How are azoles primarily eliminated from the body?

Azoles, which include antifungal agents such as fluconazole and itraconazole, are primarily eliminated from the body through hepatic metabolism followed by biliary excretion of their metabolites. The liver metabolizes these drugs, and the resultant metabolites are then excreted into bile, eventually being eliminated in the feces. This metabolic pathway is crucial as it influences the drug's pharmacokinetics, including its duration of action and potential interactions with other medications that may also be processed by the liver.

Hepatic metabolism plays a significant role because it helps to detoxify and prepare drugs for elimination, and the biliary system serves as a route for excreting these metabolites after processing by the liver. Understanding the elimination route is vital for anticipating drug interactions and potential toxicity, particularly in patients with compromised liver function.

Other elimination routes mentioned are less relevant for azoles. Renal excretion occurs with some medications but is not the primary route for azoles; direct excretion through the lungs is primarily associated with gaseous or volatile compounds rather than azoles; and absorption through the gastrointestinal tract pertains to how drugs enter circulation rather than how they are eliminated.