아졸 (Azole)

Imidazoles vs. Triazoles

Because ergosterol is present in cell membranes of fungi, yet absent in those of animals, it is a useful target for antifungal drugs.

The difference between the imidazoles and the triazoles involves the mechanism of inhibition of the cytochrome P450 enzyme. The N3 of the imidazole compound binds to the heme iron atom of ferric cytochrome P450, whereas the N4 of the triazoles bind to the heme group. The triazoles have been shown to have a higher specificity for the cytochrome P450 than imidazoles, thereby making them more potent than the imidazoles.

The triazole antifungal drugs include fluconazole, isavuconazole, itraconazole, voriconazole, pramiconazole, ravuconazole, and posaconazole.

  • fluconazole 2-(2,4-difluorophenyl)-1,3-bis(1H-1,2,4-triazol-1-yl)propan-2-ol
  • Itraconazole (2R,4S)-rel-1-(butan-2-yl)-4-{4-[4-(4-{[(2R,4S)-2-(2,4-dichlorophenyl)-2-(1H-1,2,4-triazol-1-ylmethyl)-1,3-dioxolan-4-yl]methoxy}phenyl)piperazin-1-yl]phenyl}-4,5-dihydro-1H-1,2,4-triazol-5-one
  • Metronidazole 2-(2-methyl-5-nitro-1H-imidazol-1-yl)ethanol
  • Tinidazole 1-(2-ethylsulfonylethyl)-2-methyl-5-nitro-imidazole

The substituted imidazole derivatives are valuable in treatment of many systemic fungal infections.

Imidazoles belong to the class of azole antifungals, which includes ketoconazole, miconazole, and clotrimazole.

For comparison, another group of azoles is the triazoles, which includes fluconazole, itraconazole, and voriconazole.

Synthetic imidazoles are present in many fungicides and antifungal, antiprotozoal, and antihypertensive medications. Imidazole is part of the theophylline molecule, found in tea leaves and coffee beans, that stimulates the central nervous system. It is present in the anticancer medication mercaptopurine, which combats leukemia by interfering with DNA activities.

Many drugs contain an imidazole ring, such as antifungal drugs, nitroimidazole, and the sedative midazolam.

  • Triazole antifungals: fluconazole, itraconazole, posaconazole, voriconazole
  • Imidazole antifungals: clotrimazole, econazole, miconazole, ketoconazole and tioconazole
  • Polyene antifungals: amphotericin, nystatin
  • Echinocandin antifungals: anidulafungin, caspofungin and micafungin
  • Other antifungals: these include flucytosine, griseofulvin and terbinafine

상호작용

  • There were no interactions found in our database between Flagyl IV and fluconazole
  • There are no known interactions between fluconazole and metronidazole
  • it's safe to say that you are able to take Metronidazole and Fluconazole at the same time.