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- Title
Adverse Effects Associated with Long-Term Administration of Azole Antifungal Agents.
- Authors
Benitez, Lydia L.; Carver, Peggy L.
- Abstract
Azole antifungals are first-line options in the prophylaxis and treatment of invasive fungal infections. They are often used for prolonged (weeks to months) periods of time, particularly in patients with hematologic malignancies, or in those who have received a solid organ or hematopoietic stem cell transplant. Long-term use of azoles is associated with hepatotoxicity and hormone-related effects, including gynecomastia, alopecia, decreased libido, oligospermia, azoospermia, impotence, hypokalemia, hyponatremia, and (rarely) adrenal insufficiency. Voriconazole and posaconazole have been associated with peripheral neuropathies, and itraconazole and voriconazole with pancreatitis. In addition, voriconazole has been associated with periostitis, phototoxic reactions, and squamous cell carcinoma. Since many at-risk patients are commonly receiving multiple medications, it can be difficult for care providers to identify antifungal agent causality or contribution to patient symptoms. Knowledge and recognition of adverse events caused by azoles, leading to dose reduction or discontinuation, can generally reverse these adverse events.
- Subjects
HYPONATREMIA; IMPOTENCE risk factors; PANCREATITIS; PHOTOSENSITIVITY disorders; SQUAMOUS cell carcinoma; HYPOKALEMIA; GYNECOMASTIA; BONE diseases; RISK factors in infertility; HEPATOTOXICOLOGY -- Risk factors; BALDNESS -- Risk factors; PERIPHERAL neuropathy; ADRENAL insufficiency; ANTIFUNGAL agents; HEMATOPOIETIC stem cell transplantation; MYCOSES; PSYCHOANALYTIC interpretation; TERMINATION of treatment; HEMATOLOGIC malignancies; ITRACONAZOLE; VORICONAZOLE; DISEASE risk factors; CANCER risk factors
- Publication
Drugs, 2019, Vol 79, Issue 8, p833
- ISSN
0012-6667
- Publication type
Article
- DOI
10.1007/s40265-019-01127-8