1. [Severe neurotoxicological reaction by combined treatment with vincristine and fluconazole].
- Author
-
Hellfritzsch M, Lassen P, and Nielsen LP
- Subjects
- Adult, Antifungal Agents administration & dosage, Antifungal Agents therapeutic use, Antineoplastic Agents, Phytogenic administration & dosage, Antineoplastic Agents, Phytogenic therapeutic use, Antineoplastic Combined Chemotherapy Protocols administration & dosage, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Bone Neoplasms drug therapy, Drug Interactions, Female, Fluconazole administration & dosage, Fluconazole therapeutic use, Humans, Paresthesia chemically induced, Sarcoma, Ewing drug therapy, Vincristine administration & dosage, Vincristine therapeutic use, Antifungal Agents adverse effects, Antineoplastic Agents, Phytogenic adverse effects, Antineoplastic Combined Chemotherapy Protocols adverse effects, Fluconazole adverse effects, Vincristine adverse effects
- Abstract
We describe the case of a woman, aged 41 years, who received a combination chemotherapy including vincristine, doxorubicine, ifosfamide and etoposide due to Ewings sarcoma. She was treated prophylactic with fluconazole to prevent oral candidosis. Unexpectedly, she developed severe neurotoxic side effects. Treatment with multiple substrates of cytochrome P450 3A4 combined with inhibition of the enzyme by fluconazole impairs metabolism and thereby increase plasma concentrations of vincristine, which is considered to be the main reason for the neurotoxic side effects.
- Published
- 2013