Trial reportEuropean journal of clinical pharmacology2008
Effect of voriconazole and fluconazole on the pharmacokinetics of intravenous fentanyl.
Trial report in European journal of clinical pharmacology, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 2 syntheses or guidelines pooled it, 81 citations in OpenAlex.
- A review of factors explaining variability in fentanyl pharmacokinetics; focus on implications for cancer patients.British journal of clinical pharmacology · 2017Pooled it
- Clinically significant drug-drug interactions involving opioid analgesics used for pain treatment in patients with cancer: a systematic review.Drug design, development and therapy · 2015Pooled it
- Co-Administration with Voriconazole Doubles the Exposure of Ruxolitinib in Patients with Hematological Malignancies.Drug design, development and therapy · 2022Trial
- Minor contribution of cytochrome P450 3A activity on fentanyl exposure in palliative care cancer patients.Scientific reports · 2019Trial
- Voriconazole more likely than posaconazole increases plasma exposure to sublingual buprenorphine causing a risk of a clinically important interaction.European journal of clinical pharmacology · 2016Trial
- Inhibition of the active principle of the weak opioid tilidine by the triazole antifungal voriconazole.British journal of clinical pharmacology · 2009Trial
- Voriconazole drastically increases exposure to oral oxycodone.European journal of clinical pharmacology · 2009Trial
- Assessing the Influence of CYP3A4 Inhibitors on Voriconazole Exposure across CYP2C19 Genotypes: A Physiologically Based Pharmacokinetic Model Analysis.Clinical pharmacokinetics · 2026Article
- Quantitative prediction of intravenous drug interactions caused by cytochromes P450 inhibitors and inducers.British journal of clinical pharmacology · 2026Article
- Opioid Toxicity Following Concomitant Use of Macrolide Antibiotics with Fentanyl, Hydromorphone, or Oxycodone: A Population-Based Study.Clinical pharmacology and therapeutics · 2026Article
- Evaluation of Fentanyl-Emerged Adverse Events and Pharmacokinetics in Neonates: A Physiologically Based Pharmacokinetic Modeling Approach.Clinical pharmacokinetics · 2025Article
- Pharmacological Management of Oral and Esophageal Candidiasis: A Clinical Pharmacotherapy Perspective.Journal of clinical medicine · 2025Review
- Assessment of Drug-Drug Interaction Risk Between Intravenous Fentanyl and the Glecaprevir/Pibrentasvir Combination Regimen in Hepatitis C Patients Using Physiologically Based Pharmacokinetic Modeling and Simulations.Infectious diseases and therapy · 2023Article
- Potential pharmacological confounders in the setting of death determined by neurologic criteria: a narrative review.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2023Review
- Interaction and potential mechanisms between atorvastatin and voriconazole, agents used to treat dyslipidemia and fungal infections.Frontiers in pharmacology · 2023Article
- Use of physiologically-based pharmacokinetic modeling to inform dosing of the opioid analgesics fentanyl and methadone in children with obesity.CPT: pharmacometrics & systems pharmacology · 2022Article
- Physiologically-Based Pharmacokinetic (PBPK) Modeling Providing Insights into Fentanyl Pharmacokinetics in Adults and Pediatric Patients.Pharmaceutics · 2020Article
- Influence of aprepitant and localization of the patch on fentanyl exposure in patients with cancer using transdermal fentanyl.Oncotarget · 2018Article
- Use of Fentanyl in Adolescents with Clinically Severe Obesity Undergoing Bariatric Surgery: A Pilot Study.Paediatric drugs · 2017Article
- Quantitation of Fentanyl Analogs in Dried Blood Spots by Flow-Through Desorption Coupled to Online Solid Phase Extraction Tandem Mass Spectrometry.Analytical methods : advancing methods and applications · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveFentanyl is a widely used opioid analgesic, which is extensively metabolized by hepatic cytochrome P450 (CYP) 3A. Recent reports suggest that concomitant administration of CYP3A inhibitors with fentanyl may lead to dangerous drug interactions.
methodsThe potential interactions of fentanyl with triazole antifungal agents voriconazole and fluconazole were studied in a randomized crossover study in three phases. Twelve healthy volunteers were given 5 microg/kg of intravenous fentanyl without pretreatment (control), after oral voriconazole (400 mg twice on the first day and 200 mg twice on the second day), or after oral fluconazole (400 mg once on the first day and 200 mg once on the second day). Plasma concentrations of fentanyl, norfentanyl, voriconazole, and fluconazole were determined up to 24 h. Pharmacokinetic parameters were calculated using compartmental methods.
resultsThe mean plasma clearance of intravenous fentanyl was decreased by 23% (range -22 to 48%; p < 0.05) and 16% (-34 to 53%; p < 0.05) after voriconazole and fluconazole administration, respectively. Voriconazole increased the area under the fentanyl plasma concentration-time curve by 1.4-fold (p < 0.05). The initial plasma concentrations and volume of distribution of fentanyl did not differ significantly between phases.
conclusionBoth voriconazole and fluconazole delay the elimination of fentanyl significantly. Caution should be exercised, especially in patients who are given voriconazole or fluconazole during long-lasting fentanyl treatment, because insidiously elevated fentanyl concentration may lead to respiratory depression.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.