All induction and inhibition processes were modeled using interaction parameter values either identified during the development of the perpetrator models if no experimental values could be found to parameterize their auto‐induction or auto‐inhibition (using multiple‐dose perpetrator studies only, without co‐administration of victim drugs), or taken from literature without further adjustment or fitting, as a means of further evaluation of the perpetrator and victim drug models.
Itraconazole
It works by inhibiting the synthesis of ergosterol, an essential component of the fungal cell membrane.
Itraconazole is availble in oral and intravenous formulations, and is known for its broad spectrum of activity and good tolerability profile.
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Most cited protocols related to «Itraconazole»
All induction and inhibition processes were modeled using interaction parameter values either identified during the development of the perpetrator models if no experimental values could be found to parameterize their auto‐induction or auto‐inhibition (using multiple‐dose perpetrator studies only, without co‐administration of victim drugs), or taken from literature without further adjustment or fitting, as a means of further evaluation of the perpetrator and victim drug models.
The PBPK models were developed based on a healthy male European individual, 30 years of age, with a body weight of 73 kg, and a height of 176 cm. Physiological parameters, like organ volumes, blood flow rates, and surface permeabilities, are provided within the software.
Model selection was based on the ability of the model to describe (training dataset) and predict (test dataset) plasma concentration‐time profiles from all published clinical studies as well as fraction excreted unchanged to urine. Furthermore, physiological plausibility, precision and covariance of parameter estimates, and population predictions were assessed.
Clinical antifungal MICs were determined using broth microdilution with RPMI 1640 broth for amphotericin, fluconazole, ketoconazole, itraconazole, voriconazole, and caspofungin following Clinical and Laboratory Standards Institute document M27-A3 [56] . Visual MIC endpoints were read after 24 hours of incubation at 35°C for caspofungin and after 48 hours of incubation for all other drugs. Complete inhibition was used to determine amphotericin endpoints; 50% inhibition (compared to growth control) was used for caspofungin and 80% inhibition was used for the other drugs.
Most recents protocols related to «Itraconazole»
Example 2
Twenty-eight (28) healthy, adult male and female (non-childbearing potential) subjects were enrolled in the study in total; 14 subjects in each study part (Parts 1 and 2). A minimum of 8 female subjects were enrolled in the study (i.e., a minimum of 4 female subjects per study part). Each subject participated in either Part 1 or Part 2, but not both.
Part 1
On Day 1 of Treatment Period 1, a single oral dose of 20 mg mitapivat sulfate was administered. Serial blood samples for plasma assay of mitapivat concentrations and its CYP3A4 metabolite, referred to herein as the “Metabolite” (structure below),
In Treatment Period 1, mitapivat sulfate was administered orally with approximately 240 mL of water. In Treatment Period 2, on Days 1 to 4, itraconazole was administered alone immediately followed by approximately 220 mL of water, and on Day 5, itraconazole was administered first (no water) and was immediately followed by mitapivat sulfate administration with approximately 220 mL of water. Study drugs (mitapivat sulfate and itraconazole) were administered following an overnight fast of at least 10 hours on Day 1 of Treatment Period 1 (mitapivat sulfate only) and Day 5 of Treatment Period 2 (mitapivat sulfate and itraconazole), and subjects remained fasted for 4 hours after dosing. On all other dosing days, itraconazole was administered following a predose fast of at least 4 hours and subjects remained fasted for at least 2 hours after dosing.
Part 2
On Day 1 of Treatment Period 1, a single oral dose of 50 mg mitapivat sulfate was administered. Serial blood samples for plasma assay of mitapivat and the Metabolite concentrations were collected from predose to 120 hours following administration of mitapivat sulfate. In Treatment Period 2, an oral dose of 600 mg rifampin was administered QD for 12 consecutive days (Day 1 through Day 12 of Treatment Period 2) with a single oral dose of 50 mg mitapivat sulfate coadministered on Day 8. Serial blood samples for plasma assay of mitapivat sulfate and the Metabolite concentrations were collected from predose to 120 hours following coadministration of mitapivat and rifampin on Day 8.
In Part 2, study drugs were administered with approximately 240 mL of water on all dosing days including the coadministration of mitapivat sulfate and rifampin on Day 8 of Treatment Period 2. Mitapivat sulfate and rifampin was administered following an overnight fast of at least 10 hours on Day 1 of Treatment Period 1 (mitapivat sulfate only) and Day 8 of Treatment Period 2 (both mitapivat sulfate and rifampin) and subjects remained fasted for 4 hours after dosing. On all other dosing days, rifampin was administered following a predose fast of at least 4 hours and subjects remained fasted for at least 2 hours after dosing. There was a washout period of 7 days between the mitapivat sulfate dose in Treatment Period 1 and the first itraconazole (Part 1) or rifampin (Part 2) dose in Treatment Period 2. All study drugs were consumed within 5 minutes for both Part 1 and Part 2.
IC50 values were obtained using a 3-parameter dose-response, 4-parameter dose-response, or normalized dose-response model; model comparisons were performed in Prism 6 (GraphPad Inc) to determine the optimal model for each data set. A least-squares fitting approach was used, and the Hill slope was not constrained for the 4-parameter model.
Patients with AH were treated with oral itraconazole (600 mg/day for 3 days, followed by 400 mg/day), with or without parenteral amphotericin B, according to guidelines (20 (link)). Itraconazole was continued for a period of 12–18 months. Patients with AT were treated with four drugs (isoniazid, rifampicin, pyrazinamide and ethambutol) for 2 months followed by isoniazid and rifampicin for a further 4 months. All patients received physiological doses of glucocorticoids (prednisolone (82 patients, dose 2.5–5 mg/day in two divided doses) and hydrocortisone (7 patients,15–25 mg/day in three divided doses)) and fludrocortisone (50–125 µg/day). The dose of prednisolone or hydrocortisone was doubled for the duration of rifampicin use, which is known to induce acceleration of cortisol metabolism. Advice on stress dosing was provided at every visit.