Liver injury caused by the combination of voriconazole and nirmatrelvir/ritonavir
10.3760/cma.j.cn114015-20230331-00243
- VernacularTitle:伏立康唑与奈玛特韦/利托那韦联用致肝损伤
- Author:
Dongjie GUO
1
;
Pengmei LI
1
Author Information
1. 中日友好医院药学部，北京 100029
- Publication Type:Journal Article
- Keywords:
Antiviral agents;
Antifungal agents;
Chemical and drug induced liver injury;
Voriconazole;
Drug interactions;
Lung transplantation;
Ritonavir;
Nirmatrelvir
- From:
Adverse Drug Reactions Journal
2024;26(2):123-125
- CountryChina
- Language:Chinese
-
Abstract:
A 66-year-old male patient who underwent lung transplantation took a combination therapy with tacrolimus, mycophenolate sodium, and prednisone for a long time to resist rejection.Due to the occurrence of novel coronavirus and pulmonary fungal infection,the patient was given antiviral therapy with nirmatrelvir/ritonavir (Pavlovid), followed by antifungal therapy with voriconazole 2 days later. Before voriconazole treatment, the patient′s alanine aminotransferase was 34 U/L, and aspartate aminotransferase was 28 U/L. On the 4th day of the combination of voriconazole and Paxlovid, the patient′s blood trough concentration of voriconazole was 16.06 mg/L, alanine aminotransferase was 176 U/L, and aspartate amino- transferase was 166 U/L. Voriconazole was discontinued immediately and 2 days later,Paxlovid was discontinued. Five days after discontinuation of voriconazole, the patient′s liver function returned to normal; 9 days later, blood trough concentration of voriconazole was 5.84 mg/L. It was considered that the patient′s liver injury was caused by the combination of voriconazole and Paxlovid.
