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01-05-2010 | Brief Report

Tacrolimus nephrotoxicity: beware of the association of diarrhea, drug interaction and pharmacogenetics

Authors: Sandrine Leroy, Arnaud Isapof, Sonia Fargue, May Fakhoury, Albert Bensman, Georges Deschênes, Evelyne Jacqz-Aigrain, Tim Ulinski

Published in: Pediatric Nephrology | Issue 5/2010

Abstract

Tacrolimus is known to potentially lead to adverse events in recipients with diarrhoea and/or calcium channel blocker (CCB) co-administration. We report a renal transplant recipient who suffered from severe nephrotoxicity related to a toxic tacrolimus trough concentration in both conditions, diarrhoea and CCB co-administration, and with genotyped CYP3A system and P-glycoprotein (P-gp) polymorphisms. To our knowledge, this is the first case to be investigated for such polymorphisms. Clinicians should be reminded of the possibility of highly increased levels of tacrolimus in situations of diarrhoea and/or co-administration of CCBs. It also highlights the key role in tacrolimus pharmacokinetics of the CYP3A system and P-gp polymorphisms, and their influence in high-risk situations when enzyme activity is already affected by enterocyte damage due to diarrhoea and CCB competition.

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Title: Tacrolimus nephrotoxicity: beware of the association of diarrhea, drug interaction and pharmacogenetics
Authors: Sandrine Leroy
Arnaud Isapof
Sonia Fargue
May Fakhoury
Albert Bensman
Georges Deschênes
Evelyne Jacqz-Aigrain
Tim Ulinski
Publication date: 01-05-2010
Publisher: Springer-Verlag
Published in: Pediatric Nephrology / Issue 5/2010
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-009-1402-8

At a glance: The STEP trials

Springer Medicine

Tacrolimus nephrotoxicity: beware of the association of diarrhea, drug interaction and pharmacogenetics

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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