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. 1987 Apr;31(4):647–649. doi: 10.1128/aac.31.4.647

Adrenal response to corticotropin during therapy with itraconazole.

P Phillips, J R Graybill, R Fetchick, J F Dunn
PMCID: PMC174799  PMID: 3038002

Abstract

Itraconazole is a triazole with a mechanism of action similar to that of ketoconazole. Endocrine side effects of ketoconazole, including impaired cortisol synthesis, have been well documented (A. Pont, J. R. Graybill, P. C. Craven, J. N. Galgiani, W. E. Dismukes, R. E. Reitz, and D. A. Stevens, Arch. Intern. Med. 144:2150-2153, 1984). We examined the adrenal response to corticotropin in 10 patients being treated with itraconazole. No impairment of cortisol synthesis could be demonstrated.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Contreras P., Altieri E., Liberman C., Gac A., Rojas A., Ibarra A., Ravanal M., Serón-Ferré M. Adrenal rest tumor of the liver causing Cushing's syndrome: treatment with ketoconazole preceding an apparent surgical cure. J Clin Endocrinol Metab. 1985 Jan;60(1):21–28. doi: 10.1210/jcem-60-1-21. [DOI] [PubMed] [Google Scholar]
  2. DeFelice R., Johnson D. G., Galgiani J. N. Gynecomastia with ketoconazole. Antimicrob Agents Chemother. 1981 Jun;19(6):1073–1074. doi: 10.1128/aac.19.6.1073. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Dismukes W. E., Stamm A. M., Graybill J. R., Craven P. C., Stevens D. A., Stiller R. L., Sarosi G. A., Medoff G., Gregg C. R., Gallis H. A. Treatment of systemic mycoses with ketoconazole: emphasis on toxicity and clinical response in 52 patients. National Institute of Allergy and Infectious Diseases collaborative antifungal study. Ann Intern Med. 1983 Jan;98(1):13–20. doi: 10.7326/0003-4819-98-1-13. [DOI] [PubMed] [Google Scholar]
  4. Espinel-Ingroff A., Shadomy S., Gebhart R. J. In vitro studies with R 51,211 (itraconazole). Antimicrob Agents Chemother. 1984 Jul;26(1):5–9. doi: 10.1128/aac.26.1.5. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Grosso D. S., Boyden T. W., Pamenter R. W., Johnson D. G., Stevens D. A., Galgiani J. N. Ketoconazole inhibition of testicular secretion of testosterone and displacement of steroid hormones from serum transport proteins. Antimicrob Agents Chemother. 1983 Feb;23(2):207–212. doi: 10.1128/aac.23.2.207. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Kowal J. The effect of ketoconazole on steroidogenesis in cultured mouse adrenal cortex tumor cells. Endocrinology. 1983 Apr;112(4):1541–1543. doi: 10.1210/endo-112-4-1541. [DOI] [PubMed] [Google Scholar]
  7. Lewis J. H., Zimmerman H. J., Benson G. D., Ishak K. G. Hepatic injury associated with ketoconazole therapy. Analysis of 33 cases. Gastroenterology. 1984 Mar;86(3):503–513. [PubMed] [Google Scholar]
  8. Loose D. S., Kan P. B., Hirst M. A., Marcus R. A., Feldman D. Ketoconazole blocks adrenal steroidogenesis by inhibiting cytochrome P450-dependent enzymes. J Clin Invest. 1983 May;71(5):1495–1499. doi: 10.1172/JCI110903. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Pont A., Goldman E. S., Sugar A. M., Siiteri P. K., Stevens D. A. Ketoconazole-induced increase in estradiol-testosterone ratio. Probable explanation for gynecomastia. Arch Intern Med. 1985 Aug;145(8):1429–1431. [PubMed] [Google Scholar]
  10. Pont A., Graybill J. R., Craven P. C., Galgiani J. N., Dismukes W. E., Reitz R. E., Stevens D. A. High-dose ketoconazole therapy and adrenal and testicular function in humans. Arch Intern Med. 1984 Nov;144(11):2150–2153. [PubMed] [Google Scholar]
  11. Pont A., Williams P. L., Azhar S., Reitz R. E., Bochra C., Smith E. R., Stevens D. A. Ketoconazole blocks testosterone synthesis. Arch Intern Med. 1982 Nov;142(12):2137–2140. [PubMed] [Google Scholar]
  12. Pont A., Williams P. L., Loose D. S., Feldman D., Reitz R. E., Bochra C., Stevens D. A. Ketoconazole blocks adrenal steroid synthesis. Ann Intern Med. 1982 Sep;97(3):370–372. doi: 10.7326/0003-4819-97-3-370. [DOI] [PubMed] [Google Scholar]
  13. Santen R. J., Van den Bossche H., Symoens J., Brugmans J., DeCoster R. Site of action of low dose ketoconazole on androgen biosynthesis in men. J Clin Endocrinol Metab. 1983 Oct;57(4):732–736. doi: 10.1210/jcem-57-4-732. [DOI] [PubMed] [Google Scholar]
  14. Schürmeyer T., Nieschlag E. Effect of ketoconazole and other imidazole fungicides on testosterone biosynthesis. Acta Endocrinol (Copenh) 1984 Feb;105(2):275–280. doi: 10.1530/acta.0.1050275. [DOI] [PubMed] [Google Scholar]
  15. Stevens D. A. Ketoconazole metamorphosis. An antimicrobial becomes an endocrine drug. Arch Intern Med. 1985 May;145(5):813–815. doi: 10.1001/archinte.145.5.813. [DOI] [PubMed] [Google Scholar]
  16. Trachtenberg J. Ketoconazole therapy in advanced prostatic cancer. J Urol. 1984 Jul;132(1):61–63. doi: 10.1016/s0022-5347(17)49464-x. [DOI] [PubMed] [Google Scholar]
  17. Tucker W. S., Jr, Snell B. B., Island D. P., Gregg C. R. Reversible adrenal insufficiency induced by ketoconazole. JAMA. 1985 Apr 26;253(16):2413–2414. [PubMed] [Google Scholar]
  18. Watanabe H., Menzies J. A. Depression of ovarian estradiol-17 beta following single oral dose of ketoconazole. Res Commun Chem Pathol Pharmacol. 1985 Apr;48(1):141–144. [PubMed] [Google Scholar]
  19. White M. C., Kendall-Taylor P. Adrenal hypofunction in patients taking ketoconazole. Lancet. 1985 Jan 5;1(8419):44–45. doi: 10.1016/s0140-6736(85)90988-2. [DOI] [PubMed] [Google Scholar]

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