Pharmacokinetic drug-drug interactions between calcineurin inhibitors and proliferation signal inhibitors with anti-microbial agents: implications for therapeutic drug monitoring

J Heart Lung Transplant. 2011 Feb;30(2):124-35. doi: 10.1016/j.healun.2010.09.001. Epub 2010 Nov 5.

Abstract

Infections account for 15% to 20% of deaths in transplant recipients; thus, rapid and appropriate therapeutic intervention is required. However, many anti-microbial agents can interact significantly with a transplant recipient's immunosuppressive regimen, placing them at risk for a potential adverse drug reaction and prolonged hospitalization. This investigation highlights the pharmacokinetic drug-drug interactions between the calcineurin inhibitors and proliferation signal inhibitors with commonly used anti-microbial agents, specifically addressing mechanism, management, onset of action, magnitude of effect and strength of evidence for each interaction.

MeSH terms

  • Anti-Infective Agents / pharmacokinetics*
  • Anti-Infective Agents / pharmacology
  • Calcineurin Inhibitors
  • Cyclosporine / pharmacokinetics
  • Cyclosporine / pharmacology
  • Drug Interactions
  • Drug Monitoring / trends*
  • Humans
  • Immunosuppressive Agents / pharmacokinetics*
  • Immunosuppressive Agents / pharmacology
  • Signal Transduction / drug effects
  • Tacrolimus / pharmacokinetics
  • Tacrolimus / pharmacology

Substances

  • Anti-Infective Agents
  • Calcineurin Inhibitors
  • Immunosuppressive Agents
  • Cyclosporine
  • Tacrolimus