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- Title
Effects of voriconazole on tacrolimus metabolism in a kidney transplant recipient.
- Authors
Capone, D.; Tarantino, G.; Gentile, A.; Sabbatini, M.; Polichetti, G.; Santangelo, M.; Nappi, R.; Ciotola, A.; D'Alessandro, V.; Renda, A.; Basile, V.; Federico, S.
- Abstract
Infection occurs frequently in the organ transplant recipients during the post-transplant period because of immunosuppression. Therefore, prophylactic antimicrobial agents are often used. The azole antifungals, widely prescribed prophylactically, are known to have many drug–drug interactions. This report presents a case of drug–drug interaction between voriconazole and tacrolimus in a kidney transplant recipient. Voriconazole treatment led to a dramatic increase in tacrolimus concentration that required its discontinuation in spite of the manufacturer’s guidelines that recommend a reduction of tacrolimus dosage by one-third. The present drug–drug interaction can be attributed to a strong inhibitory effect on cytochrome P450-3A4 activity by voriconazole. When voriconazole and tacrolimus are coadministered, close monitoring of tacrolimus blood levels is recommended as the rule-of-thumb reduction of tacrolimus dose by one-third may not be satisfactory.
- Subjects
KIDNEY transplantation; TACROLIMUS; ANTI-infective agents; IMMUNOREGULATION; DRUG interactions
- Publication
Journal of Clinical Pharmacy & Therapeutics, 2010, Vol 35, Issue 1, p121
- ISSN
0269-4727
- Publication type
Article
- DOI
10.1111/j.1365-2710.2009.01070.x