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Antimicrobial Agents and Chemotherapy, April 2009, p. 1712-1714, Vol. 53, No. 4
0066-4804/09/$08.00+0     doi:10.1128/AAC.01221-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Accelerated Metabolism of Voriconazole and Its Partial Reversal by Cimetidine{triangledown}

Brad Moriyama,1 Jason Elinoff,2 Robert L. Danner,2 Juan Gea-Banacloche,3 Gennethel Pennick,4 Michael G. Rinaldi,4 and Thomas J. Walsh3*

NIH Clinical Center Pharmacy Dept., Bethesda, Maryland,1 Critical Care Medicine Department, Bethesda, Maryland,2 National Cancer Institute, Bethesda, Maryland,3 University of Texas Health Science Center, San Antonio, Texas4

Received 15 September 2008/ Returned for modification 22 November 2008/ Accepted 19 January 2009

We report a case of accelerated metabolism of voriconazole during therapy for invasive pulmonary aspergillosis, resulting in subtherapeutic levels. Target voriconazole levels were restored with high dosages of voriconazole (up to 40 mg/kg of body weight/day) and the addition of cimetidine as a cytochrome P450 enzyme inhibitor.

* Corresponding author. Mailing address: National Cancer Institute, CRC 1-5750, 10 Center Drive, Bethesda, MD 20892. Phone: (301) 402-0023. Fax: (301) 480-2308. E-mail: walsht{at}mail.nih.gov

{triangledown} Published ahead of print on 26 January 2009.

Antimicrobial Agents and Chemotherapy, April 2009, p. 1712-1714, Vol. 53, No. 4
0066-4804/09/$08.00+0     doi:10.1128/AAC.01221-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.





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