An Unusual Case Report of Iatrogenic Metrorrhagia and Hematochezia Following Itraconazole

Yashaswi Rai
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Abstract

Itraconazole is an effective triazole antimycotic drug that has a desirable pharmacokinetic profile to combat various fungal pathogens. It acts by inhibiting ergosterol biosynthesis in fungal cell membranes. Itraconazole is not totally selective toward Cytochrome P450 family 3 subfamily A member 4 (CYP450 3A4), but exhibits the most potent inhibition of CYP450 3A4. Thus, these drugs interfere with CYP450 3A4 proteins expressed in the liver, intestine, kidney, adrenals, ovary, and testis. We present a case report of metrorrhagia and hematochezia following intake of itraconazole, a commonly used azole drug against dermatophytic infection. This article strongly highlights eliciting menstrual history and gynecological- and surgical-related problems before prescribing itraconazole. Also, to be aware of the vaginal bleeding being the unusual side effects of itraconazole.
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伊曲康唑引起的先天性月经过多和血崩的罕见病例报告
伊曲康唑是一种有效的三唑类抗真菌药物,具有理想的药代动力学特征,可用于抗击各种真菌病原体。它通过抑制真菌细胞膜上麦角甾醇的生物合成发挥作用。伊曲康唑对细胞色素 P450 家族 3 亚家族 A 成员 4(CYP450 3A4)没有完全的选择性,但对 CYP450 3A4 的抑制作用最强。因此,这些药物会干扰在肝、肠、肾、肾上腺、卵巢和睾丸中表达的 CYP450 3A4 蛋白。我们报告了一例服用伊曲康唑(一种常用的抗皮癣菌感染的唑类药物)后出现月经过多和血崩的病例。本文着重强调,在开具伊曲康唑处方前,应了解月经史以及妇科和外科相关问题。此外,还要注意阴道出血是伊曲康唑的异常副作用。
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