Details

Autor(en) / Beteiligte

• Valk-Swinkels, Corinne G H
• Alidjan, Fazil
• Rommers, Mirjam K
• Bakker, René C
• Swen, Jesse J
• van 't Veer, Nils E

Titel

Low cyclosporin levels induced by the brief use of rifampicin; immunosuppression may fail for several weeks

Ist Teil von

• Nederlands tijdschrift voor geneeskunde, 2013, Vol.157 (28), p.A5667

Ort / Verlag

Netherlands

Erscheinungsjahr

2013

Quelle

MEDLINE

Beschreibungen/Notizen

• Cyclosporin is an immunosuppressive agent with a wide range of therapeutic uses. In transplant patients, it is used for the prevention of rejection and graft-versus-host reactions. The metabolism and bioavailability of cyclosporin can be significantly and persistently influenced through induction of CYP3A4 caused by the concomitant use of rifampicin. However, awareness of the need for the timely and frequent monitoring of cyclosporin levels during and especially after treatment with rifampicin has not fully been addressed. Here, we describe 3 patient cases concerning significant episodes of sub-therapeutic cyclosporin levels after short-term rifampicin therapy. Rifampicin was administered for three to five days and decreased cyclosporin levels were observed ± 7 days after the initiation of rifampicin, and continued during the following weeks even after the cessation of rifampicin therapy. Cyclosporin dosage-adjustments were made based on the cyclosporin blood levels and all 3 patients showed good therapeutic and clinical responses.