Antifungal Drug-Drug Interactions with Commonly Used Pharmaceutics in European Pediatric Patients with Acute Lymphoblastic Leukemia

Author:

Sienkiewicz-Oleszkiewicz Beata1,Salamonowicz-Bodzioch Małgorzata2,Słonka Justyna3,Kałwak Krzysztof2

Affiliation:

1. Department of Clinical Pharmacology, Faculty of Pharmacy, Wrocław Medical University, ul. Borowska 211a, 50-556 Wrocław, Poland

2. Department and Clinic of Pediatric Oncology, Hematology and Bone Marrow Transplantation, Wrocław Medical University, Borowska 213, 50-556 Wrocław, Poland

3. Gilead Sciences Poland Sp. z o.o., ul. Postepu 17A, 02-676 Warsaw, Poland

Abstract

Leukemia is one of the leading childhood malignancies, with acute lymphoblastic leukemia (ALL) being the most common type. Invasive fungal disease is a concerning problem also at pediatric hemato-oncology units. Available guidelines underline the need for antifungal prophylaxis and give recommendations for proper treatment in various clinical scenarios. Nonetheless, antifungal agents are often involved in drug-drug interaction (DDI) occurrence. The prediction of those interactions in the pediatric population is complicated because of the physiological differences in adults, and the lack of pharmacological data. In this review, we discuss the potential DDIs between antifungal agents and commonly used pharmaceutics in pediatric hemato-oncology settings, with special emphasis on the use of liposomal amphotericin B and ALL treatment. We obtained information from Micromedex® and Drugs.com® interaction checking databases and checked the EudraVigilance® database to source the frequency of severe adverse drug reactions that resulted from antifungal drug interactions. Several major DDIs were identified, showing a favorable safety profile of echinocandins and liposomal amphotericin B. Interestingly, although there are numerous available drug interaction checking tools facilitating the identification of potential serious DDIs, it is important to use more than one tool, as the presented searching results may differ between particular checking programs.

Funder

Gilead Sciences Poland sp. z o.o.

Publisher

MDPI AG

Subject

General Medicine

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