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Four triazole antifungal drugs, voriconazole, posaconazole, itraconazole, and isavuconazole, are approved to treat invasive aspergillosis either as first\u2010 or second\u2010line therapy. All of these agents are inhibitors of cytochrome P450 3A4, which plays a key role in metabolizing immunosuppressant drugs such as cyclosporine, tacrolimus, and sirolimus. Thus, co\u2010administration of a triazole antifungal drug with these immunosuppressant drugs can potentially increase plasma concentrations of the immunosuppressant drugs, thereby resulting in toxicity, or upon discontinuation, inadvertently decrease the respective concentrations with increased risk of rejection or graft\u2010versus\u2010host disease. In this article, we review the evidence for the extent of inhibition of cytochrome P450 3A4 by each of these triazole antifungal drugs and assess their effects on cyclosporine, tacrolimus, and sirolimus. We also consider other factors affecting interactions of these two classes of drugs. Finally, we examine recommendations and strategies to evaluate and address those potential drug\u2010drug interactions in these patients.<\/jats:p>","DOI":"10.1111\/tid.12751","type":"journal-article","created":{"date-parts":[[2017,7,19]],"date-time":"2017-07-19T08:11:40Z","timestamp":1500451900000},"source":"Crossref","is-referenced-by-count":126,"title":["Drug\u2010drug interactions between triazole antifungal agents used to treat invasive aspergillosis and immunosuppressants metabolized by cytochrome P450 3A4"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1188-393X","authenticated-orcid":false,"given":"Andreas H.","family":"Groll","sequence":"first","affiliation":[{"name":"Department of Pediatric Hematology\/Oncology University Children's Hospital M\u00fcnster M\u00fcnster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Townsend","sequence":"additional","affiliation":[{"name":"Astellas Pharma Global Development, Inc. Northbrook IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Desai","sequence":"additional","affiliation":[{"name":"Astellas Pharma Global Development, Inc. Northbrook IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nkechi","family":"Azie","sequence":"additional","affiliation":[{"name":"Astellas Pharma Global Development, Inc. 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