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[Two cases of pulmonary aspergilosis, which deteriorated with generic itraconazole].
[allergic bronchopulmonary aspergillosis]
We
experienced
two
cases
of
pulmonary
aspergillosis
,
which
deteriorated
during
treatment
with
generic
itraconazole
(
ITCZ
)
because
of
low
plasma
concentration
.
One
case
was
chronic
pulmonary
aspergillosis
and
the
other
was
allergic
bronchopulmonary
aspergillosis
(
ABPA
)
.
Treatment
of
both
cases
was
started
with
a
brand-name-
ITCZ
,
and
changed
to
a
generic
ITCZ
.
Deterioration
of
pulmonary
aspergillosis
occurred
after
8
months
and
9
months
from
change
to
generic
ITCZ
respectively
.
In
the
first
case
,
the
ITCZ-plasma
concentration
was
46
.
9
ng
/
mL
and
of
OH
-ITCZ
96
.
5
ng
/
mL
with
generic
ITCZ
at
the
dose
of
300
mg
/
day
,
but
increased
to
1
,
559
.
7
ng
/
mL
and
to
2
,
485
.
0
ng
/
mL
with
the
brand-name-
ITCZ
300
mg
/
day
,
respectively
.
In
the
second
case
,
the
ITCZ-plasma
concentration
was
27
.
2
ng
/
mL
and
of
OH
-ITCZ
20
.
1
ng
/
mL
with
150
mg
/
day
for
generic
ITCZ
,
but
reached
857
.
3
ng
/
mL
and
to
1
,
144
.
2
ng
/
ml
with
the
brand-name-
ITCZ
300
mg
/
day
,
respectively
.
After
treatment
failure
,
the
first
case
was
changed
to
voriconazole
,
then
brand-name-
ITCZ
300
mg
/
day
,
and
the
second
case
to
the
brand-name-
ITCZ
300
mg
/
day
,
with
successful
clinical
course
.
Plasma
concentrations
of
ITCZ
can
differ
significantly
depending
on
the
patient
or
type
of
ITCZ
.
The
ITCZ-plasma
concentration
should
be
controlled
after
changing
from
a
brand-name-
ITCZ
to
a
generic
ITCZ
.
Diseases
Validation
Diseases presenting
"chronic pulmonary aspergillosis"
symptom
allergic bronchopulmonary aspergillosis
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