{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T01:53:09Z","timestamp":1777859589989,"version":"3.51.4"},"reference-count":15,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,3,20]],"date-time":"2025-03-20T00:00:00Z","timestamp":1742428800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Pharmacy Practice"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:p>\n                    <jats:bold>Introduction:<\/jats:bold>\n                    Roux-en-Y gastric bypass (RYGB) is a surgical weight-loss procedure that combines gastric restriction with malabsorption for weight reduction. There is currently a paucity of data to guide pharmacists and healthcare providers in optimizing oral medication therapy in patients with a history of bariatric surgery. Fluconazole is a commonly used triazole antifungal with high oral bioavailability. The literature is limited regarding how RYGB affects oral fluconazole absorption.\n                    <jats:bold>Case:<\/jats:bold>\n                    We investigated fluconazole oral bioavailability in a patient with a history of RYGB status-post revision with esophagojejunal anastomosis. The patient had been maintained on combination therapy with intravenous (IV) micafungin and oral fluconazole due to persistent candidemia prior to source control and concerns regarding fluconazole absorption. On admission, the patient was switched to IV fluconazole in the setting of possible small bowel obstruction. Steady-state fluconazole trough levels obtained during IV and oral therapy were 41.9\u00a0\u03bcg\/mL and 44.4\u00a0\u03bcg\/mL, respectively.\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    We were able to demonstrate oral fluconazole maintains high bioavailability in a patient with RYGB. Fluconazole displays linear pharmacokinetics, therefore the degree of oral absorption reduction would directly correspond to a decreased trough level. Pharmacists and providers should continue to be vigilant when evaluating drug efficacy in patients who have undergone gastric bypass procedures, especially those with malabsorptive mechanisms.\n                  <\/jats:p>","DOI":"10.1177\/08971900251328787","type":"journal-article","created":{"date-parts":[[2025,3,20]],"date-time":"2025-03-20T19:44:17Z","timestamp":1742499857000},"page":"113-116","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Oral Fluconazole Absorption in a Complicated Post-Roux-en-Y Gastric Bypass Patient: A Case Report"],"prefix":"10.1177","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2121-2497","authenticated-orcid":false,"given":"Diana R.","family":"Langworthy","sequence":"first","affiliation":[{"name":"University of Minnesota College of Pharmacy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer K.","family":"Ross","sequence":"additional","affiliation":[{"name":"M Health Fairview University of Minnesota Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,3,20]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.2146\/ajhp151062"},{"key":"e_1_3_3_3_2","unstructured":"\u201cEstimate of bariatric surgery numbers. 2011-2020.\u201d American Society for Metabolic and Bariatric Surgery (ASMBS). Available at: https:\/\/asmbs.org\/resources\/estimate-of-bariatric-surgery-numbers. Accessed 24 March 2023."},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.14913"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/12.Supplement_3.S318"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.2042-7158.2012.01538.x"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.37.10.2187"},{"key":"e_1_3_3_8_2","first-page":"409","article-title":"Medication management and pharmacokinetic changes after bariatric surgery","volume":"66","author":"Lorico S","year":"2020","unstructured":"Lorico S, Colton B. Medication management and pharmacokinetic changes after bariatric surgery. Can Fam Physician. 2020;66:409-416.","journal-title":"Can Fam Physician"},{"key":"e_1_3_3_9_2","volume-title":"Drug Bioavailability. StatPearls","author":"Price G","year":"2023","unstructured":"Price G, Patel DA. Drug Bioavailability. StatPearls. StatPearls Publishing LLC \u00a9; 2023."},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkt508"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40121-020-00280-y"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.5688\/ajpe7335"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1021\/acs.molpharmaceut.5b00135"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/jphp.12928"},{"key":"e_1_3_3_15_2","volume-title":"Fluconazole [package Insert]","year":"2011","unstructured":"Fluconazole [package Insert]. New York, NY, Pfizer, Inc, 2011."},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.3390\/pharmaceutics12090846"}],"container-title":["Journal of Pharmacy Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08971900251328787","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/08971900251328787","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08971900251328787","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:33:52Z","timestamp":1777509232000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/08971900251328787"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,20]]},"references-count":15,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1177\/08971900251328787"],"URL":"https:\/\/doi.org\/10.1177\/08971900251328787","relation":{},"ISSN":["0897-1900","1531-1937"],"issn-type":[{"value":"0897-1900","type":"print"},{"value":"1531-1937","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,20]]}}}