Coadministration of azoles and vincristine has been shown to increase vincristine neurotoxic effects due to the inhibition of\r\ncytochrome P450 (CYP) isoform 3A4, for which vincristine is a substrate. Despite the absence of any casual relationship between\r\nseizure and coadministration of azoles, few case reports of vincristine-induced seizure have been documented after coadministration\r\nof fluconazole or posaconazole in children. In this paper we are reporting the first young female adult who experienced generalized\r\nseizure after coadministration of posaconazole and vincristine. The 19-year-old female was diagnosed with acute lymphoblastic\r\nleukemia. She started induction phase of Berlin Frankfurt Muenster protocol along with posaconazole 200 mg three times\r\ndaily as prophylactic antifungal therapy. Five days after the third vincristine dose, she developed generalized seizure accompanied\r\nby high blood pressure and SIADH. Her neurological exam/CT scan did not show any abnormality. In conclusion, this study\r\nreports a novel finding in the sense that all previous case reports pertaining to posaconazole-vincristine-induced seizure in\r\nliterature involved children. Physicians should be made aware of this rare possible outcome to closely monitor their patients and\r\ntake appropriate measures to prevent such possible adverse effect.
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