Drug interaction in a renal transplant patient: Cyclosporin-Neoral and orlistat

Evans, Sally K.; Robson, Michael G.; Wells, Hayley; MacLean, Douglas; Gordon, Isabel; Taylor, John; Goldsmith, David

doi:10.1053/ajkd.2003.50061

Cited by 38 publications

(16 citation statements)

References 8 publications

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“…KTR should have access to dietary advice, and to weight management services if necessary. Pharmacological intervention for obesity has not been assessed in a clinical trial in KTR and may interfere with the metabolism and absorption of immunosuppressive agents [58]. Bariatric surgery is similarly unproven in this population and likely to have a higher incidence of side effects and potential interactions.…”

Section: Rationale For Clinical Practice Guidelines For Post-operativmentioning

confidence: 99%

Renal association clinical practice guideline in post-operative care in the kidney transplant recipient

et al. 2017

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These guidelines cover the care of patients from the period following kidney transplantation until the transplant is no longer working or the patient dies. During the early phase prevention of acute rejection and infection are the priority. After around 3–6 months, the priorities change to preservation of transplant function and avoiding the long-term complications of immunosuppressive medication (the medication used to suppress the immune system to prevent rejection). The topics discussed include organization of outpatient follow up, immunosuppressive medication, treatment of acute and chronic rejection, and prevention of complications. The potential complications discussed include heart disease, infection, cancer, bone disease and blood disorders. There is also a section on contraception and reproductive issues.Immediately after the introduction there is a statement of all the recommendations. These recommendations are written in a language that we think should be understandable by many patients, relatives, carers and other interested people. Consequently we have not reworded or restated them in this lay summary. They are graded 1 or 2 depending on the strength of the recommendation by the authors, and AD depending on the quality of the evidence that the recommendation is based on.

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Section: Rationale For Clinical Practice Guidelines For Post-operativmentioning

confidence: 99%

Renal association clinical practice guideline in post-operative care in the kidney transplant recipient

et al. 2017

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“…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.…”

Section: What Is Known and Objectivementioning

confidence: 99%

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

et al. 2017

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“…There are multiple case reports of decreased absorption of cyclosporine, which could potentially lead to transplant organ rejection [108,109]. The etiology of the interaction is unknown, and in one case, separating doses did not prevent the interaction [106].…”

Section: Drug To Drug Interactionsmentioning

confidence: 99%