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Diltiazem use in tacrolimus‐treated renal transplant recipients
Author(s) -
Kothari J.,
Nash M.,
Zaltzman J.,
Ramesh Prasad G. V.
Publication year - 2004
Publication title -
journal of clinical pharmacy and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.622
H-Index - 73
eISSN - 1365-2710
pISSN - 0269-4727
DOI - 10.1111/j.1365-2710.2004.00578.x
Subject(s) - diltiazem , tacrolimus , medicine , calcineurin , urology , prednisone , transplantation , surgery , anesthesia , calcium
Summary Background: Calcium channel blockers are widely used in the treatment of post‐transplant hypertension but have the potential for drug interaction with calcineurin inhibitors. Renal allograft outcomes when diltiazem is used with cyclosporine have been reported, but similar data with tacrolimus are not available. Methods: We performed a retrospective analysis of all our renal transplant recipients from March 1997 to March 2002 who were given tacrolimus, mycophenolate mofetil and prednisone. Patients were divided into two groups based on whether diltiazem was started in the first postoperative week. Outcome measures included renal function up to 2 years post‐transplant, blood pressure (BP) control, tacrolimus exposure, and costs related to tacrolimus monitoring. Results: Sixty‐four patients constituted the diltiazem group and 32 the control group. Their baseline characteristics were similar. The mean average daily dose of diltiazem used was 213·95 mg/day. There was no difference in renal function, graft survival, or patient survival over 2 years. BP control was similar although the diltiazem group required more medication. Diltiazem was discontinued in four patients due to side‐effects. There was no difference in tacrolimus‐related side‐effects between the two groups. There was also no difference in tacrolimus exposure, cost related to tacrolimus monitoring, or combined costs when the expense of diltiazem was added. Conclusion: Diltiazem use is acceptably safe and efficacious in renal transplant recipients treated with tacrolimus‐based immunosuppressive therapy. It can be considered as a first‐line antihypertensive in these patients and is cost neutral for tacrolimus use.