Lack of interaction between tacrolimus (FK506) and methotrexate in bone marrow transplant recipients
Autor: | I Bekersky, Richard A. Nash, GW Boswell, Donna Przepiorka, Steve Devine, JL Klein, Rochelle M. Maher, John R. Wingard, Joseph W. Fay, Voravit Ratanatharathorn, William E. Fitzsimmons |
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Rok vydání: | 1997 |
Předmět: |
Adult
Antimetabolites Antineoplastic medicine.medical_specialty Adolescent Graft vs Host Disease chemical and pharmacologic phenomena Gastroenterology Tacrolimus Pharmacokinetics Internal medicine Humans Transplantation Homologous Medicine Drug Interactions Child Bone Marrow Transplantation Transplantation business.industry Area under the curve Hematology Drug interaction medicine.disease Regimen Methotrexate surgical procedures operative Graft-versus-host disease Immunology Chemoprophylaxis business Immunosuppressive Agents medicine.drug |
Zdroj: | Bone Marrow Transplantation. 20:49-51 |
ISSN: | 1476-5365 0268-3369 |
Popis: | Tacrolimus (FK506) is a macrolide lactone effective in the control of graft-versus-host disease (GVHD). An interaction between high-dose methotrexate and a macrolide antibiotic (pristinamycin) leading to prolonged methotrexate exposure has been described. Because a randomized prospective trial comparing tacrolimus with cyclosporine (both in combination with methotrexate) following allogeneic BMT showed the tacrolimus plus methotrexate regimen to be more effective in prevention of GVHD, we assessed methotrexate pharmacokinetics in a subgroup of the participants of this trial to evaluate the possibility that an interaction of FK506 and methotrexate was the explanation for the clinical findings. Mean and median methotrexate levels at various time-points after the day 1 and 6 methotrexate doses were comparable in the tacrolimus and cyclosporine cohorts and were elevated in only three of 70 study patients. Area under the curve (AUC) concentrations were also similar after the day 1 and 6 methotrexate doses. Thus, no significant interaction between tacrolimus and methotrexate is apparent and the differences in efficacy between tacrolimus and cyclosporine are unlikely to be attributable to pharmacologic interactions with methotrexate. |
Databáze: | OpenAIRE |
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