Minor
Suspected
Description
Fluconazole inhibits CYP2C8-mediated metabolism of montelukast, modestly increasing montelukast plasma concentrations; the clinical impact is generally minor given montelukast's wide therapeutic index.
Mécanisme
Montelukast is primarily metabolised by CYP2C8 and to a lesser extent CYP3A4; fluconazole inhibits both enzymes, reducing montelukast clearance and elevating systemic exposure.
Signification clinique
Pharmacokinetic modelling predicts a moderate increase in montelukast AUC; no clinical case reports of montelukast toxicity due to fluconazole have been identified.
Prise en charge
No dose adjustment is required; standard monitoring is adequate.