Interaction between FK506 and clotrimazole in a liver transplant recipient.
Interaction between FK506 and clotrimazole in a liver transplant recipient.
复制标题
FK506 与克霉唑在肝移植受者体内的相互作用。
DOI：
10.1097/00007890-199112000-00029
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发表时间：
1991
期刊：
影响因子：
6.2
通讯作者：
Starzl,TE
中科院分区：
文献类型：
--
作者：
Mieles,L;Venkataramanan,R;Yokoyama,I;Warty,VJ;Starzl,TE
FK506, a new and powerful immunosuppressant, has become the principal drug in the immunosuppressive regimens of organ transplant recipients at the University of Pittsburgh (1–3). It is well known that transplant patients often receive multiple-drug therapy, and that many of these co-administered agents can alter the kinetics of immunosuppressive drugs, such as cyclosporine and prednisone (4, 5). In this communication we report for the first time a potential interaction between FK506 and the antifungal agent clotrimazole in a liver transplant recipient.The recipient, a 55-year-old male received a liver transplant, on November 28, 1989, at the Veterans Affairs Medical Center of Pittsburgh, for chronic non-A–non-B hepatitis. His immunosuppressive regimen consisted of FK506 and prednisone, and after uneventful recovery he was discharged on the 15th postoperative day. On the 84th posttransplant day, he was readmitted with hyperglycemia, elevated liver function tests, mild elevation of the serum creatinine, and oropharyngeal moniliasis despite prophylactic nystatin therapy. The trough plasma FK506 concentration, 24 hr after admission, was 3.5 ng/ml. Since his liver biopsy disclosed mild lobular hepatitis, both his FK506 and steroid doses were decreased. The carbohydrate metabolism improved, but his serum creatinine and FK506 levels continued to rise in spite of a dose reduction (Fig. 1). Since the increase in plasma FK506 concentration could not be solely attributed to the mild hepatic dysfunction, a drug interaction with clotrimazole was suspected, since this drug, started on the 88th posttransplant day, was the only new medication added to the patient’s therapy.
