ArticleFrontiers in pharmacology2026
Physiologically based pharmacokinetic modeling of fluconazole: interpretation of gender-dependent pharmacokinetics and cytochrome P450 inhibition.
Article in Frontiers in pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
The accurate prediction of clinical drug-drug interactions (DDIs) in modeling analysis relies on the fraction of metabolism and transport of the substrate drugs and on the inhibitory potency and plasma exposure of index inhibitors. Fluconazole is frequently used as a clinical index inhibitor of cytochrome P450 (CYP) 2C9 and CYP3A4 to assess DDI liabilities involving these CYP enzymes. It also inhibits uridine diphosphate glucuronosyltransferase (UGT) 2B7 and exhibits gender-dependent pharmacokinetics (PK). The currently available model profile of fluconazole does not account for these population-specific PK variations. Therefore, extrapolating from one fluconazole DDI dataset to another remains questionable when it is used as an index inhibitor. In the present study, a physiologically based pharmacokinetic (PBPK) model of fluconazole was developed using PK data from male and female subjects. A minimal PBPK model with advanced dissolution, absorption, and metabolism (ADAM) for fluconazole was built in the Simcyp Simulator (V22). The base model from the Simcyp compound library captured fluconazole plasma profiles following oral administration only in male subjects, but not in female subjects. The volume of distribution at steady state (V
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