Genotypic variation in the metabolizing enzyme CYP2C19 is one of the major determinants of the VRCZ blood level. The frequency of poor metabolizers (PM), with defective or diminished metabolic capacity, is higher among Japanese patients. Variability in the plasma concentrations, arising from these previously mentioned aspects, may lead to variability in efficacy or toxicity. Determining the plasma concentration is indicated in some situations to guide dosing and to individualize and improve the treatment options, resulting in a better therapeutic outcome or fewer side effects. …
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Metadata
Title
Practice guidelines for therapeutic drug monitoring of voriconazole: a consensus review of the Japanese Society of Chemotherapy and the Japanese Society of Therapeutic Drug Monitoring
Authors
Yukihiro Hamada
Issei Tokimatsu
Hiroshige Mikamo
Masao Kimura
Masafumi Seki
Shunji Takakura
Norio Ohmagari
Yoshiko Takahashi
Kei Kasahara
Kazuaki Matsumoto
Kenji Okada
Masahiro Igarashi
Masahiro Kobayashi
Takahiro Mochizuki
Yoshifumi Nishi
Yusuke Tanigawara
Toshimi Kimura
Yoshio Takesue
Publication date
01-06-2013
Publisher
Springer Japan
Published in
Journal of Infection and Chemotherapy / Issue 3/2013
Print ISSN: 1341-321X
Electronic ISSN: 1437-7780
DOI
https://doi.org/10.1007/s10156-013-0607-8

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