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The effects of the systemic antimycotics, itraconazole and fluconazole, on the pharmacokinetics and pharmacodynamics of intravenous and oral midazolam.

Author: AhonenJ, NeuvonenP J, OlkkolaK T

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Overview

Itraconazole and fluconazole, azole antimycotics, significantly increased the effects of oral midazolam, raising its AUC and peak concentration by 3.5-fold and two-fold, respectively. This interaction also led to a profound increase in psychomotor effects. While the interaction with IV midazolam was weak, large doses of IV midazolam could still lead to clinically significant interactions. Using oral midazolam with itraconazole and fluconazole should be avoided.
Paper Details　
Original Abstract of the Article :
We studied the interaction of azole antimycotics with intravenous (IV) and oral midazolam using a cross-over design in 12 volunteers, who ingested placebo, itraconazole, or fluconazole for 6 days. A 7.5-mg dose of midazolam was ingested on the first day, 0.05 mg/kg was administered IV on the fourth ...See full text at original site
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引用元：
https://doi.org/10.1097/00000539-199603000-00015

データ提供：米国国立医学図書館（NLM）

Antimycotics and Midazolam: A Tale of Drug Interactions

This study investigates the interaction between azole antimycotics, itraconazole and fluconazole, and midazolam, a sedative drug. The researchers conducted a crossover study in volunteers, comparing the pharmacokinetics and pharmacodynamics of intravenous and oral midazolam with and without the antimycotics.

Imagine a desert caravan, where different medications are like travelers with unique characteristics. These travelers can interact in complex ways, sometimes leading to unexpected outcomes. This study explores the interaction between antimycotics and midazolam, highlighting the potential for drug interactions.

Significant Drug Interactions: Increased Sedation

The study found that itraconazole and fluconazole significantly increased the effects of midazolam, both intravenously and orally. This finding suggests that the antimycotics inhibit the metabolism of midazolam, leading to increased sedation and prolonged drug effects.

Clinical Implications: Cautious Use

The study emphasizes the importance of cautious use of midazolam in combination with itraconazole and fluconazole. The use of large doses of IV midazolam increases the risk of significant interactions, while oral midazolam should be avoided altogether in patients taking these antimycotics.

Dr. Camel's Conclusion

This study highlights the significant drug interactions between azole antimycotics and midazolam. Clinicians must be aware of these interactions and adjust medication dosages or choose alternative therapies when necessary to ensure patient safety.

Date :
  1. Date Completed 1996-06-14
  2. Date Revised 2019-07-04
Further Info :

Pubmed ID

8623953

DOI: Digital Object Identifier

10.1097/00000539-199603000-00015

SNS
PICO Info
in preparation
Languages

English

Positive IndicatorAn AI analysis index that serves as a benchmark for how positive the results of the study are. Note that it is a benchmark and requires careful interpretation and consideration of different perspectives.

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