Grapefruit juice decreases the systemic availability of itraconazole capsules in healthy volunteers

Scott R. Penzak, Paul O. Gubbins, Bill J. Gurley, Pei Ling Wang, Michael Saccente

Research output: Contribution to journalArticle

46 Scopus citations

Abstract

The systemic availability of itraconazole capsules may be reduced secondary to elevated gastric pH and possibly by presystemic intestinal metabolism via CYP3A4. Grapefruit juice is acidic and an inhibitor of intestinal CYP3A4. To determine the effect of grapefruit juice on the systemic availability of itraconazole capsules, serum itraconazole and hydroxy-itraconazole concentrations were determined in eleven healthy volunteers studied in a randomized, two-way crossover design. Concurrent grapefruit juice resulted in a 43% decrease in the mean itraconazole AUC0- 48 (2507 ng · hr/mL versus 1434 ng · hr/mL, p = 0.046) and a 47% decrease in the mean hydroxy-itraconazole AUC0-72 (7264 ng · hr/mL versus 3880 ng · hr/mL, p = 0.025). Grapefruit juice also significantly increased the mean itraconazole T(max) (5.5 versus 4 hours). We conclude that concomitant grapefruit juice does not enhance the systemic availability of itraconazole capsules, but rather appears to impair itraconazole absorption. Therefore, concomitant grapefruit juice will not likely be useful in improving the oral availability of itraconazole capsules.

Original languageEnglish
Pages (from-to)304-309
Number of pages6
JournalTherapeutic Drug Monitoring
Volume21
Issue number3
DOIs
StatePublished - 1 Jun 1999

Keywords

  • Absorption
  • CYP3A4
  • Grapefruit juice
  • Itraconazole

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