Drug Interactions in Solid Organ Transplant Recipients

Manitpisitkul, Wana; Wilson, Nikita S.; Lee, Sabrina; Weir, Matthew R.

doi:10.1007/978-1-4939-0342-9_34

Cited by 2 publications

(3 citation statements)

References 117 publications

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“…Co-administration of mTOR inhibitors and protease inhibitors has been contraindicated [18]. In kidney transplant recipients who were taking lopinavir/ritonavir, only 1 mg per week of tacrolimus provided sufficient therapeutic blood concentration [18,27]. Only 5-20% of the baseline doses were sufficient to attain desired blood concentrations in patients who were taking cyclosporine [18].…”

Section: Interactions Between Immunosuppressive Drugs and Medications Used To Manage Covid-19mentioning

confidence: 99%

“…Increased risk of acute rejection has been reported in kidney transplant patients with hepatitis C who were treated with interferon alpha [27]. There is no report of such interaction with interferon beta.…”

Section: Interactions Between Immunosuppressive Drugs and Medications Used To Manage Covid-19mentioning

confidence: 99%

“…Interactions of immunosuppressive and COVID-19 drugs[18,26,27]. Increase, decrease and no change in immunosuppressive drug, respectively.…”

mentioning

confidence: 99%

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Pharmacotherapeutic considerations in solid organ transplant patients with COVID-19

Dashti‐Khavidaki

Mohammadi

Khalili

et al. 2020

Expert Opinion on Pharmacotherapy

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Introduction: Coronavirus disease 2019 (COVID-19) has spread rapidly worldwide. While there are presently a few case reports/series on COVID-19 amongst solid organ transplant (SOT) patients, there is no official guideline for the management of SOT patients. Areas covered: The authors discuss the pharmacotherapeutic management of SOT patients during the COVID-19 outbreak and provide their expert perspectives. Expert opinion: Prophylactic reduction of immunosuppression because of fear of COVID-19 is not suggested in SOT patients. With maintenance immunosuppressive regimens, corticosteroids can be continued during COVID-19. Continuing other immunosuppressive drugs with lowest effective dose/ blood concentration is suggested for patients with mild to moderate COVID-19. Discontinuation of antimetabolites and perhaps inhibitors of mammalian target of rapamycin (mTOR) is suggested in moderate to severe COVID-19. Calcineurin inhibitors (CNIs) may be continued or substituted for mTOR inhibitors with lowest therapeutic concentrations in moderate to severe COVID-19. If continued in patients with COVID-19, therapeutic drug monitoring of CNIs/mTOR inhibitors and appropriate dose reduction is recommended in co-administration with protease inhibitors, hydroxychloroquine/chloroquine, or interleukin (IL)-1/IL-6 receptor antagonists. Complete blood count monitoring is recommended in patients who continue taking antimetabolites or mTOR inhibitors. Dose modification/ avoidance should be considered for chloroquine, atazanavir, oseltamivir, ribavirin, anakinra, and Janus associated kinase inhibitors in patients with organ function impairment.

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Section: Interactions Between Immunosuppressive Drugs and Medications Used To Manage Covid-19mentioning

confidence: 99%

Section: Interactions Between Immunosuppressive Drugs and Medications Used To Manage Covid-19mentioning

confidence: 99%