Elsevier

Transplantation Proceedings

Volume 30, Issue 7, November 1998, Pages 3570-3572
Transplantation Proceedings

Immunosuppressions
Effects of rifampin on cyclosporine disposition in kidney recipients with tuberculosis

https://doi.org/10.1016/S0041-1345(98)01139-7Get rights and content

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Patients and methods

This study included four patients (three men and one woman; weight range 49 to 81 kg; age range 35 to 51 years; 12 to 72 months after kidney transplantation). All patients were treated with a triple immunosuppressive regimen consisting of CyA, azathioprine, and prednisone. Two patients had pulmonary Tbc, one patient had biopsy-proven Tbc pleurisy, and one patient had renal Tbc. They were administered isoniazid, RFP, ethambutol, and pyrazinamide. A dosage of 600 mg of RFP was given daily to all

Results

The blood pharmacokinetic parameter estimates of individual subjects with and without RFP are shown in Table 1. Statistically significant decreases were seen in blood CyA pharmacokinetic parameters, including the following: AUC (ng/mL per hour) (4582.95 ± 239.71 vs 2790.48 ± 251.34), t1/2(h) (3.35 ± 0.12 vs 2.80 ± 0.28) before and after RFP therapy, respectively. The CyA blood clearance increased significantly (0.37 ± 0.03 vs 1.24 ± 0.14) after RFP administration. No significant changes were

Discussion

Cyclosporine is a widely used immunosuppresant to prevent organ rejection. The susceptibility to infections such as Mycobacterium tuberculosis is one of the complications of long-term immunosuppression. Conventional treatment for Tbc usually uses a combination chemotherapy, including RFP. It is well established that RFP is a complex macrocyclic zwitterion that has properties of hepatic enzyme induction. Drug interaction studies have shown that RFP and other agents affected the hepatic

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