Interpretation and Understanding of Clinical Drug Interactions Between Azoles and Immunosuppressants in Solid Organ Transplant Recipients

Purpose of Review The aim of this paper is to discuss clinical interactions between the azole antifungals and the commonly used immunosuppressants for the prevention of rejection in solid organ transplant recipients. Recent Findings Drug–drug interactions between azole antifungals and immunosuppressants have largely been reported in healthy subjects or the hematopoietic stem cell transplant (HSCT) population. Data is emerging evaluating these interactions in solid organ transplant recipients. Summary Drug–drug interactions between azole antifungals and immunosuppressants occur at or near the same magnitude as in healthy subjects or the HSCT population. Factors affecting these drug–drug interactions include the influence of the interacting agents on CYP enzymes, the doses of the drugs administered, and the route of administration of both the azoles and immunosuppressants. Care and caution should be exercised when managing solid organ transplant patients receiving medications from both classes.