Effect of Diltiazem on Blood Concentration of Tacrolimus in Patients with Nephrotic Syndrome
10.3870/j.issn.1004-0781.2025.02.018
- VernacularTitle:地尔硫(卓)对肾病综合征患者他克莫司血药浓度的影响
- Author:
Kuikui GENG
1
;
Lei LAN
;
Shengyu ZHANG
;
Aizong SHEN
;
Wei WU
;
Tianlu SHI
Author Information
1. 中国科学技术大学附属第一医院药学部、精准药物制剂与临床药学安徽省重点实验室,合肥 230001
- Publication Type:Journal Article
- Keywords:
Diltiazem;
Tacrolimus;
Nephrotic syndrome;
Plasma concentration
- From:
Herald of Medicine
2025;44(2):287-292
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the effect of diltiazem on blood concentration of tacrolimus(TAC)retrospectively,and to provide reference for individual administration of tacrolimus in patients with nephrotic syndrome(NS).Methods The patients with NS who were treated in the outpatient/inpatient department of our hospital from January 2018 to December 2022 were collected,and the general information,combined drug use,blood drug concentration and other information of the patients were recorded.The patients were divided into two groups according to whether diltiazem was used or not:TAC group alone and TAC group combined with diltiazem.The effect of diltiazem on tacrolimus concentration was analyzed.Results A total of 45 patients with NS were included in this study,and 21 patients in the TAC group were treated with TAC alone.The mean blood concentration of TAC after medication was(5.77±2.87)ng·mL-1,which reached the effective therapeutic concentration range.The average blood concentration of TAC+Diltiazem group in the 24 patients was(2.90±1.29)ng·mL-1 before combined treatment,and increased to(5.74±2.46)ng·mL-1 after combined with diltiazem,with a growth rate of(127.34±119.57)％.The increase range was from 10％to 288％,and there was significant difference(P＜0.05).According to the observation within 6 months after the combination of the two drugs,the average blood concentration of TAC continued to increase,especially in the 5th month after the administration of TAC,and the concentration tended to be stable after 5 months.By compare with the effect of diltiazem dosage on the blood concentration of TAC,90 mg·d-1 and 180 mg·d-1 had little difference in improving the blood concentration of TAC.At the same time,the combination of the two drugs did not cause adverse reactions.Conclusion A daily dose of 90 mg of Diltiazem can significantly increase the TAC blood concentration in patients with NS who cannot reach the effective therapeutic concentration with conventional doses.It can reach the effective clinical therapeutic concentration without increasing the dose of tacrolimus.The combination of the two drugs were generally safe and effective.
