Demonstration of the Rationale for Therapeutic Drug Monitoring of Isavuconazole

Eliška Dvořáčková, Andrea Zajacová, Jan Havlín, Eva Klapková, Robert Lischke, Ondřej Slanař, Martin Šíma

Demonstration of the Rationale for Therapeutic Drug Monitoring of Isavuconazole

Číslo: 4/2023
Periodikum: Prague Medical Report
DOI: 10.14712/23362936.2023.34

Klíčová slova: Isavuconazole, Antifungals, Pharmacokinetics, Therapeutic drug monitoring, Lung transplant recipient

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Anotace: Mucormycosis is a rare invasive fungal disease diagnosed in immunocompromised patients, including those with diabetes or iron overload, and in patients treated for hematological malignancies or after transplantation. Isavuconazole is a triazole antifungal effective against Mucorales with good tolerability, but with potential for relatively high interindividual variability in pharmacokinetics. This report demonstrates the case of a lung transplant recipient treated with isavuconasole that exhibits a very long elimination half-life of 159 hours, and discusses the practical implications of this finding for dosage adjustment and need for therapeutic drug monitoring.