Clinically Significant Drug−Drug Interaction Between Tacrolimus and Phenobarbital

Abstract

Upon tacrolimus dose increases, discontinuation of carbamazepine, and minimization of phenobarbital dose, effective tacrolimus trough levels were achieved in our patient. Identification and elimination of such drug-drug interactions is necessary to assure adequate immunosuppression in renal transplant recipients.

Clinical decision support systems differ in their ability to identify clinically relevant drug interactions of immunosuppressants in kidney transplant patients

“…Due to polypharmacy and immunosuppressants with a narrow therapeutic window, kidney transplant patients are likely to be particularly vulnerable to ADEs caused by DDIs . As a consequence of a DDI, blood levels of immunosuppressants may either increase potentially leading to toxicity, or decrease potentially leading to rejection of the organ . Thus, preventing DDIs of immunosuppressants in kidney transplant patients is essential.…”

“…2, 3 As a consequence of a DDI, blood levels of immunosuppressants may either increase potentially leading to toxicity, or decrease potentially leading to rejection of the organ. [4][5][6][7][8][9][10] Thus, preventing DDIs of immunosuppressants in kidney transplant patients is essential. Clinical decision support systems (CDSSs) can be successfully used to reduce serious potential DDIs (pDDIs).…”

Case Report: Boldo (Peumus boldus) and Tacrolimus Interaction in a Renal Transplant Patient

“…The consequences from consumption of boldo with its potential tacrolimus interaction resulting in subtherapeutic tacrolimus levels may have been severe. Acute rejection is the risk; it was reported in a renal transplant patient with low tacrolimus levels as a result of drug interaction with phenobarbital [14].…”