title: Effect of posaconazole on cyclosporine blood levels and dose adjustment in allogeneic blood and marrow transplant recipients.
abstract: The posaconazole prescribing information recommends an upfront cyclosporine dose reduction upon initiation of posaconazole prophylaxis. We examined this recommendation in the early phase of allogeneic transplantation, where cyclosporine levels potentially becoming subtherapeutic following upfront dose reduction would be deleterious to transplant outcome. Our data show that while posaconazole leads to an increase in cyclosporine levels, subsequent cyclosporine dose reduction can be safely guided by therapeutic drug monitoring and is not required upfront. Therefore, the current recommendation may be modified.
authors.affiliation: Department of Clinical Hematology, Catalan Institute of Oncology, Hospital Duran i Reynals, Barcelona, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Sánchez-Ortega
authors.forename: Lourdes
authors.initials: L
authors.lastname: Vázquez
authors.forename: Carmen
authors.initials: C
authors.lastname: Montes
authors.forename: Beatriz
authors.initials: B
authors.lastname: Patiño
authors.forename: Montserrat
authors.initials: M
authors.lastname: Arnan
authors.forename: Arancha
authors.initials: A
authors.lastname: Bermúdez
authors.forename: Lucrecia
authors.initials: L
authors.lastname: Yáñez
authors.forename: Teresa
authors.initials: T
authors.lastname: Caballero
authors.forename: Rafael F
authors.initials: RF
authors.lastname: Duarte
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000009:adverse effects*; D001803:Blood Transfusion; D016026:Bone Marrow Transplantation / Q000276:immunology*; D016572:Cyclosporine / Q000097:blood*; D004347:Drug Interactions; D016903:Drug Monitoring; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000097:blood*; D007951:Leukemia, Myeloid / Q000097:blood / Q000628:therapy; D008232:Lymphoproliferative Disorders / Q000097:blood / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000517:prevention & control; D009190:Myelodysplastic Syndromes / Q000097:blood / Q000628:therapy; D014230:Triazoles / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D007166:Immunosuppressive Agents; D014230:Triazoles; C101425:posaconazole; D016572:Cyclosporine