title: Severe decrease of cyclosporine levels in a heart transplant recipient receiving the direct thrombin inhibitor argatroban.
abstract: This case report is about a suspected interaction between argatroban, a direct thrombin inhibitor, and cyclosporine, which occurred in a 60-year-old patient after a second heart transplantation. We explored 4 possible mechanisms of interaction, which are an analytical interference, an idiopathic hemodilution, an increase of renal and hepatic clearance, and a metabolic drug-drug interaction.
authors.affiliation: CHU Timone Hospital, Marseille, France.
authors.forename: Romain
authors.initials: R
authors.lastname: Sanchez
authors.forename: Nicolas
authors.initials: N
authors.lastname: Picard
authors.forename: Annick
authors.initials: A
authors.lastname: Mouly-Bandini
authors.forename: Virginie
authors.initials: V
authors.lastname: Chalvignac
authors.forename: Bruno
authors.initials: B
authors.lastname: Lacarelle
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Sampol-Manos
mesh_terms: D000991:Antithrombins / Q000494:pharmacology*; D001120:Arginine / Q000031:analogs & derivatives; D003404:Creatinine / Q000378:metabolism; D016572:Cyclosporine / Q000097:blood / Q000493:pharmacokinetics*; D065701:Cytochrome P-450 CYP3A Inducers; D004336:Drug Antagonism; D016027:Heart Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000097:blood / Q000493:pharmacokinetics*; D008875:Middle Aged; D010875:Pipecolic Acids / Q000494:pharmacology*; D013449:Sulfonamides; D066027:Transplant Recipients
chemical_list: D000991:Antithrombins; D065701:Cytochrome P-450 CYP3A Inducers; D007166:Immunosuppressive Agents; D010875:Pipecolic Acids; D013449:Sulfonamides; D016572:Cyclosporine; D001120:Arginine; D003404:Creatinine; C031942:argatroban