Department of Clinical Pharmacy, Anadolu University Faculty of Pharmacy, Eskisehir, Turkey
Department of Clinical Pharmacy, Hacettepe University Faculty of Pharmacy, Ankara, Turkey.
Eur J Hosp Pharm. 2024 Oct 25;31(6):560-563. doi: 10.1136/ejhpharm-2023-003757.
Cyclosporine is an immunosuppressive drug with a high potential for drug interactions that is frequently used in renal transplant patients. The purpose of this study was to assess the change in cyclosporine concentration in patients taking cyclosporine and lercanidipine concurrently.
The potential drug interactions in renal transplant patients who received lercanidipine and cyclosporine concurrently in a university hospital between January 2008 and January 2018 were evaluated retrospectively. Patients had renal transplantation from deceased donors or living related donors. The Drug Interaction Probability Scale (DIPS) criteria were used to assess the causality of cyclosporine and lercanidipine drug interaction.
The study included six renal transplant patients. The median cyclosporine concentration before lercanidipine use was 325 ng/mL (min-max 101-356) and 592.5 ng/mL (min-max 198-799) thereafter (p=0.028). Serum creatinine and proteinuria levels did not change significantly during lercanidipine treatment (p=0.686 and p=0.116, respectively). According to the DIPS evaluation, cyclosporine and lercanidipine interaction was classified as "possible (score 3)".
Concomitant use of cyclosporine and lercanidipine increases the concentration of cyclosporine, which may result in side effects during effective treatment in renal transplant patients. Therefore, cyclosporine concentrations should definitely be monitored while patients are taking lercanidipine.
环孢素是一种具有高度药物相互作用潜力的免疫抑制剂，常用于肾移植患者。本研究旨在评估同时服用环孢素和乐卡地平的患者中环孢素浓度的变化。
回顾性评估 2008 年 1 月至 2018 年 1 月期间在一所大学医院接受乐卡地平和环孢素联合治疗的肾移植患者中潜在的药物相互作用。患者均接受来自已故供体或活体亲属供体的肾移植。采用药物相互作用可能性评分（DIPS）标准评估环孢素和乐卡地平药物相互作用的因果关系。
本研究纳入 6 例肾移植患者。在开始使用乐卡地平之前，环孢素的中位浓度为 325ng/mL（最小值-最大值 101-356），此后为 592.5ng/mL（最小值-最大值 198-799）（p=0.028）。在乐卡地平治疗期间，血清肌酐和蛋白尿水平没有显著变化（p=0.686 和 p=0.116，分别）。根据 DIPS 评估，环孢素和乐卡地平的相互作用被归类为“可能（评分 3）”。
肾移植患者同时使用环孢素和乐卡地平会增加环孢素的浓度，这可能导致在有效治疗期间出现副作用。因此，患者服用乐卡地平时，应密切监测环孢素的浓度。
