Influence of oral felodipine on serum cyclosporine concentrations.
Hypertension and nephrotoxicity are frequent in renal transplant patients treated with cyclosporine. Calcium-channel blockers, because of their vasodilatory effects on the renal afferent arteriole, may be the anti-hypertensive agents of choice in this population. Unfortunately, many calcium channel blockers inhibit the clearance of cyclosporine, resulting in elevated blood levels, and worsening nephrotoxicity. Thirteen hypertensive renal transplant patients, on stable cyclosporine doses and with stable cyclosporine blood levels, had felodipine added to their antihypertensive regimens. The effect on cyclosporine level was measured. Mean trough serum cyclosporine concentration increased slightly, from 122.8 +/- 51.8 ng/ml to 143.1 +/- 81.9 ng/ml with chronic felodipine administration (p = NS). Mean systolic and diastolic pressures both fell significantly, by approximately 10 mmHg (systolic from 161 +/- 14 to 152 +/- 13 mmHg; diastolic from 100 +/- 6 to 90 +/- 7 mmHg). Serum creatinine remained unchanged. Four patients eventually discontinued felodipine. There was no significant change in their mean trough serum cyclosporine concentration when felodipine was discontinued. Thus, felodipine is an effective anti-hypertensive medication in cyclosporine-treated renal transplant recipients, without significant effect on cyclosporine blood levels, or adverse effect on allograft function.
Cohen
D J
DJ
Department of Medicine, Columbia University College of Physicians & Surgeons, Columbia Presbyterian Medical Center, New York, NY.
Teng
S N
SN
Appel
G B
GB
D000284:Administration, Oral; D000328:Adult; D000959:Antihypertensive Agents / Q000008:administration & dosage* / Q000494:pharmacology; D001794:Blood Pressure / Q000187:drug effects; D016572:Cyclosporine / Q000009:adverse effects / Q000097:blood* / Q000627:therapeutic use; D004347:Drug Interactions; D015736:Felodipine / Q000008:administration & dosage* / Q000494:pharmacology; D006801:Humans; D006977:Hypertension, Renal / Q000188:drug therapy*; D007165:Immunosuppression Therapy; D016030:Kidney Transplantation; D011183:Postoperative Complications / Q000188:drug therapy*
D000959:Antihypertensive Agents; D016572:Cyclosporine; D015736:Felodipine