Change of the blood concentration of tacrolimus after the switch from fluconazole to voriconazole in patients receiving allogeneic hematopoietic stem cell transplantation.
The purpose of this study was to assess the impact by switching co-administered triazole antifungal agent from fluconazole (FCZ) to voriconazole (VCZ) on the blood concentration of tacrolimus (FK506) in patients receiving allogeneic hematopoietic stem cell transplantation. We performed a retrospective study presented as case reports. The blood concentration of FK506 was increased after the switch from FCZ to VCZ, resulting in increase of the concentration/dose (C/D) ratio of FK506. Thus, the mean C/D ratios of FK506 with oral administration was surprisingly increased over 4.5-fold after the switch. Therefore, it was necessary to reduce the FK506 dose when co-administered FCZ is switched to VCZ. We should be careful when interpreting the results of these case reports; however, in some patients, it is recommended that the dose of FK506 be reduced to one-fifth after the switch.
Kawazoe
Hitoshi
H
Department of Pharmacy, Kagawa University Hospital, Japan. khitochi@med.kagawa-u.ac.jp
Takiguchi
Yoshiharu
Y
Tanaka
Hiroaki
H
Fukuoka
Noriyasu
N
Ohnishi
Hiroaki
H
Ishida
Toshihiko
T
Houchi
Hitoshi
H
D015725:Fluconazole / Q000008:administration & dosage*; D006801:Humans; D007166:Immunosuppressive Agents / Q000097:blood*; D011743:Pyrimidines / Q000008:administration & dosage*; D012189:Retrospective Studies; D033581:Stem Cell Transplantation; D016559:Tacrolimus / Q000097:blood*; D014230:Triazoles / Q000008:administration & dosage*; D065819:Voriconazole
D007166:Immunosuppressive Agents; D011743:Pyrimidines; D014230:Triazoles; D015725:Fluconazole; D065819:Voriconazole; D016559:Tacrolimus