| Autor: |
Ayumi Tsuzawa, Yoshiki Katada, Keisuke Umemura, Mitsuhiro Sugimoto, Asami Nishikawa, Yu-ki Sato, Yuko Yoshida, Noriaki Kitada, Atsushi Yonezawa, Daisuke Nakajima, Hiroshi Date, Tomohiro Terada |
| Jazyk: |
angličtina |
| Rok vydání: |
2023 |
| Předmět: |
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| Zdroj: |
Journal of Pharmaceutical Health Care and Sciences, Vol 9, Iss 1, Pp 1-6 (2023) |
| Druh dokumentu: |
article |
| ISSN: |
2055-0294 |
| DOI: |
10.1186/s40780-023-00280-3 |
| Popis: |
Abstract Background Drug-drug interaction management is complex. Nirmatrelvir/ritonavir is a potent cytochrome P450 (CYP) 3A inhibitor and influences pharmacokinetics of co-administered drugs. Although there are several reports about drug-drug interactions of nirmatrelvir/ritonavir, an influence of a concomitant use of nirmatrelvir/ritonavir and another potent CYP3A inhibitor on tacrolimus remains unclear. Here, we experienced a lung transplant patient with the novel coronavirus disease 2019 (COVID-19). In this patient, nirmatrelvir/ritonavir was administered, and the inhibitory effect of itraconazole on CYP3A was prolonged. Case presentation We present a case in forties who had undergone lung transplantation. He was administered itraconazole and tacrolimus 1.0 mg/d, with a trough value of 8–12 ng/mL. The patient contracted the COVID-19, and a nirmatrelvir/ritonavir treatment was initiated. During the antiviral treatment, tacrolimus administration was discontinued for 5 d. Tacrolimus was resumed at 1.0 mg/d after completion of the nirmatrelvir/ritonavir treatment, but the trough value after 7 d was high at 31.6 ng/mL. Subsequently, the patient was placed on another 36-h tacrolimus discontinuation, but the trough value decreased to only 16.0 ng/mL. Conclusions Co-administration of ritonavir caused a prolonged decrease in tacrolimus clearance through its inhibitory effects on CYP3A in a patient taking itraconazole. Management of drug-drug interaction by pharmacists can be important for patients with multiple medications. |
| Databáze: |
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| Externí odkaz: |
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