title: Drug interactions between micafungin at high doses and cyclosporine A in febrile neutropenia patients after allogeneic hematopoietic stem cell transplantation.
abstract: OBJECTIVE
  The aim of this study was to assess the drug interaction between high doses of micafungin and cyclosporine A (CyA) in allo-HSCT patients.
  
  
  METHODS
  We assigned 15 patients to Groups 1, 2, or 3. We investigated the serial changes in the blood concentration/dose (C/dose) of intravenous CyA during micafungin coadministration in 5 patients during the switch from the prophylactic dose (150 mg/body) to the therapeutic dose (300 mg/body) of micafungin (Group 1), and compared each of the 5 patients in Group 1 with those who continued to receive the prophylactic doses of 150 mg or 50 mg/body of micafungin (Groups 2 and 3). We collected blood samples from patients in Group 1 receiving CyA at 0 h (C0) and (C3) 3 h on the 7th day after allo-HSCT, and on the 3rd and 10th days after escalation of the dose of micafungin to 300 mg.
  
  
  RESULTS
  In Group 1, no significant difference was observed between C0/dose (2.11 ± 0.14) and C3/dose ratios of CyA (11.1 ± 5.34, p > 0.05) under 150 mg; the C0/dose and C3/dose ratios of CyA were 2.40 ± 0.60 and 10.8 ± 4.72 on the 3rd day and 2.23 ± 0.41 and 11.8 ± 3.06 on the 10th day, respectively, after dose escalation of micafungin to 300 mg. No significant differences were observed in those ratios between Groups 1 and 2 and between Groups 1 and 3.
  
  
  CONCLUSIONS
  Thus, high dose of micafungin seems to be safe and does not significantly interact with CyA in allo-HSCT.
authors.affiliation: Division of Hematology and Oncology, Department of Internal Medicine, St. Marianna University, School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki 216-8511, Japan. ino-yasu@marianna-u.ac.jp
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Inoue
authors.forename: Tasuku
authors.initials: T
authors.lastname: Saito
authors.forename: Kohei
authors.initials: K
authors.lastname: Ogawa
authors.forename: Yuji
authors.initials: Y
authors.lastname: Nishio
authors.forename: Shigeki
authors.initials: S
authors.lastname: Kosugi
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kato
authors.forename: Takahiro
authors.initials: T
authors.lastname: Sakai
authors.forename: Masatomo
authors.initials: M
authors.lastname: Takahashi
authors.forename: Ikuo
authors.initials: I
authors.lastname: Miura
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000935:Antifungal Agents / Q000008:administration & dosage*; D016572:Cyclosporine / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics*; D004347:Drug Interactions; D016903:Drug Monitoring; D054714:Echinocandins / Q000008:administration & dosage*; D005260:Female; D005334:Fever / Q000188:drug therapy* / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics*; D007564:Japan; D055666:Lipopeptides / Q000008:administration & dosage*; D008297:Male; D000077551:Micafungin; D008875:Middle Aged; D008954:Models, Biological; D009503:Neutropenia / Q000175:diagnosis* / Q000209:etiology; D010865:Pilot Projects
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D007166:Immunosuppressive Agents; D055666:Lipopeptides; D016572:Cyclosporine; D000077551:Micafungin