Фармакологическая регуляция активности CYP3A4 гепатопротекторами как перспективный путьуменьшения гепатотоксичности противогрибковыхпрепаратов при лечении онихомикозов

Antifungal azoles (itraconazole, fluconazole, ketoconazole, etc.) are widely used for antifungal treatment of diseases, their effectiveness is proved, but the purpose of this group of drugs is limited by the development of side effects, the most significant of which is hepatotoxic. Antifungal drugs are metabolized by cytochrome CYP3A4, and are themselves not only a substrate but an inhibitor of the cytochrome. The more long-term they used, the lower the activity of cytochrome, the higher the concentration of antifungal azoles and stronger than their hepatotoxicity. Clinically justified the appointment together with antifungal drugs gepatoprotectorov. It is known that hepatoprotectors differ on the effect on the activity of cytochrome CYP3A4: do not change (e.g., silibinin), depress (e.g., ziksorin) and activated (e.g., taurine). Rational choice hepatoprotector taking into account its effect on the activity of CYP3A4 makes it possible to significantly reduce the hepatotoxicity of antifungal azoles. Pharmacological regulation of the activity of CYP3A4 by gepatopotectors can be used as a promising area of prevention of unwanted reactions.