Galatti Laura, Mazzaglia Giampiero, Greco Antonella, Sessa Emiliano, Cricelli Claudio, Schito Gian Carlo, Nicoletti Giuseppe, Spina Edoardo, Caputi Achille P
Department of Clinical and Experimental Medicine and Pharmacology, University of Messina, Torre Biologica-Policlinico Universitario, Via Consolare Valeria-Gazzi, Messina, Italy.
Pharmacoepidemiol Drug Saf. 2007 Apr;16(4):422-8. doi: 10.1002/pds.1389.
To determine the prevalence of concomitant use of drugs potentially responsible for interactions among itraconazole and fluconazole users in general practice.
During the years 1999-2002, we obtained information from the 'Health Search Database', (HSD) an Italian general practice research database. Among a total sample of 457 672 eligible patients, we included those aged >16 years, and whose diagnoses could be classified as mycosis. Itraconazole and fluconazole users were then selected. A potentially drug-drug interaction (DDI) occurred when the use of concomitant drugs were recorded within +/-30 days from the date of the first azoles prescription. Interacting drugs were classified according to the summary of product characteristics (SPC) as provided by the Italian Pharmaceutical Repertory (REFI).
From 18 323 cases of mycosis, we selected 4843 itraconazole and 1446 fluconazole users. Potentially interacting drugs were prescribed in 8.7% of itraconazole and 6.1% of fluconazole users. For itraconazole, calcium channel blockers were the most common interacting drugs (3.3%), followed by statins (1.7%) and clarithromycin (1.3%), whereas gestoden + ethynylestradiol (2.5%) and benzodiazepines (1.8%) resulted as the most common interacting drugs among fluconazole users.
Data indicate a relevant prevalence of concomitant use of medications potentially leading to drug interactions among azoles users. Because of the wide use of these medications in general practice, they should be used with clinical monitoring in view of their known side effects as well as their potential risk for drug interaction.
确定在普通医疗实践中，伊曲康唑和氟康唑使用者同时使用可能导致相互作用药物的情况。
在1999年至2002年期间，我们从意大利普通医疗实践研究数据库“健康搜索数据库”（HSD）中获取信息。在总共457672名符合条件的患者样本中，我们纳入了年龄大于16岁且诊断可归类为真菌病的患者。然后选择伊曲康唑和氟康唑使用者。当在首次使用唑类药物处方日期的正负30天内记录到同时使用的药物时，就发生了潜在的药物相互作用（DDI）。相互作用的药物根据意大利药品汇编（REFI）提供的产品特性摘要（SPC）进行分类。
从18323例真菌病病例中，我们选择了4843名伊曲康唑使用者和1446名氟康唑使用者。在8.7%的伊曲康唑使用者和6.1%的氟康唑使用者中开具了可能相互作用的药物。对于伊曲康唑，钙通道阻滞剂是最常见的相互作用药物（3.3%），其次是他汀类药物（1.7%）和克拉霉素（1.3%），而炔诺孕酮+乙炔雌二醇（2.5%）和苯二氮䓬类药物（1.8%）是氟康唑使用者中最常见的相互作用药物。
数据表明，唑类药物使用者中同时使用可能导致药物相互作用的药物的情况较为普遍。由于这些药物在普通医疗实践中广泛使用，鉴于其已知的副作用以及潜在的药物相互作用风险，应在临床监测下使用。
