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Drug interactions and safety profiles with concomitant use of caspofungin and calcineurin inhibitors in allogeneic haematopoietic cell transplantation
Author(s) -
Nishimoto Mitsutaka,
Koh Hideo,
Tokuwame Atsushi,
Makuuchi Yosuke,
Kuno Masatomo,
Takakuwa Teruhito,
Okamura Hiroshi,
Koh Shiro,
Yoshimura Takuro,
Nanno Satoru,
Nakamae Mika,
Hirose Asao,
Nakashima Yasuhiro,
Nakane Takahiko,
Hino Masayuki,
Nakamae Hirohisa
Publication year - 2017
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/bcp.13303
Subject(s) - calcineurin , medicine , concomitant , tacrolimus , transplantation , adverse effect , pharmacokinetics , pharmacology , drug interaction , drug , haematopoiesis , gastroenterology , stem cell , biology , genetics
Aim Small‐scale clinical studies have reported on drug interactions between caspofungin (CPFG) and calcineurin inhibitors in healthy subjects; however, little is known about these interactions in allogeneic haematopoietic cell transplantation (allo‐HCT) patients. Methods We retrospectively assessed the drug interactions and safety profiles in allo‐HCT recipients treated concomitantly with CPFG and calcineurin inhibitors. Results Ninety‐one consecutive cases were evaluated. There were no statistically significant differences in the plasma concentration/dose (C/D) ratios of tacrolimus (TAC) in 34 patients before and after co‐administration with CPFG (median: 575.6–672.4, P = 0.200). In contrast, the median C/D ratio of cyclosporin A (CsA) in 16 patients was significantly elevated after co‐administration with CPFG (median: 62.8–74.9, P = 0.016). There were no serious adverse effects on liver or renal function associated with the therapy. Conclusions Our data show that CPFG did not affect the pharmacokinetics of TAC and that it could mildly increase CsA blood concentrations in allo‐HCT patients.