Transplantation · 1998 · 34 citations · 5 references
MedicinePharmacologyPharmacotherapyClinical PharmacologyKidney TransplantationRenal PharmacotherapyCytochrome P450 InteractionsDrug DispositionDrug Interactions In TransplantationImmunosuppression In Kidney TransplantationRenal PharmacologyTransplant PharmacologyAcute Rejection MonitoringCyclosporine InteractionsCyclosporine PharmacokineticsCyp450-mediated InteractionsNephrotoxic MedicationsOral Hypoglycemic TherapyPharmacokinetics In TransplantationRenal Transplant Rejection
BACKGROUND: Troglitazone (Rezulin) is a promising new oral hypoglycemic agent recently approved by the Federal Drug Administration for use in type II diabetes mellitus. Although troglitazone is not metabolized by the cytochrome p450 3A isozyme family, it is a potential inducer of this system. Other medications, e.g., rifampin and phenobarbital, which also induce p450 3A activity, have been reported to significantly decrease cyclosporine (CsA) concentrations. METHODS: We report a case of a stable renal transplant patient who had a decrease in CsA concentration after beginning troglitazone and who subsequently developed an acute rejection episode. We then reviewed all stable renal patients begun on troglitazone over the previous 6 months. RESULTS: The seven transplant patients who had been started on troglitazone therapy experienced a statistically and clinically significant decrease in CsA 12-hr trough levels immediately after the institution of troglitazone therapy. CONCLUSION: A potential interaction exists between troglitazone and CsA. Transplant patients on CsA who receive troglitazone therapy should be monitored closely.
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Mary F. Hébert, John P. Roberts, Thomayant Prueksaritanont et al. · Clinical Pharmacology & Therapeutics · 1992 · 339 citations
Edgar A. Mueller, John M. Kovarik, Johannes B. van Bree et al. · Transplantation · 1994 · 145 citations