58 Interaction of Tacrolimus (Fk 506) and Fluconazole

Braun, Felix; Schütz, E; Grupp, Clemens; Canelo, Rubén; Armstrong, Victor W.; Oellerich, Michael; Rinqe, B

doi:10.1097/00007691-199508000-00070

Cited by 2 publications

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nephrotoxicity might be aggravated in transplant recipients by cyclosporin or tacrolimus, both drugs with dose‐dependent nephrotoxicity. Furthermore, fluconazole could inhibit CsA and tacrolimus metabolism by inhibiting cytochrome P450 3A [9, 27]. Besides antimycotic drugs, the high mortality of invasive aspergillosis had led to such radical approaches as pulmonary resection in immunosuppressed patients [28].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Systemic mycoses during prophylactical use of liposomal amphotericin B (Ambisome^®) after liver transplantation

Lorf¹,

Braun²,

Rüchel³

et al. 1999

Mycoses

View full text Add to dashboard Cite

We investigated the prophylactical administration of liposomal amphotericin B (Ambisome) in the early phase after liver transplantation (LTx). Fifty-eight patients received Ambisome prophylactically after LTx. Ambisome (1 mg kg-1 day-1) was given intravenously for 7 days after LTx. Immunosuppressive prophylaxis was cyclosporin A (CsA) based in 11 patients. Forty-seven patients had a tacrolimus-based immunosuppressive regimen. CsA and tacrolimus dosages were adjusted to trough levels of 150-250 ng ml-1 (EMIT) and 5-15 ng ml-1 (MEIA II) respectively. Three patients died from sepsis due to Aspergillus fumigatus infection. Reasons for a fatal outcome were foudroyant Aspergillus pneumonia in a patient transplanted for fulminant hepatic failure on post-operative day (pod) 8; Aspergillus sepsis with severe endocardidtis in a patient with two retransplantations for graft non/dysfunction on pod 24; and disseminated aspergillosis due to Aspergillus fumigatus in a patient retransplanted for primary non-function (pod 19). All three patients underwent haemofiltration for renal failure. One patient with Candida albicans sepsis (pod 4) recovered under increased dosage of Ambisome (3 mg kg-1 per day). Ambisome (1 mg kg-1 per day) seems to be beneficial against systemic Candida infections. However, the onset of systemic Aspergillus infections could not be prevented. Obviously, higher Ambisome doses appear to be necessary against Aspergillus. We recommend the use of Ambisome (3 mg kg-1 per day) for patients with risk factors such as graft dys-/non-function, retransplantation, haemofiltration and complicated acute liver failure to prevent invasive aspergillosis.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Furthermore, amphotericin B could aggravate nephrotoxicity of the immunosuppressants cyclosporin A (CsA) and tacrolimus [7]. Moreover, fluconazole can inhibit CYP3A metabolism of CsA and tacrolimus resulting in overimmunosuppression [8, 9].…”

Section: Introductionmentioning

confidence: 99%

Systemic mycoses during prophylactical use of liposomal amphotericin B (Ambisome^®) after liver transplantation

Lorf¹,

Braun²,

Rüchel³

et al. 1999

Mycoses

View full text Add to dashboard Cite

show abstract

Drugs acting on the immune system

Vial¹,

Descotes²

1995

Side Effects of Drugs Annual

View full text Add to dashboard Cite

58 Interaction of Tacrolimus (Fk 506) and Fluconazole

Cited by 2 publications

References 0 publications

Systemic mycoses during prophylactical use of liposomal amphotericin B (Ambisome^®) after liver transplantation

Systemic mycoses during prophylactical use of liposomal amphotericin B (Ambisome^®) after liver transplantation

Drugs acting on the immune system

Contact Info

Product

Resources

About

58 Interaction of Tacrolimus (Fk 506) and Fluconazole

Cited by 2 publications

References 0 publications

Systemic mycoses during prophylactical use of liposomal amphotericin B (Ambisome®) after liver transplantation

Systemic mycoses during prophylactical use of liposomal amphotericin B (Ambisome®) after liver transplantation

Drugs acting on the immune system

Contact Info

Product

Resources

About

Systemic mycoses during prophylactical use of liposomal amphotericin B (Ambisome^®) after liver transplantation

Systemic mycoses during prophylactical use of liposomal amphotericin B (Ambisome^®) after liver transplantation