Pharmacokinetic drug interactions of azoles

Drug-drug interactions are a major concern with triazoles. Azoles are potent metabolic inhibitors and interactions commonly occur via metabolizing enzymes (ie, cytochrome P450 isoenzyme superfamily) or drug transporters (ie, P-glycoprotein). However, the clinical relevance of these interactions may vary upon the azole involved and upon the “target” drug. Azoles may also be under influence of and become targets of metabolic drug-drug interactions. Potential interactions between antifungal agents and over-the-counter or alternative medicines and herbs should not be underestimated. Here, we provide a comprehensive overview of different types of pharmacokinetic drug interactions involving azoles with selected examples.