Proton Pump Inhibitor Co-medication Reduces Mycophenolate Acid Drug Exposure in Heart Transplant Recipients

Kofler, Sieglinde; Deutsch, Marcus-André; Bigdeli, Amir K.; Shvets, Nataliya; Vogeser, Michael; Mueller, Thomas; Meiser, Bruno; Steinbeck, Gerhard; Reichart, Bruno; Kaczmarek, Ingo

doi:10.1016/j.healun.2009.03.006

Cited by 53 publications

(45 citation statements)

References 36 publications

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“…There is evidence from the study presented here that 3-g MMF might overcome the low exposures seen with higher sCr levels, but a larger sample size is required to confirm this observation. The use of proton pump inhibitors (PPIs) has recently been associated with lower MPA exposures in heart transplant patients receiving pantoprazole (16). However, we did not observe this effect in the entire cohort (day 5 MPA AUC 51.3 Ϯ 24.8 mg⅐h/L PPI (n ϭ 67) versus 55.8 Ϯ 24.9 mg⅐h/L no PPI (n ϭ 51, P ϭ 0.265) or in each of the individual arms (data not shown).…”

Section: Discussionmentioning

confidence: 99%

The CLEAR Study

Gourishankar

Houde²,

Keown³

et al. 2010

Clinical Journal of the American Society of Nephrology

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Section: Discussionmentioning

confidence: 99%

The CLEAR Study

Gourishankar

Houde²,

Keown³

et al. 2010

Clinical Journal of the American Society of Nephrology

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“…Indeed, by increasing the gastric pH, the PPI decreases the dissolution and the solubilization of some administered medicines per bone, such as antifungals (for example, the itraconazole [45]) or the immunosuppressors (such as the mycophenolate mofetil [46]). On the contrary, they can increase the reduction of some medicines such as the saquinavir [47].…”

Section: Esophageal Abnormalitiesmentioning

confidence: 99%

Prescription of Proton Pump Inhibitors in Elderly Subjects in Real Life: A Retrospective Study in a Gastroenterology Department

Boudabous¹,

Gdoura²,

Mnif³

et al. 2017

Esophageal Abnormalities

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The proton-pump inhibitor (PPI) is an effective and widely used treatment but may cause side effects, especially for the elderly. Materials and methods: this is a cross-sectional study including 45 patients older than 65 years, followed at our outpatient and treated with PPIs for at least a year. The indication for PPI, the results of any endoscopy, and the quality of the tolerance of these molecules is specified by the data folder. During the consultation, we conducted an interrogation to an update of the history and medications to our patients and a type checking of the molecule, the dose, and the quality of the observance. Results: patients were divided into 32 women and 13 men with a mean age of 75 ± 7 years (65-92). The average length of PPI use was 6 ± 4 years (1-16) with a consumption of a double dose for at least 1 year in 28.8% of cases. The prescribed dose was higher than the recommended dose in at least 15.5% of cases. PPIs were well tolerated. One patient had presented a microscopic colitis, revealed by diarrhea regressed after discontinuation of PPIs. Conclusion: PPIs were prescribed in elderly subjects by gastroenterologists, in a university center, with a high dose and long. In our series, this treatment is well tolerated in the elderly.

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“…En augmentant le pH gastrique, les IPP diminuent la dissolution et la solubilisation de certains médicaments administrés per os, tels que des antifongiques (itraconazole [50]), des immunosuppresseurs (mycophénolate mofétil [51]) ou encore des antirétroviraux (atazanavir [52], indinavir [53], nelfinavir [54]). À l'inverse, ils peuvent augmenter la résorption de certains médicaments comme le saquinavir [55].…”

Section: Altération De L'absorption Des Médicamentsunclassified

Effets indésirables des inhibiteurs de la pompe à proton : faut-il craindre de les prescrire au long cours ?

Roulet

Vernaz

Giostra

et al. 2012

La Revue de Médecine Interne

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Mots clés :Inhibiteurs de la pompe à proton Fractures ostéoporotiques Infections Cancer gastrique Pharmacodépendance r é s u m é La prévalence des traitements de longue durée par inhibiteurs de la pompe à proton (IPP) est en augmentation. Si leur tolérance à court terme est bonne, des réserves ont vu le jour sur d'éventuels effets indésirables graves associés à une exposition prolongée. Ainsi, l'association avec le risque fracturaire semble être confirmée, notamment au niveau vertébral, ainsi que le risque d'effet rebond sur la sécrétion acide à l'arrêt du traitement. Le risque de pneumopathie communautaire n'est pas établi dans la population générale et semble limité aux patients les plus fragiles. L'association avec le risque d'infection digestive à Clostridium difficile est probable. Les cas de néphrite tubulo-intestitielle sont rares mais peuvent conduire à une insuffisance rénale chronique. Les données disponibles sont encore insuffisantes pour évaluer le risque de carence en vitamine B12, en fer ou en magnésium et le risque de cancer digestif, même si des bases physiopathologiques existent dans le cas du cancer gastrique. Il existe des interactions avec de nombreux autres médicaments, notamment ceux qui sont métabolisés par certaines isoenzymes du cytochrome P450. Enfin, la balance bénéfice-risque de l'utilisation des IPP au long cours chez l'enfant semble défavorable dans la plupart des cas.© 2012 Société nationale française de médecine interne (SNFMI). Publié par Elsevier Masson SAS. Tous droits réservés. Keywords: Proton pump inhibitors Osteoporotic fractures Infection Stomach neoplasms Substance withdrawal syndrome a b s t r a c tLong-term treatment with proton pump inhibitors (PPI) is becoming more prevalent. Although they are well tolerated in the short term, serious concerns about long-term use have arisen. Recent data suggest that the latter is associated with an increased risk for osteoporotic fracture (especially vertebral), Clostridium difficile infection and rebound acid hypersecretion after treatment discontinuation. Acute interstitial nephritis is rare but may progress to chronic renal failure. An increased risk of communityacquired pneumonia has not been established in the general population and seems limited to the most vulnerable patients. Consistent data are still missing to correctly assess the risk of iron deficiency, vitamin B12 deficiency or hypomagnesaemia and the risk of digestive malignant diseases, despite the pathophysiological basis that exists concerning gastric malignancy. Many drug interactions can occur on long-term treatment, including some that imply the cytochrome P450 enzymes. Finally, the risk-benefit balance for a chronic PPI use in children seems unfavorable in most cases.

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Proton Pump Inhibitor Co-medication Reduces Mycophenolate Acid Drug Exposure in Heart Transplant Recipients

Cited by 53 publications

References 36 publications

The CLEAR Study

The CLEAR Study

Prescription of Proton Pump Inhibitors in Elderly Subjects in Real Life: A Retrospective Study in a Gastroenterology Department

Effets indésirables des inhibiteurs de la pompe à proton : faut-il craindre de les prescrire au long cours ?

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