In another example, while voriconazole inhibition of CYP3A4-mediated metabolism of inhaled/intranasal corticosteroids such as fluticasone may result in Cushing syndrome in some patients, alternative corticosteroids less dependent on CYP3A4 metabolism (such as beclomethasone), or switching to isavuconazole, are likely safe [20]. The gene discussed is CYP3A4; the disease is Cushing syndrome due to macronodular adrenal hyperplasia.