Maggio T G, Bartels D W
Swedish American Hospital, Rockford, IL.
Drug Intell Clin Pharm. 1988 Sep;22(9):705-7. doi: 10.1177/106002808802200914.
Cyclosporine is an immunosuppressive agent used to prevent rejection of transplanted organs. Monitoring cyclosporine blood concentrations is important to ensure adequate levels to prevent graft rejection while minimizing the risk of toxicity. A 45-year-old man who received a kidney transplant seven months previously is described. He had been receiving cyclosporine along with azathioprine and prednisone for immunosuppression since the transplant. His cyclosporine blood concentrations and renal function were stable during this time. Due to uncontrolled hypertension, sustained-release (SR) verapamil 240 mg/d was added with no change in cyclosporine levels. However, after increasing the dose of verapamil SR to 360 mg/d a dramatic increase in cyclosporine concentrations occurred. His renal function remained stable during this time. The interaction between cyclosporine and the calcium-channel blocking agents along with a possible nephroprotective effect of the calcium-channel blocking agents when used with cyclosporine are discussed.
环孢素是一种免疫抑制剂，用于预防移植器官的排斥反应。监测环孢素血药浓度对于确保达到足够水平以预防移植物排斥反应同时将毒性风险降至最低非常重要。本文描述了一名7个月前接受肾移植的45岁男性。自移植以来，他一直在接受环孢素联合硫唑嘌呤和泼尼松进行免疫抑制治疗。在此期间，他的环孢素血药浓度和肾功能保持稳定。由于高血压控制不佳，加用了240毫克/天的缓释维拉帕米，环孢素水平未发生变化。然而，在将维拉帕米缓释片剂量增加至360毫克/天后，环孢素浓度急剧升高。在此期间，他的肾功能保持稳定。本文讨论了环孢素与钙通道阻滞剂之间的相互作用，以及钙通道阻滞剂与环孢素合用时可能的肾保护作用。
