Wright D H, Lake K D, Bruhn P S, Emery R W
University of Minnesota, College of Pharmacy, Minneapolis, USA.
J Heart Lung Transplant. 1999 Sep;18(9):913-5. doi: 10.1016/s1053-2498(98)00036-9.
Depression is a significant post-transplant complication often necessitating drug therapy. Many of the newer selective serotonin reuptake inhibitor (SSRI) antidepressants are metabolized by the same cytochrome P450IIIA isoenzyme system that is responsible for the metabolism of cyclosporine, and these agents pose an interactive risk in transplant patients. We have observed nearly a 10-fold increase in whole blood cyclosporine concentrations in a cardiac transplant patient shortly after the addition of nefazodone antidepressant therapy. We suggest there is a clinically significant drug-drug interaction between nefazodone and cyclosporine due to inhibition of cytochrome P-450 IIIA4 isoenzymes by nefazodone.
