Capone D, Aiello C, Santoro G A, Gentile A, Stanziale P, D'Alessandro R, Imperatore P, Basile V
Department of Neurosciences, School of Medicine, Federico II, University, Naples, Italy.
Int J Clin Pharmacol Res. 1996;16(2-3):73-6.
In the post-transplant period, antimicrobial agents are often coadministered with cyclosporine (CsA) to treat the infections occurring in the immunosuppressed patients. These agents produce drug interactions with cyclosporine and can increase or reduce the blood concentration of the immunosuppressant. We report two cases of drug interaction between cyclosporine and two antimicrobial agents, josamycin and rifampicin, coadministered in a kidney-transplanted and a liver-transplanted patient, respectively. Josamycin increased the CsA blood levels by inhibiting the CsA metabolism through the hepatic cytochrome P450 enzymes. Conversely, rifampicin decreased the CsA blood levels by stimulating the same enzymatic system. When using these agents it is necessary to adjust the CsA doses to avoid risks of CsA toxicity or allograft rejection.
在移植后阶段，抗菌药物常与环孢素（CsA）联合使用，以治疗免疫抑制患者发生的感染。这些药物会与环孢素产生药物相互作用，可能会增加或降低免疫抑制剂的血药浓度。我们报告了两例环孢素与两种抗菌药物（分别为交沙霉素和利福平）之间的药物相互作用病例，这两种药物分别在一名肾移植患者和一名肝移植患者中联合使用。交沙霉素通过抑制肝脏细胞色素P450酶对环孢素的代谢，从而提高了环孢素的血药浓度。相反，利福平通过刺激同一酶系统降低了环孢素的血药浓度。使用这些药物时，有必要调整环孢素的剂量，以避免环孢素毒性风险或同种异体移植物排斥反应。
