Korean Journal of Clinical Pharmacy (한국임상약학회지)

Korean College Of Clinical Pharmacy (한국임상약학회)
권호 표지

Effect of Voriconazole or Itraconazole on the Plasma Concentrations of Tacrolimus in Lung Transplant Recipients

폐이식 환자에서 tacrolimus와 itraconazole 혹은 voriconazole 병용 시 tacrolimus의 혈중 농도 변화에 미치는 영향

  • Jung, Yoo Jin (Department of Pharmacy, Severance Hospital, Yonsei University Health System) ;
  • Yi, Young Suk (Department of Pharmacy, Severance Hospital, Yonsei University Health System) ;
  • Ahn, Ji Hyune (Department of Pharmacy, Severance Hospital, Yonsei University Health System) ;
  • Son, Eun Sun (Department of Pharmacy, Severance Hospital, Yonsei University Health System) ;
  • Park, Min Soo (Department of Pharmaceutical Medicines and Regulatory Science, Colleges of Medicine and Pharmacy, Yonsei University) ;
  • Lee, Jangik I. (Seoul National University College of Pharmacy) ;
  • Chang, Min Jung (Department of Pharmaceutical Medicines and Regulatory Science, Colleges of Medicine and Pharmacy, Yonsei University)
  • 정유진 (연세대학교 세브란스병원) ;
  • 이영숙 (연세대학교 세브란스병원) ;
  • 안지현 (연세대학교 세브란스병원) ;
  • 손은선 (연세대학교 세브란스병원) ;
  • 박민수 (연세대학교 제약의료.규제과학과 의대.약대 협동과정) ;
  • 이장익 (서울대학교 약학대학) ;
  • 장민정 (연세대학교 제약의료.규제과학과 의대.약대 협동과정)
  • Received : 2016.08.24
  • Accepted : 2016.12.07
  • Published : 2016.12.31
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Abstract

Objective: This study was performed to compare the changes in the blood concentrations of tacrolimus when either itraconazole or voriconazole is together with tacrolimus to prevent or treat invasive aspergillus pneumonia (IAP) in patients with lung transplants. Therefore we can compare the degree of drug-drug interactions between tacrolimus and itraconazole against tacrolimus and voriconazole. Methods: Patients who were admitted and had lung transplants in a territory referral hospital from September 2012 to May 2015 were analyzed retrospectively. The effects of itraconazole and voriconazole on the plasma concentrations of tacrolimus were analyzed. Results: Mean tacrolimus concentrations was $10.49{\pm}2.35ng/mL$ vs. $10.95{\pm}2.98ng/mL$ (p=0.722), and mean concentration of tacrolimus over the dose of tacrolimus per day was $8.510{\pm}5.890(ng/mL)/(mg/d)$ vs. $15.45{\pm}28.47(ng/mL)/(mg/d)$ (p=0.947) in itraconazole vs. voriconazole group each. The ratio of the number of the results out of target tacrolimus concentrations to the total number of tacrolimus concentration results was $18.0{\pm}13.3%$ vs. $24.4{\pm}18.5%$ (p=0.185). Conclusion: There were no significant differences between itraconzaole and voriconazole to have influences on mean concentrations of tacrolimus over tacrolimus dose per weight per day. However voriconazole tended to raise tacrolimus plasma concentrations more than itraconazole. Safer and more effective drug management to prevent and treat fungal infections should be done by therapeutic drug monitoring not only of tacrolimus but of itraconazole and voriconazole in lung transplant patients.

Keywords

References

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