Serious renal transplant rejection and adrenal hypofunction after gradual withdrawal of prednisolone two years after transplantation.

Naik, R. B.; Chakraborty, J.; English, J.; Slapak, M; Lee, H A

doi:10.1136/bmj.280.6228.1337

Cited by 9 publications

(1 citation statement)

References 8 publications

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“…In few clinical situations is the possible ill-effect of a markedly reduced extent of bioavailability of prednisolone as serious as in kidney transplantation, where most patients are treated with high doses of prednisolone to prevent rejection of the transplanted kidney. Low prednisolone levels have been associated with increased graft loss, whether secondary to empirical reduction of daily prednisolone to doses below 10 mg (29,30) or to enzyme induction due to treatment with antiepileptic drugs…”

Section: Free Prednisolone Ng/mlmentioning

confidence: 99%

Altered Prednisolone Pharmacokinetics in Patients Treated with Rifampicin

Bergrem¹,

Refvem²

1983

Journal of Internal Medicine

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The pharmacokinetics and protein binding of prednisolone were studied in 7 patients before and after 3 weeks of rifampicin therapy. The elimination half‐time for prednisolone decreased by 45±8.1% (p<0.01), and the total body clearance of prednisolone increased by 91±26% (p<0.01). The area under the time‐concentration curve (AUC) of total (free plus protein‐bound) prednisolone decreased by 48±7.3% (p<0.01) and of free, unbound prednisolone by 57±9.8% (p<0.01). The reduction in AUC was greater for free than for total prednisolone (p<0.05) mainly due to the non‐linear nature of prednisolone protein binding. There was no significant change in the volume of distribution. Because of the marked reduction in total and especially free prednisolone, the dosage should be adjusted accordingly if prednisolone and rifampicin are prescribed concomitantly.

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Section: Free Prednisolone Ng/mlmentioning

confidence: 99%