ArticleAntimicrobial agents and chemotherapy2015
In vitro study of the variable effects of proton pump inhibitors on voriconazole.
Article in Antimicrobial agents and chemotherapy, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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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.
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Who cites it
16 citing papers in PubMed, 33 citations in OpenAlex.
- Co-Administration with Voriconazole Doubles the Exposure of Ruxolitinib in Patients with Hematological Malignancies.Drug design, development and therapy · 2022Trial
- Factors affecting trough concentrations of voriconazole: a dual-center retrospective analysis focusing on loading dose and inflammatory state effects.Frontiers in pharmacology · 2026Article
- The Fragile Patient: Considerations in the Management of Invasive Mould Infections (IMIs) in India.Cureus · 2023Review
- The Effects of Intravitreal Administration of Antifungal Drugs on the Structure and Mechanical Properties Peripheral Blood Erythrocyte Surface in Rabbits.International journal of molecular sciences · 2022Article
- Population pharmacokinetics of voriconazole and initial dosage optimization in patients with talaromycosis.Frontiers in pharmacology · 2022Article
- Analysis of Combined Effect of CYP2C19 Genetic Polymorphism and Proton Pump Inhibitors Coadministration on Trough Concentration of Voriconazole.Pharmacogenomics and personalized medicine · 2021Article
- A multicentre prospective study evaluating the impact of proton-pump inhibitors omeprazole and pantoprazole on voriconazole plasma concentrations.British journal of clinical pharmacology · 2020Observational
- Effect of Gender and Age on Voriconazole Trough Concentrations in Italian Adult Patients.European journal of drug metabolism and pharmacokinetics · 2020Article
- Effects of Voriconazole on the Pharmacokinetics of Vonoprazan in Rats.Drug design, development and therapy · 2020Article
- Pharmacological Effects and Toxicogenetic Impacts of Omeprazole: Genomic Instability and Cancer.Oxidative medicine and cellular longevity · 2020Review
- Therapeutic Drug Monitoring of Voriconazole in Children from a Tertiary Care Center in China.Antimicrobial agents and chemotherapy · 2018Article
- Reduced Effectiveness of Interruptive Drug-Drug Interaction Alerts after Conversion to a Commercial Electronic Health Record.Journal of general internal medicine · 2018Article
- Therapeutic drug monitoring of voriconazole for treatment and prophylaxis of invasive fungal infection in children.British journal of clinical pharmacology · 2018Article
- Gastroesophageal Reflux Disease and Pulmonary Diseases Associated with Aspergillosis: Is There a Connection?Mycopathologia · 2017Article
- Acid-Suppressive Therapy and Risk of Infections: Pros and Cons.Clinical drug investigation · 2017Review
- Antagonism of Fluconazole and a Proton Pump Inhibitor against Candida albicans.Antimicrobial agents and chemotherapy · 2016Article
Corrections and comments
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Authors and funding
3 authors at 3 institutions in 1 country.
Funding
Abstract
Voriconazole is a broad-spectrum antifungal agent used for the treatment of severe fungal infections. Maintaining therapeutic concentrations of 1 to 5.5 μg/ml is currently recommended to maximize the exposure-response relationship of voriconazole. However, this is challenging, given the highly variable pharmacokinetics of the drug, which includes metabolism by cytochrome P450 (CYP450) isotypes CYP2C19, CYP3A4, and CYP2C9, through which common metabolic pathways for many medications take place and which are also expressed in different isoforms with various metabolic efficacies. Proton pump inhibitors (PPIs) are also metabolized through these enzymes, making them competitive inhibitors of voriconazole metabolism, and coadministration with voriconazole has been reported to increase total voriconazole exposure. We examined the effects of five PPIs (rabeprazole, pantoprazole, lansoprazole, omeprazole, and esomeprazole) on voriconazole concentrations using four sets of human liver microsomes (HLMs) of different CYP450 phenotypes. Overall, the use of voriconazole in combination with any PPI led to a significantly higher voriconazole yield compared to that achieved with voriconazole alone in both pooled HLMs (77% versus 59%; P < 0.001) and individual HLMs (86% versus 76%; P < 0.001). The mean percent change in the voriconazole yield from that at the baseline after PPI exposure in pooled microsomes ranged from 22% with pantoprazole to 51% with esomeprazole. Future studies are warranted to confirm whether and how the deliberate coadministration of voriconazole and PPIs can be used to boost voriconazole levels in patients with difficult-to-treat fungal infections.
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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.