Antifungal medications are used to fight infections caused by fungi, often in patients with suppressed immune function. There are a number of classes of antifungal drugs, and azoles are the most commonly prescribed antifungal. Azoles work by inhibiting a chemical that keeps the fungus growing. (Clinical Microbiology Review “Human Pharmacogenomic Variations and Their Implications for Antifungal Efficacy,” Oct 2006).
Serious Side Effects of Antifungals
Severe side effects of antifungals, though relatively rare, can occur in individuals who genetically do not metabolize antifungal agents effectively. These serious adverse effects include low potassium, which can cause cardiac arrhythmia, liver damage, low white blood cell count (resulting in reduced immunity to disease and infection), and anaphylactic shock.
(Bone Marrow Transplantation “Has the era of individualised medicine arrived for antifungals? A review of antifungal pharmacogenomics,” July 2012).
Common Side Effects
Antifungals are usually fairly well tolerated. Different azoles will have slightly different side effects profiles. However they are broadly the same. Some common side effects when taking azole antifungal medications include (occur in more than 1% of patients):
- Abdominal Pain
- Dyspepsia (indigestion)
- Increase ALT and AST (a marker of liver damage)
(Clinical Microbiology Review “Human Pharmacogenomic Variations and Their Implications for Antifungal Efficacy,” Oct 2006).
Understand Your Risks with the Rxight® Genetic Test
Individual genetic variation in drug metabolism genes can predict how a patient will respond to a pharmacological agent. Variation in any of these genes means that the enzyme made from the genetic instructions is also altered, resulting in unpredictable side effects. Rxight® pharmacogenetic testing determines how an individual’s genes encode for their metabolism of a pharmacological agent. Rxight® tests for 18 genes and their alleles to determine with one simple cheek swab how you will react to a panel of over 200 commonly prescribed medications, including common antifungals. The results will guide clinicians in finding a dose that is safe and effective or an alternative medication – preferably before treatment begins.
Contributors to this Article:
Michael Sapko, MD, PhD; Deborah Kallick, PhD, Medicinal Chemistry