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.

Effects of voriconazole on tacrolimus metabolism in a kidney transplant recipient / Capone, Domenico; Tarantino, Giovanni; Gentile, Antonio; Sabbatini, Massimo; Polichetti, G; Santangelo, Michele; Nappi, Riccardo; Ciotola, A; D'Alessandro, V; Renda, Andrea; Basile, Vincenzo; Federico, Stefano. - In: JOURNAL OF CLINICAL PHARMACY AND THERAPEUTICS. - ISSN 0269-4727. - 35:1(2010), pp. 121-124. [10.1111/j.1365-2710.2009.01070.x]

Effects of voriconazole on tacrolimus metabolism in a kidney transplant recipient.

CAPONE, DOMENICO;TARANTINO, GIOVANNI;GENTILE, ANTONIO;SABBATINI, MASSIMO;SANTANGELO, MICHELE;NAPPI, RICCARDO;RENDA, ANDREA;BASILE, VINCENZO;FEDERICO, STEFANO
2010

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.
2010
Effects of voriconazole on tacrolimus metabolism in a kidney transplant recipient / Capone, Domenico; Tarantino, Giovanni; Gentile, Antonio; Sabbatini, Massimo; Polichetti, G; Santangelo, Michele; Nappi, Riccardo; Ciotola, A; D'Alessandro, V; Renda, Andrea; Basile, Vincenzo; Federico, Stefano. - In: JOURNAL OF CLINICAL PHARMACY AND THERAPEUTICS. - ISSN 0269-4727. - 35:1(2010), pp. 121-124. [10.1111/j.1365-2710.2009.01070.x]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11588/367917
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