SYSTEMIC AVAILABILITY OF ITRACONAZOLE IN LUNG TRANSPLANTATION

Systemic availability of itraconazole in lung transplantation was eval uated by serially measuring the bioactivity of itraconazole in lung tr ansplant patients who received itraconazole for prophylaxis (n = 12) o r therapy (n = 5). These patients also received concomitant antacid an d H-2 blocker therapy. In patients receiving itraconazole at 200 and 4 00 mg/day, the median concentrations in serum were 0.5 mu g/ml (range, <0.5 to 2.7) and 3.5 mu g/ml (<0.5 to 14), respectively. The concentr ation following administration of 400 mg/day was >2.5 mu g/ml in 56% o f samples, while only 4% of samples from patients who were administere d 200 mg/day had levels over 2.5 mu g/ml. This study documents that it raconazole can be absorbed in patients receiving concomitant antacid a nd H-2 blocker therapy. However, the reduced and variable absorption s uggests the importance of confirming drug delivery by measurement of c oncentrations in serum.