Investigation of pharmacologic interactions between omeprazole and tacrolimus in a membranous nephropathy patient with CYP3A5 nonexpresser: a case report

被引：2

作者：

Li, Yanli ^{[1
]}

Liu, Yi ^{[1
]}

Sun, Zengxian ^{[1
]}

机构：

[1] First Peoples Hosp Lianyungang, Dept Pharm, 182 Tongguan North Rd, Lianyungang 222002, Peoples R China

来源：

PHARMACOGENETICS AND GENOMICS | 2022年 / 32卷 / 07期

关键词：

ABCB1; omeprazole; tacrolimus; DRUG-INTERACTION; TRANSPLANT; POLYMORPHISMS; LANSOPRAZOLE; CYP2C19; IMPACT; MDR1;

D O I：

10.1097/FPC.0000000000000478

中图分类号：

Q81 [生物工程学（生物技术）]; Q93 [微生物学];

学科分类号：

071005 ; 0836 ; 090102 ; 100705 ;

摘要：

Tacrolimus has been widely used in membranous nephropathy in recent years. The drug interactions of the coadministration of tacrolimus with omeprazole in CYP3A5 nonexpresser membranous nephropathy patients have not been demonstrated. Here, we report an idiopathic membranous nephropathy patient who was with CYP2C19*2/*2, CYP3A5*3/*3 (nonexpresser) and ABCB1 (3435 TT, 1236 computed tomography, 2677 TT) genotype requiring treatment with tacrolimus and omeprazole and found to have fluctuating metabolism of tacrolimus. This study shows that tacrolimus and omeprazole have pharmacologic drug interactions in CYP3A5 nonexpressers, implying that the CYP3A and ABCB1 gene mutations linked to tacrolimus metabolism may alter tacrolimus levels in the blood. The observed concentrations of tacrolimus were decreased after the discontinuation of omeprazole therapy. It demonstrates that, in addition to genotype, clinical covariates, such as omeprazole are important when it comes to better understanding and prediction of tacrolimus dosage. It is deemed necessary to monitor tacrolimus blood concentrations and make dose adjustments when patients were coadministered with omeprazole.

引用

页码：268 / 271

页数：4

共 18 条

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