Moradi O, Karimzadeh I, Davani-Davari D, Shafiekhani M, Sagheb M M, Raees-Jalali G A
Department of Clinical Pharmacy, Faculty of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Clinical Pharmacy, Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran.
Int J Organ Transplant Med. 2020;11(4):185-195.
Number of patients undergoing kidney transplantation is ever increasing. Drug-drug interactions (DDIs) can complicate transplant patient's treatment course.
To investigate patterns and factors associated with potential DDIs in kidney transplant recipients under maintenance immunosuppressive regimen at a referral transplantation center in Shiraz, Iran.
390 eligible kidney transplant outpatients referred to Motahhari clinic and one of the attending nephrologist's private office during an18-month period were assessed for DDIs. Using the Lexi-Interact online drug interactions software, the prescribed drugs were assessed for the number and type of potential DDIs. Only type D and X interactions were considered eligible for inclusion.
During the study period, 344 DDIs were detected of which, 290 were type D; 54 were type XDDIs. 81% of the detected DDIs were pharmacokinetics. Interaction between cyclosporine + mycophenolic acid (32.3%) was the most frequent DDIs followed by cyclosporine + atorvastatin (11.3%). Immunosuppressant (43.44%) was the most frequently used medication responsible for DDIs. Number of co-administered medications (OR: 1.34, 95% CI: 1.12-1.51) and cyclosporine as main immunosuppressive main drug (OR: 10.43, 95% CI: 6.24-17.42) were identified as independent risk factors for DDIs.
Major DDIs were common in kidney transplant recipients. Considering the importance of DDIs in kidney transplant patients, more attention is warranted in this regard by health care members, especially physicians and pharmacists.
接受肾移植的患者数量不断增加。药物相互作用（DDIs）会使移植患者的治疗过程复杂化。
在伊朗设拉子的一家转诊移植中心，调查维持免疫抑制方案下肾移植受者中潜在药物相互作用的模式及相关因素。
在18个月期间，对转诊至莫塔哈里诊所及一位主治肾病专家私人诊所的390名符合条件的肾移植门诊患者进行药物相互作用评估。使用Lexi-Interact在线药物相互作用软件，评估所开药物潜在药物相互作用的数量和类型。仅D型和X型相互作用被视为符合纳入标准。
在研究期间，共检测到344例药物相互作用，其中290例为D型；54例为X型药物相互作用。81%检测到的药物相互作用为药代动力学方面的。环孢素+霉酚酸之间的相互作用（32.3%）是最常见的药物相互作用，其次是环孢素+阿托伐他汀（11.3%）。免疫抑制剂（43.44%）是导致药物相互作用最常用的药物。同时使用药物的数量（OR：1.34，95%CI：1.12 - 1.51）和环孢素作为主要免疫抑制药物（OR：10.43，95%CI：6.24 - 17.42）被确定为药物相互作用的独立危险因素。
主要药物相互作用在肾移植受者中很常见。鉴于药物相互作用在肾移植患者中的重要性，医疗保健人员，尤其是医生和药剂师在这方面应给予更多关注。
