title: Drug interaction between tacrolimus and carbamazepine in a Japanese heart transplant recipient: a case report.
abstract: This article reports changes in tacrolimus (FK506) blood levels connected with carbamazepine (CBZ). A drug interaction between FK506 and CBZ was investigated in a woman, who was in her 40s, who underwent heart transplantation. Pharmacokinetic parameters were measured, including dose and trough blood levels (C(0)), area under the serum concentration-time curve from 0 to 12 hours (AUC(0-12h)), and apparent clearance of oral FK506 (CL/F) for FK506 alone (about 3 months before starting CBZ) and combined with CBZ (11 days and about 3 months after starting CBZ). FK506 C(0) levels were decreased within 7 days of CBZ treatment. FK506 dosing required a 1.3- to 1.4-fold increase to maintain adequate blood levels while taking 200 mg CBZ daily. The AUC(0-12h)/dose 11 days after CBZ treatment was about 50% of the value before CBZ, and was about 70% at 3 months after CBZ treatment. The CL/F at 11 days and about 3 months after starting CBZ treatment was about 2 times higher than before CBZ therapy. FK506 C(0) levels are decreased by CBZ treatment, and blood levels should be closely monitored.
authors.affiliation: Department of Pharmacy, National Cardiovascular Center, Osaka, Japan. kwada@hsp.ncvc.go.jp
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Wada
authors.forename: Mitsutaka
authors.initials: M
authors.lastname: Takada
authors.forename: Mika
authors.initials: M
authors.lastname: Sakai
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ochi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kotake
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Okada
authors.forename: Hideki
authors.initials: H
authors.lastname: Morishita
authors.forename: Noboru
authors.initials: N
authors.lastname: Oda
authors.forename: Akiko
authors.initials: A
authors.lastname: Mano
authors.forename: Tomoko S
authors.initials: TS
authors.lastname: Kato
authors.forename: Kazuo
authors.initials: K
authors.lastname: Komamura
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nakatani