Increase of trough concentration of tacrolimus induced by combination of nirmatrelvir/ritonavir and tacrolimus
10.3760/cma.j.cn114015-20230130-00040
- VernacularTitle:奈玛特韦/利托那韦与他克莫司联用致他克莫司血药谷浓度升高
- Author:
Lu WANG
1
;
Weijie LI
1
;
Lu ZENG
1
;
Anhua WEI
1
;
Ling GUI
1
;
Wenting ZHANG
1
;
Xuepeng GONG
1
Author Information
1. 华中科技大学同济医学院附属同济医院药学部，武汉 430030
- Publication Type:Journal Article
- Keywords:
Lung transplantation;
Immunosuppressive agents;
Drug interactions;
Tacrolimus;
Therapeutic drug monitoring;
Ritonavir;
Nirmatrelvir
- From:
Adverse Drug Reactions Journal
2024;26(2):126-128
- CountryChina
- Language:Chinese
-
Abstract:
A 55-year-old male patient was treated with tacrolimus (2.5 mg in the morning and 2 mg at night) for 6 months after lung transplantation to prevent rejection. The blood trough concentration of tacrolimus was stable at 8.0-10.0 μg/L. The patient received antiviral treatment due to corona virus disease 2019 (nirmatrelvir/ritonavir 300 mg/100 mg twice daily orally for a total of 5 days). During the antiviral treatment, the patient continued the anti-rejection treatment. On the second day of antiviral treatment, the patient′s blood trough concentration of tacrolimus increased to >40.0 μg/L, which was considered to be caused by the interaction between nirmatrelvir/ritonavir and tacrolimus. Tacrolimus was withdrawn and antiviral therapy was continued. After discontinuation of tacrolimus for 8 days and nirmatrelvir/ritonavir for 3 days, the blood trough concentration of tacrolimus decreased to 25.7 μg/L. After re-giving tacrolimus at reducing dosage for 3 days, the blood trough concentration of tacrolimus was 8.3 μg/L. After 13 days of resuming administration of tacrolimus at the original dose and frequency, the patient′s blood trough concentration of tacrolimus was 9.2 μg/L. Since then, the blood trough concentration of tacrolimus in the patient was not abnormal again.
