Absence of pharmacokinetic interference of moxifloxacin on cyclosporine and tacrolimus in kidney transplant recipients

J Clin Pharmacol. 2010 May;50(5):576-80. doi: 10.1177/0091270009347869. Epub 2010 Jan 20.

Abstract

This study investigates the potential pharmacokinetic interactions between an antimicrobial agent, moxifloxacin, and 2 immunosuppressant drugs, cyclosporine and tacrolimus, in kidney transplant recipients. Twenty-two kidney transplant patients needing antibiotic therapy for urinary tract infections are enrolled. Eleven patients are under cyclosporine treatment and the other 11 patients are under tacrolimus treatment. Because the urinary tract infections are caused by gram-negative aerobes sensitive to moxifloxacin, this antibiotic is administered by oral route at a dose of 400 mg/d for 1 week; in each patient pharmacokinetic studies are carried out before and at the seventh day of therapy. For both immunosuppressors, none of the pharmacokinetic parameters investigated show statistically significant differences between values obtained before and during treatment with moxifloxacin. In fact, the concentration-time profiles of monoclonal cyclosporine, polyclonal cyclosporine, and tacrolimus are not significantly different before and during the antimicrobial therapy. The results of the present study rule out interference of moxifloxacin with both cyclosporine and tacrolimus kinetics and indicate that the concomitant administration of the fluoroquinolone and cyclosporine or tacrolimus does not require modifications of the dosages of 2 immunosuppressant drugs.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Administration, Oral
  • Adult
  • Anti-Infective Agents / pharmacology
  • Anti-Infective Agents / therapeutic use
  • Aza Compounds / pharmacology*
  • Aza Compounds / therapeutic use
  • Cyclosporine / pharmacokinetics*
  • Cyclosporine / therapeutic use
  • Female
  • Fluoroquinolones
  • Gram-Negative Bacteria / isolation & purification
  • Gram-Negative Bacterial Infections / drug therapy
  • Gram-Negative Bacterial Infections / microbiology
  • Humans
  • Immunosuppressive Agents / pharmacokinetics*
  • Immunosuppressive Agents / therapeutic use
  • Kidney Transplantation
  • Male
  • Middle Aged
  • Moxifloxacin
  • Quinolines / pharmacology*
  • Quinolines / therapeutic use
  • Tacrolimus / pharmacokinetics*
  • Tacrolimus / therapeutic use
  • Time Factors
  • Urinary Tract Infections / drug therapy
  • Urinary Tract Infections / microbiology

Substances

  • Anti-Infective Agents
  • Aza Compounds
  • Fluoroquinolones
  • Immunosuppressive Agents
  • Quinolines
  • Cyclosporine
  • Moxifloxacin
  • Tacrolimus