Ciclosporin-Nicardipine Interaction

Deray, Gilbert; Aupetit, B.; Martinez, F.; Baumelou, A; Worcel, Alexandre; Benhmida, Mohamed; Legrand, J.; Jacobs, C

doi:10.1159/000167993

Cited by 6 publications

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References 3 publications

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“…Studies on the interaction observed between cyclosporine and dihydropyridine calcium channel blockers have demonstrated a significant increase in cyclosporine concentration in renal transplant patients treated with amlodipine for several weeks 5 20 21. The interaction between cyclosporine and nicardipine has been evaluated in many studies 6 22–25. Conversely, studies have shown that felodipine, nifedipine and amlodipine do not alter the cyclosporine concentration 26–28.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of drug interaction between cyclosporine and lercanidipine: a descriptive study

et al. 2023

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ObjectivesCyclosporine is an immunosuppressive drug with a high potential for drug interactions that is frequently used in renal transplant patients. The purpose of this study was to assess the change in cyclosporine concentration in patients taking cyclosporine and lercanidipine concurrently.MethodsThe potential drug interactions in renal transplant patients who received lercanidipine and cyclosporine concurrently in a university hospital between January 2008 and January 2018 were evaluated retrospectively. Patients had renal transplantation from deceased donors or living related donors. The Drug Interaction Probability Scale (DIPS) criteria were used to assess the causality of cyclosporine and lercanidipine drug interaction.ResultsThe study included six renal transplant patients. The median cyclosporine concentration before lercanidipine use was 325 ng/mL (min–max 101–356) and 592.5 ng/mL (min–max 198–799) thereafter (p=0.028). Serum creatinine and proteinuria levels did not change significantly during lercanidipine treatment (p=0.686 and p=0.116, respectively). According to the DIPS evaluation, cyclosporine and lercanidipine interaction was classified as “possible (score 3)".ConclusionsConcomitant use of cyclosporine and lercanidipine increases the concentration of cyclosporine, which may result in side effects during effective treatment in renal transplant patients. Therefore, cyclosporine concentrations should definitely be monitored while patients are taking lercanidipine.

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Section: Discussionmentioning

confidence: 99%

Evaluation of drug interaction between cyclosporine and lercanidipine: a descriptive study

et al. 2023

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Nicardipine As Antihypertensive Therapy in Liver Transplant Recipients: Results of Long–Term Use

et al. 1997

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antihypertensive therapy. 6 Nicardipine, a 1-4 dihydropyriArterial hypertension is frequent in liver transplant dine CCB efficient to control arterial hypertension 7,8 is availrecipients on cyclosporine A (CsA). Nicardipine is a calable in an intravenous form which makes its use very convecium channel blocker (CCB) that has been shown to nient in the immediate postoperative period. 9,10 However, be efficient in controlling postoperative hypertension.some reports point out interactions of nicardipine with CsA However, its use has been limited in organ recipients metabolism in renal transplant recipients 11-13 with a possibecause of its reported interaction with CsA metaboble enhanced CsA toxicity. Therefore, caution is recomlism. In this report, we studied the results of the longmended when using nicardipine in these patients, 12 and it term use of nicardipine after liver transplantation.has been proposed to avoid this drug in organ transplant Forty-nine consecutive liver transplant recipients with recipients. In our liver transplant unit, we chose to use nia follow-up longer than 2 years were studied. Immunocardipine as part of the regular postoperative, antihypertensuppressive regimen was based on CsA and prednisone.sive program because of its convenience. The aim of this Patients with immediate postoperative hypertenstudy is to report our experience of the post-LT, long-term sion received intravenous nicardipine, secondarily use of this drug. switched to oral nicardipine (group 1, n Å 27). Patients with delayed hypertension (i.e., ú2 weeks posttrans- PATIENTS AND METHODS plant) received other antihypertensive drugs which didA study was made of 61 consecutive liver transplantation recipinot interact with CsA metabolism. These patients and ents who had completed a posttransplantation follow-up longer than those without hypertension formed group 2 (n Å 22).two years. Twelve patients were excluded from the analysis becauseThe two groups were similar for age, sex, body weight, of an immunosuppressive regimen other than CsA (FK 506) in three and transplantation indications. Interaction of nicar-cases, an associated enzyme-inducer treatment in three cases, comdipine with CsA metabolism was confirmed. Whereas bined liver-kidney transplant in four cases, and malabsorption in cyclosporine blood levels were similar in both groups two cases. Overall, 49 patients were evaluated as the basis of this at any time during the study, the mean cyclosporine report.The induction immunosuppressive regimen that we used was predaily dose required to achieve such levels was 30% viously reported.14 Briefly, when serum creatinine at postoperative lower in group 1 compared with group 2 (P õ .01). This (LT) has allowed considerable improvement in long-term Arterial hypertension was defined by an increase in systemic results of this procedure. 1,2 However, CsA administration is blood pressure above 160/95 mmHg. 15 Postoperative management associated with a 50% to 75% incidence of arterial hyperten-of hypertension was designed as follows. (...

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Calcium Antagonists

Rosenthal

Ezra²

1995

Drug Safety

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The interaction of calcium antagonists, including the dihydropyridine calcium antagonists (e.g. nifedipine), verapamil and diltiazem, with drugs from other classes has major clinical ramifications as the use of drug combinations increases in frequency. Combinations are used in the treatment of disorders ranging from hypertension to cardiac rhythm disturbances, angina pectoris and peripheral vasospastic disease. In this era of organ transplantation, drugs like cyclosporin are coming into potential conflict with an ever-growing list of drugs. Drug combinations used as part of long term therapies are also making their appearance in toxic drug reactions, including antituberculous and anticonvulsant agents. Bronchodilators and H2-blockers also fall into this category of potential culprits of combined drug toxicity, and the interactions of calcium antagonists with beta-blockers and antiarrhythmic agents are also becoming a matter of concern.

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Ciclosporin-Nicardipine Interaction

Cited by 6 publications

References 3 publications

Evaluation of drug interaction between cyclosporine and lercanidipine: a descriptive study

Evaluation of drug interaction between cyclosporine and lercanidipine: a descriptive study

Nicardipine As Antihypertensive Therapy in Liver Transplant Recipients: Results of Long–Term Use

Calcium Antagonists

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