Drug-interactions of azole antifungals with selected immunosuppressants in transplant patients: strategies for optimal management in clinical practice

被引：59

作者：

Lempers, Vincent J. C. ^{[1
,2
]}

Martial, Lisa C. ^{[1
,2
]}

Schreuder, Michiel F. ^{[3
]}

Blijlevens, Nicole M. ^{[2
,4
]}

Burger, David M. ^{[1
,2
]}

Aarnoutse, Rob E. ^{[1
,2
]}

Bruggemann, Roger J. M. ^{[1
,2
]}

机构：

[1] Radboud Univ Nijmegen, Med Ctr, Dept Pharm, NL-6525 ED Nijmegen, Netherlands

[2] Radboud Inst Hlth Sci, Nijmegen, Netherlands

[3] Radboud Univ Nijmegen, Med Ctr, Amalia Childrens Hosp, Dept Pediat Nephrol, NL-6525 ED Nijmegen, Netherlands

[4] Radboud Univ Nijmegen, Med Ctr, Dept Hematol, NL-6525 ED Nijmegen, Netherlands

来源：

CURRENT OPINION IN PHARMACOLOGY | 2015年 / 24卷

关键词：

STEM-CELL TRANSPLANTATION; CALCINEURIN INHIBITORS; CYCLOSPORINE-A; MARROW-TRANSPLANTATION; PHARMACOKINETICS; VORICONAZOLE; TACROLIMUS; RECIPIENTS; AGENTS; CONSEQUENCES;

D O I：

10.1016/j.coph.2015.07.002

中图分类号：

R9 [药学];

学科分类号：

1007 ;

摘要：

The management of drug-drug interactions (DDIs) between azole antifungals (fluconazole, itraconazole, posaconazole and voriconazole) and immunosuppressants (cyclosporine, tacrolimus, everolimus and sirolimus) in transplant patients remains challenging, as the impact of altered immunosuppressant concentrations puts the patient at high risk for either toxicity or transplant rejection. As a result, it is a complex task for the clinician to maintain immunosuppressant concentrations within the desired therapeutic range and this requires a highly individualized patient approach. We provide important tools for adequate assessment of the drug interactions that cause this pharmacokinetic variability of immunosuppressants. A stepwise approach for the evaluation and subsequent management options, including a decision flow chart, are provided for optimal handling of these clinically relevant DDIs.

引用

页码：38 / 44

页数：7

共 47 条

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