Lack of effect of spiramycin on cyclosporin pharmacokinetics [see comments]

Abstract

1. The influence of spiramycin coadministration on cyclosporin pharmacokinetics was studied in five renal transplant patients. The plasma concentrations of cyclosporin were measured both by non‐specific radioimmunoassay (RIA) and high‐performance liquid chromatography (h.p.l.c.). 2. The kinetics of cyclosporin were followed before treatment, and after 1 day and then 2 weeks of oral treatment with spiramycin (3 X 10(6) iu, twice daily). The main pharmacokinetic parameters (the area under the plasma drug concentration‐time curve, the maximum plasma drug concentration and the time to reach it) obtained both by RIA and h.p.l.c. were not modified by spiramycin cotreatment after 1 day, nor after 2 weeks of spiramycin administration. Therefore, the pharmacokinetics of cyclosporin (parent drug and parent drug plus metabolites) are not influenced by the coadministration of spiramycin macrolide at therapeutic dosage. 3. Spiramycin may be preferable to other macrolide antibiotics known to interact with cyclosporin such as erythromycin or josamycin.

Pharmacokinetic Drug Interactions of Antimicrobial Drugs: A Systematic Review on Oxazolidinones, Rifamycines, Macrolides, Fluoroquinolones, and Beta-Lactams

“…An open-label placebo-controlled study of eight stable renal transplant patients found a 7% increase in AUC and 19% increase in C max of cyclosporine A, a CYP3A4 substrate, after co-administration of AZM, and concluded the drug-drug interaction not to be clinically significant [ 213 ]. No effect on PK parameters was observed when spiramycin was combined with cyclosporine A [ 214 ].…”

Drug interactions with azithromycin and the macrolides: an overview

“…In a study of 3995 patients treated with azithromycin, no cases of cyclosporin-azithromycin interaction were detected. Similarly, there have been no reports of clarithromycin interacting with cyclosporin, and spiramycin, administered to five renal transplant patients, did not affect the pharmacokinetics of cyclosporin (Vernillet et al, 1989). Some macrolides, including erythromycin, appear to increase cyclosporin concentrations.…”

Risk-benefit associated with azithromycin: A brief review

“…Increases plasma concentration causes renal dysfunction, hepatotoxicity, abdominal pain, psychosis, etc (Jensen et al, 1987). In a study 3995 patients administer Azithromycin, no case has been found in Azithromycin-Cyclosporine interaction (Vernillet et al, 1989). As a result of no interaction occurs between Azithromycin-Cyclosporine.…”