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