Adverse Effects Associated with Long-Term Administration of Azole Antifungal Agents

    May 2019 in “Drugs
    Lydia Benitez, Peggy L. Carver
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    TLDR Long-term use of azole antifungals can cause hair loss, hormonal imbalances, and severe skin reactions.
    The 2019 document discussed the adverse effects of long-term use of azole antifungal agents, including fluconazole, voriconazole, and ketoconazole. It was noted that these drugs were associated with alopecia (hair loss), with several studies and case reports cited. The document also highlighted the impact of these drugs on hormonal balance, with ketoconazole inhibiting adrenal steroid synthesis and testosterone production, potentially leading to conditions like gynecomastia, and fluconazole causing adrenal insufficiency. Additionally, the document discussed the link between prolonged use of voriconazole and severe phototoxicity, leading to conditions such as cutaneous squamous cell carcinoma, melanoma, and pseudoporphyria in various patient populations. Voriconazole was also found to interfere with vitamin A metabolism. The document did not provide specific numbers of people studied.
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