Pharmacokinetic drug-drug interactions between calcineurin inhibitors and proliferation signal inhibitors with anti-microbial agents: implications for therapeutic drug monitoring.
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.
Department of Clinical Pharmacy, University of Colorado, Aurora, Colorado 80045, USA. robert.page@ucdenver.edu
Robert L
RL
Page
Scott W
SW
Mueller
Marilyn E
ME
Levi
Joann
J
Lindenfeld
D000890:Anti-Infective Agents / Q000493:pharmacokinetics* / Q000494:pharmacology; D065095:Calcineurin Inhibitors; D016572:Cyclosporine / Q000493:pharmacokinetics / Q000494:pharmacology; D004347:Drug Interactions; D016903:Drug Monitoring / Q000639:trends*; D006801:Humans; D007166:Immunosuppressive Agents / Q000493:pharmacokinetics* / Q000494:pharmacology; D015398:Signal Transduction / Q000187:drug effects; D016559:Tacrolimus / Q000493:pharmacokinetics / Q000494:pharmacology
D000890:Anti-Infective Agents; D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D016559:Tacrolimus