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Nirmatrelvir/ritonavir-induced elevation of blood tacrolimus levels in a patient in the maintenance phase post liver transplantation.

Author: ArakakiShingo, NakamuraKatsunori, ShiohiraHideo, UeharaHitoshi, UeharaWataru, YamamotoKazuko

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Overview

This case report highlights a potential drug interaction between nirmatrelvir/ritonavir, an antiviral drug for COVID-19, and tacrolimus, an immunosuppressant used in liver transplant patients. The interaction caused a significant increase in tacrolimus levels, leading to nausea and vomiting. Therefore, tacrolimus dosage reduction or discontinuation is necessary during COVID-19 treatment with nirmatrelvir/ritonavir in liver transplant patients.
Paper Details　
Original Abstract of the Article :
Nirmatrelvir is an orally administered anti-SARS-CoV-2 drug used in combination with ritonavir, the drug-metabolizing cytochrome P450 (CYP) 3A inhibitor, to evade metabolism and extend bioavailability. Meanwhile, the immunosuppressant tacrolimus is a CYP3A4/5 substrate, and CYP3A inhibition results ...See full text at original site
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引用元：
https://doi.org/10.1016/j.jiac.2023.09.006

データ提供：米国国立医学図書館（NLM）

Nirmatrelvir/ritonavir-induced Elevation of Blood Tacrolimus Levels in a Patient in the Maintenance Phase Post Liver Transplantation

Drug interactions can be a real desert storm in the world of medicine, creating unexpected and potentially dangerous consequences for patients. This study explores the potential for a drug-drug interaction between nirmatrelvir/ritonavir, a COVID-19 treatment, and tacrolimus, an immunosuppressant medication commonly used after liver transplantation. The researchers report a case study of a liver transplant recipient who experienced a significant increase in blood tacrolimus levels after starting treatment with nirmatrelvir/ritonavir. Their findings highlight the importance of careful monitoring and potential dose adjustments for tacrolimus in patients receiving nirmatrelvir/ritonavir treatment, ensuring safe and effective management of both medications.

Navigating the Desert of Drug Interactions

The study found that nirmatrelvir/ritonavir, through its inhibition of CYP3A4/5 enzymes, can lead to a substantial increase in blood tacrolimus levels. This discovery is like encountering a hidden oasis in the desert of drug interactions, revealing a potential risk that requires careful consideration. The researchers emphasized the need for close monitoring of blood tacrolimus levels in patients receiving nirmatrelvir/ritonavir treatment, potentially requiring dose adjustments or discontinuation of tacrolimus to prevent adverse effects.

Ensuring Safe Passage Through the Desert of Medication Management

The study underscores the importance of vigilance and careful medication management in patients receiving both nirmatrelvir/ritonavir and tacrolimus. It highlights the potential for drug interactions and emphasizes the need for close monitoring and potential dose adjustments to ensure safe and effective treatment for all. This study serves as a reminder that the desert of drug interactions is vast and complex, requiring ongoing research and careful consideration to prevent potential adverse outcomes.

Dr.Camel's Conclusion

This study serves as a reminder that the desert of drug interactions is vast and complex, requiring careful consideration and close monitoring to ensure patient safety. By understanding the potential for drug interactions, we can navigate the complexities of medication management and provide optimal care for all.

Date :
  1. Date Completed 2023-11-21
  2. Date Revised 2023-11-21
Further Info :

Pubmed ID

37689137

DOI: Digital Object Identifier

10.1016/j.jiac.2023.09.006

SNS
PICO Info
in preparation
Languages

English

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