Drug-Drug Interactions in Treatment Using Azole Antifungal Agents—Reply

Cutaneous fungal infections in solid organ transplant recipients

“…Therefore, upon initiation of oral azole therapy, these immunosuppressant drug levels must be monitored and adjusted after consultation with the nephrologist. Reduction of the dose of the tacrolimus and cyclosporin may be necessary, to avoid the risk of side effects, particularly nephrotoxicity 12,13 .…”

Effects of the administration of miconazole by different routes on the biomarkers of the “steroidal module” of the Athlete Biological Passport

“…Indeed, they can alter the biotransformation and conjugation metabolic reactions also in humans, with effects on the dynamics of the biosynthetic pathways of numerous biologically active substances, including steroids. [6][7][8][9][10][11][12][13][14][15][16][17][18] Different studies reported (i) the ability of ketoconazole to interact with both the 17αhydroxylase and 17,20-lyase activity of cytochrome P450c17, the enzyme that converts pregnenolone to dehydroepiandrosterone and progesterone to androstenedione in the human testes, ovaries, and adrenal glands [6][7][8] ; (ii) the inhibitory effect of several triazole antifungals on the CYP19, responsible for the conversion of testosterone to estradiol, and androstenedione to estrone, due to their structural homology with several aromatase inhibitors, such as letrozole and anastrozole 9,10 ; and (iii) the strong inhibitory effect of antifungals on several hepatic CYP450 isoforms (e.g., CYP3A4) and uridine 5 0 -diphosphoglucuronosyltransferases (UGTs) involved in the biotransformation pathways of steroids. [11][12][13][14][15][16][17][18] In the doping control field, the alteration of the natural fluctuation of several endogenous steroids (currently: testosterone [T],…”

“…[6][7][8][9][10][11][12][13][14][15][16][17][18] Different studies reported (i) the ability of ketoconazole to interact with both the 17αhydroxylase and 17,20-lyase activity of cytochrome P450c17, the enzyme that converts pregnenolone to dehydroepiandrosterone and progesterone to androstenedione in the human testes, ovaries, and adrenal glands [6][7][8] ; (ii) the inhibitory effect of several triazole antifungals on the CYP19, responsible for the conversion of testosterone to estradiol, and androstenedione to estrone, due to their structural homology with several aromatase inhibitors, such as letrozole and anastrozole 9,10 ; and (iii) the strong inhibitory effect of antifungals on several hepatic CYP450 isoforms (e.g., CYP3A4) and uridine 5 0 -diphosphoglucuronosyltransferases (UGTs) involved in the biotransformation pathways of steroids. [11][12][13][14][15][16][17][18] In the doping control field, the alteration of the natural fluctuation of several endogenous steroids (currently: testosterone [T],…”