イトラコナゾールカプセルの吸収における黒酢の効果についての検討

Abstract

Itraconazole (ITCZ), a useful oral drug effective against Aspergillus, is reported to cause insufficient blood concentration through unstable enteral absorption. Hypoacidic gastic conditions have been reported to reduce absorption, whereas acidic drinks promote it. We present a case of pulmonary aspergillosis in a subject administered ITCZ with black vinegar, a popular health food in Japan. The 59-year-old man showed high blood concentrations of ITCZ, resulting in good Aspergillosis control. To confirm the efficacy in black vinegar on absorbing ITCZ, we administered ITCZ capsules with and without black vinegar to 10 healthy adults after preparation with a proton pump inhibitor to decrease gastric acidity, and measured blood concentrations of ITCZ and the metabolite OH-ITCZ. Administration of this combination increased ITCZ and OH-ITCZ Cmax significantly. For patients who produce too little gastric juice, black vinegar could thus serve to promote ITCZ capsule absorption.