Changes in the blood cyclosporine level after switching from voriconazole to isavuconazole in a patient with aplastic anemia: insights from physiologically based pharmacokinetic model simulation and the Adverse Event Reporting System database study.

ABSTRACT:

Introduction

Isavuconazole, a broad-spectrum triazole approved by the United States Food and Drug Administration (FDA) in 2015, moderately inhibits cytochrome P450 3A4. Although antifungal agents are often used concomitantly with cyclosporine, the effect of switching from voriconazole to isavuconazole on the blood cyclosporine level remains unclear.

Case

A 63-year-old Japanese male was administered oral cyclosporine (10:00 and 21:00) for severe aplastic anemia. Following pneumonia with positive Aspergillus antigen and an elevated β-D-glucan level, antifungal therapy was initiated. After switching from voriconazole (10:00 and 21:00) to isavuconazole (approximately 08:00), the blood cyclosporine level decreased by more than half. Although the blood cyclosporine level de

SUBMITTER: Shiraishi C 

PROVIDER: S-EPMC11891238 | biostudies-literature | 2025

REPOSITORIES: biostudies-literature