Expertos Invitados




Artículos relacionadosArtículos relacionadosArtículos relacionados
Artículos afines de siicsalud publicados en los últimos 4 meses
INTENSIDAD Y DOSIS DE LAS ESTATINAS Y RIESGO DE DIABETES MELLITUS DE NUEVA APARICIÓN
Scientific Reports 14(19438):1-10
Difundido en siicsalud: 12 dic 2024
ROSUVASTATINA/EZETIMIBE FRENTE A ROSUVASTATINA EN DOSIS ALTA
Diabetes & Metabolism Journal 47(6):818-825
Difundido en siicsalud: 31 jul 2024

INTERACCIONES BILATERALES ENTRE CICLOSPORINA A Y TRATAMIENTOS HIPOLIPEMIANTES

(especial para SIIC © Derechos reservados)
La ciclosporina A tiene un índice terapéutico estrecho en receptores de trasplante de órganos sólidos, por lo cual es importante tener en cuenta todas las potenciales interacciones farmacocinéticas cuando se la administra simultáneamente con agentes que reducen los niveles de los lípidos en la sangre.
Autor:
Anders Asberg
Columnista Experto de SIIC

Institución:
Department of Pharmaceutical Bioscience, School of Pharmacy, University of Oslo

Artículos publicados por Anders Asberg
Recepción del artículo
5 de Julio, 2005 		Aprobación
13 de Julio, 2005
Primera edición
20 de Febrero, 2006 		Segunda edición, ampliada y corregida
7 de Junio, 2021

INTERACCIONES BILATERALES ENTRE CICLOSPORINA A Y TRATAMIENTOS HIPOLIPEMIANTES

Resumen
En comparación con la población general, la dislipidemia es más frecuente en receptores de trasplantes de órganos sólidos, debido principalmente al tratamiento con drogas inmunosupresoras (como ciclosporina A [CsA] y esteroides). En estos pacientes, los fármacos hipolipemiantes se comenzaron a utilizar ampliamente, en especial los inhibidores de la enzima HMG-CoA reductasa (estatinas). Tanto la CsA como la mayoría de las estatinas son sustratos para la enzima CYP3A4, por lo que pueden producirse interacciones bilaterales entre ambos agentes farmacológicos. Sin embargo, los resultados de diversos estudios muestran que las estatinas no inducen un incremento clínicamente relevante en la exposición sistémica a la CsA. Por otro lado, el tratamiento con CsA provoca un aumento de varias veces en la exposición sistémica de todas las estatinas. No es probable que el mecanismo de esta interacción se deba a la inhibición del metabolismo de la CYP3A4, pero se sospecha que la CsA interfiere con el transporte de las estatinas en el organismo. Otros agentes hipolipemiantes, como los derivados del ácido fíbrico, los aceites de pescado y los que provocan el secuestro de sales biliares no interactúan con la farmacocinética de la CsA, pero existen informes que indican que tanto el probucol como el orlistat reducen la biodisponibilidad de la CsA a un nivel importante desde el punto de vista clínico.

Palabras clave
Ciclosporina A, estatinas, interacción farmacocinética, dislipidemia, colesterol


Artículo completo
(castellano)
Extensión:  +/-13.73 páginas impresas en papel A4
Exclusivo para suscriptores/assinantes

THE BILATERAL INTERACTIONS BETWEEN CYCLOSPORINE A AND LIPID-LOWERING THERAPIES

Abstract
Dyslipidemia is more frequent in solid organ transplant recipients as compared to the general population, primarily due to the treatment with immunosuppressive drugs (i.e. cyclosporine A (CsA) and steroids). Lipid-lowering drugs have become widely used in this population, especially HMG-CoA reductase inhibitors (statins). CsA as well as most statins are substrates for CYP3A4 and a bilateral pharmacokinetic interaction between these drugs may occur. However, results from several studies show that statins do not induce clinically relevant increase in systemic exposure of CsA. On the other hand CsA treatment leads to several-fold higher systemic exposure of all statins. The mechanism for this interaction is not likely to be due to inhibition of CYP3A4 metabolism, but CsA is rather believed to interfere with statin-transport in the body. Other lipid-lowering drugs, such as fibric acid derivates, bile acid sequestrants and fish oils do not interact with CsA pharmacokinetics, but there are reports indicating that both probucol and orlistat reduce CsA bioavailability to a clinically relevant extent.

Key words
Cyclosporine A, statins, pharmacokinetic interaction, dyslipidemia, cholesterol


Full text
(english)
 para suscriptores/ assinantes
Clasificación en siicsalud
Artículos originales > Expertos del Mundo >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Farmacología, Trasplantes
Relacionadas: Cardiología, Diagnóstico por Laboratorio, Inmunología, Medicina Farmacéutica, Medicina Interna



Comprar este artículo
Extensión: 13.73 páginas impresas en papel A4

file05.gif (1491 bytes) Artículos seleccionados para su compra



Bibliografía del artículo
  1. Ojo AO, Hanson JA, Wolfe RA, Leichtman AB, Agodoa LY, Port FK. Long-term survival in renal transplant recipients with graft function. Kidney Int 2000; 57:307-313.
  2. Wierzbicki AS. The role of lipid lowering in transplantation. Int J Clin Pract 1999; 53:54-59.
  3. Holdaas H, Fellström B, Jardine AG, Holme I, Nyberg G, Fauchald P, Grönhagen-Riska C, Madsen S, Neumayer HH, Cole E, Maes B, Ambuhl P, Olsson AG, Hartmann A, Solbu DO, Pedersen TR. Effect of fluvastatin on cardiac outcomes in renal transplant recipients: a multicentre, randomised, placebo-controlled trial. Lancet 2003; 361:2024-2031.
  4. Omar MA, Wilson JP, Cox TS. Rhabdomyolysis and HMG-CoA reductase inhibitors. Ann Pharmacother 2001; 35:1096-1107.
  5. Omar MA, Wilson JP. FDA adverse event reports on statin-associated rhabdomyolysis. Ann Pharmacother 2002; 36:288-295.
  6. Jardine A. Assessing cardiovascular risk profile of immunosuppressive agents. Transplantation 2001; 72:SS81-SS88.
  7. Åsberg A. Interactions between cyclosporin and lipid-lowering drugs: implications for organ transplant recipients. Drugs 2003; 63:367-378.
  8. Christians U, Jacobsen W, Floren LC. Metabolism and drug interactions of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors in transplant patients: are the statins mechanistically similar Pharmacol Ther 1998; 80:1-34.
  9. Prueksaritanont T, Gorham LM, Ma B, Liu L, Yu X, Zhao JJ, Slaughter DE, Arison BH, Vyas KP. In vitro metabolism of simvastatin in humans [SBT]identification of metabolizing enzymes and effect of the drug on hepatic P450s. Drug Metab Dispos 1997; 25:1191-1199.
  10. Malinowski JM. Atorvastatin: a hydroxymethylglutaryl-coenzyme A reductase inhibitor. Am J Health Syst Pharm 1998; 55:2253-2267; quiz 2302-2253.
  11. Mück W. Rational assessment of the interaction profile of cerivastatin supports its low propensity for drug interactions. Drugs 1998; 56:15-23.
  12. Jacobsen W, Kirchner G, Hallensleben K, Mancinelli L, Deters M, Hackbarth I, Benet LZ, Sewing KF, Christians U. Comparison of cytochrome P-450-dependent metabolism and drug interactions of the 3-hydroxy-3-methylglutaryl-CoA reductase inhibitors lovastatin and pravastatin in the liver. Drug Metab Dispos 1999; 27:173-179.
  13. Jacobsen W, Kirchner G, Hallensleben K, Mancinelli L, Deters M, Hackbarth I, Baner K, Benet LZ, Sewing KF, Christians U. Small intestinal metabolism of the 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitor lovastatin and comparison with pravastatin. J Pharmacol Exp Ther 1999; 291:131-139.
  14. Singhvi SM, Pan HY, Morrison RA, Willard DA. Disposition of pravastatin sodium, a tissue-selective HMG-CoA reductase inhibitor, in healthy subjects. Br J Clin Pharmacol 1990; 29:239-243.
  15. Fischer V, Johanson L, Heitz F, Tullman R, Graham E, Baldeck JP, Robinson WT. The 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor fluvastatin: effect on human cytochrome P-450 and implications for metabolic drug interactions. Drug Metab Dispos 1999; 27:410-416.
  16. Scripture CD, Pieper JA. Clinical pharmacokinetics of fluvastatin. Clin Pharmacokinet 2001; 40:263-281.
  17. Zhang Y, Benet LZ. The gut as a barrier to drug absorption: combined role of cytochrome P450 3A and P-glycoprotein. Clin Pharmacokinet 2001; 40:159-168.
  18. Bramow S, Ott P, Thomsen Nielsen F, Bangert K, Tygstrup N, Dalhoff K. Cholestasis and regulation of genes related to drug metabolism and biliary transport in rat liver following treatment with cyclosporine A and sirolimus (Rapamycin). Pharmacol Toxicol 2001; 89:133-139.
  19. Lemahieu WP, Maes BD, Verbeke K, Vanrenterghem Y. CYP3A4 and P-glycoprotein activity in healthy controls and transplant patients on cyclosporin vs. tacrolimus vs. sirolimus. Am J Transplant 2004; 4:1514-1522.
  20. Akhlaghi F, McLachlan AJ, Keogh AM, Brown KF. Effect of simvastatin on cyclosporine unbound fraction and apparent blood clearance in heart transplant recipients. Br J Clin Pharmacol 1997; 44:537-542.
  21. Garcia-Saiz M, Lopez-Gil A, Alfonso I, Boada JN, Armijo JA. Factors influencing cyclosporine blood concentration-dose ratio. Ann Pharmacother 2002; 36:193-199.
  22. Demetriou D, Shabpar A, Bohmig G, Schmaldienst S, Horl WH, Watschinger B. Beneficial effects of atorvastatin in the treatment of hyperlipidemia after renal transplantation. Wien Klin Wochenschr 2000; 112:358-361.
  23. Renders L, Mayer-Kadner I, Koch C, Schärffe S, Burkhardt K, Veelken R, Schmieder RE, Hauser IA. Efficacy and drug interactions of the new HMG-CoA reductase inhibitors cerivastatin and atorvastatin in CsA-treated renal transplant recipients. Nephrol Dial Transplant 2001; 16:141-146.
  24. Taylor PJ, Kubler PA, Lynch SV, Allen J, Butler M, Pillans PI. Effect of atorvastatin on cyclosporine pharmacokinetics in liver transplant recipients. Ann Pharmacother 2004; 38:205-208.
  25. Åsberg A, Hartmann A, Fjeldså E, Bergan S, Holdaas H. Bilateral pharmacokinetic interaction between cyclosporine A and atorvastatin in renal transplant recipients. Am J Transplant 2001; 1:382-386.
  26. Hermann M, Asberg A, Christensen H, Holdaas H, Hartmann A, Reubsaet JL. Substantially elevated levels of atorvastatin and metabolites in cyclosporine-treated renal transplant recipients. Clin Pharmacol Ther 2004; 76:388-391.
  27. Mück W, Mai I, Fritsche L, Ochmann K, Rohde G, Unger S, Johne A, Bauer S, Budde K, Roots I, Neumayer HH, Kuhlmann J. Increase in cerivastatin systemic exposure after single and multiple dosing in cyclosporine-treated kidney transplant recipients. Clin Pharmacol Ther 1999; 65:251-261.
  28. Renders L, Czock D, Schocklmann H, Kunzendorf U. Determination of the pharmacokinetics of cerivastatin when administered in combination with sirolimus and cyclosporin A in patients with kidney transplant, and review of the relevant literature. Int J Clin Pharmacol Ther 2003; 41:499-503.
  29. Schrama YC, Hene RJ, de Jonge N, Joles JA, Van Rijn HJ, Bar DR, Ververs TF, Van Tol A, Koomans HA. Efficacy and muscle safety of fluvastatin in cyclosporine-treated cardiac and renal transplant recipients: an exercise provocation test. Transplantation 1998; 66:1175-1181.
  30. Holdaas H, Hartmann A, Stenstrøm J, Dahl KJ, Borge M, Pfister P. Effect of fluvastatin for safely lowering atherogenic lipids in renal transplant patients receiving cyclosporine. Am J Cardiol 1995; 76:102A-106A.
  31. Martinez-Castelao A, Grinyo JM, Fiol C, Castineiras MJ, Hurtado I, Gil-Vernet S, Seron D, Porta I, Minarro A, Villarroya A, Alsina J. Fluvastatin and low-density lipoprotein oxidation in hypercholesterolemic renal transplant patients. Kidney Int Suppl 1999; 71:S231-234.
  32. Li PK, Mak TW, Wang AY, Lee YT, Leung CB, Lui SF, Lam CW, Lai KN. The interaction of fluvastatin and cyclosporin A in renal transplant patients. Int J Clin Pharmacol Ther 1995; 33:246-248.
  33. Hadjigavriel M, Kyriakides G. Fluvastatin in renal transplantation. Transplant Proc 1997; 29:3050.
  34. Goldberg R, Roth D. Evaluation of fluvastatin in the treatment of hypercholesterolemia in renal transplant recipients taking cyclosporine. Transplantation 1996; 62:1559-1564.
  35. Park JW, Siekmeier R, Lattke P, Merz M, Mix C, Schuler S, Jaross W. Pharmacokinetics and pharmacodynamics of fluvastatin in heart transplant recipients taking cyclosporine A. J Cardiovasc Pharmacol Ther 2001; 6:351-361.
  36. Gullestad L, Nordal KP, Berg KJ, Cheng H, Schwartz MS, Simonsen S. Interaction between lovastatin and cyclosporine A after heart and kidney transplantation. Transplant Proc 1999; 31:2163-2165.
  37. Olbricht C, Wanner C, Eisenhauer T, Kliem V, Doll R, Boddaert M, O'Grady P, Krekler M, Mangold B, Christians U. Accumulation of lovastatin, but not pravastatin, in the blood of cyclosporine-treated kidney graft patients after multiple doses. Clin Pharmacol Ther 1997; 62:311-321.
  38. Traindl O, Reading S, Franz M, Falger S, Klauser R, Gisinger J, Widhalm K, Kovarik J. Low-dose lovastatin in hyperlipidemic kidney graft recipients with cyclosporine A. Transplant Proc 1992; 24:2745-2747.
  39. Fujino H, Nakai D, Nakagomi R, Saito M, Tokui T, Kojima J. Metabolic stability and uptake by human hepatocytes of pitavastatin, a new inhibitor of HMG-CoA reductase. Arzneimittelforschung 2004; 54:382-388.
  40. Regazzi MB, Iacona I, Campana C, Gavazzi A, Vigano M, Perani G. Clinical efficacy and pharmacokinetics of HMG-CoA reductase inhibitors in heart transplant patients treated with cyclosporin A. Transplant Proc 1994; 26:2644-2645.
  41. Park JW, Siekmeier R, Merz M, Krell B, Harder S, Marz W, Seidel D, Schuler S, Gross W. Pharmacokinetics of pravastatin in heart-transplant patients taking cyclosporin A. Int J Clin Pharmacol Ther 2002; 40:439-450.
  42. Hedman M, Neuvonen PJ, Neuvonen M, Holmberg C, Antikainen M. Pharmacokinetics and pharmacodynamics of pravastatin in pediatric and adolescent cardiac transplant recipients on a regimen of triple immunosuppression. Clin Pharmacol Ther 2004; 75:101-109.
  43. Simonson SG, Raza A, Martin PD, Mitchell PD, Jarcho JA, Brown CD, Windass AS, Schneck DW. Rosuvastatin pharmacokinetics in heart transplant recipients administered an antirejection regimen including cyclosporine. Clin Pharmacol Ther 2004; 76:167-177.
  44. Arnadottir M, Eriksson LO, Thysell H, Karkas JD. Plasma concentration profiles of simvastatin 3-hydroxy-3-methyl- glutaryl-coenzyme A reductase inhibitory activity in kidney transplant recipients with and without ciclosporin. Nephron 1993; 65:410-413.
  45. Arnadottir M, Eriksson LO, Germershausen JI, Thysell H. Low-dose simvastatin is a well-tolerated and efficacious cholesterol-lowering agent in ciclosporin-treated kidney transplant recipients: double-blind, randomized, placebo-controlled study in 40 patients. Nephron 1994; 68:57-62.
  46. Campana C, Iacona I, Regazzi MB, Gavazzi A, Perani G, Raddato V, Montemartini C, Vigano M. Efficacy and pharmacokinetics of simvastatin in heart transplant recipients. Ann Pharmacother 1995; 29:235-239.
  47. Rehman MA, al-Sulaiman MH, Mousa DH, al-Hawas FA, Abdalla AH, Rassoul Z, al-Khader AA. Effects of simvastatin in hyperlipidemic renal transplant patients receiving cyclosporine. Transplantation 1995; 60:397-399.
  48. Martinez Hernandez BE, Persaud JW, Varghese Z, Moorhead JF. Low-dose simvastatin is safe in hyperlipidaemic renal transplant patients. Nephrol Dial Transplant 1993; 8:637-641.
  49. Capone D, Stanziale P, Gentile A, Imperatore P, Pellegrino T, Basile V. Effects of simvastatin and pravastatin on hyperlipidemia and cyclosporin blood levels in renal transplant recipients. Am J Nephrol 1999; 19:411-415.
  50. Pflugfelder PW, Huff M, Oskalns R, Rudas L, Kostuk WJ. Cholesterol-lowering therapy after heart transplantation: a 12-month randomized trial. J Heart Lung Transplant 1995; 14:613-622.
  51. Vanhaecke J, Van Cleemput J, Van Lierde J, Daenen W, De Geest H. Safety and efficacy of low dose simvastatin in cardiac transplant recipients treated with cyclosporine. Transplantation 1994; 58:42-45.
  52. Lepre F, Rigby R, Hawley C, Saltissi D, Brown A, Walsh Z. A double-blind placebo controlled trial of simvastatin for the treatment of dyslipidaemia in renal allograft recipients. Clin Transplant 1999; 13:520-525.
  53. Hermann M, Asberg A, Christensen H, Reubsaet JL, Holdaas H, Hartmann A. Atorvastatin does not affect the pharmacokinetics of cyclosporine in renal transplant recipients. Eur J Clin Pharmacol 2005; 61:59-62.
  54. Smith PF, Eydelloth RS, Grossman SJ, Stubbs RJ, Schwartz MS, Germershausen JI, Vyas KP, Kari PH, MacDonald JS. HMG-CoA reductase inhibitor-induced myopathy in the rat: cyclosporine A interaction and mechanism studies. J Pharmacol Exp Ther 1991; 257:1225-1235.
  55. Bogman K, Peyer AK, Torok M, Kusters E, Drewe J. HMG-CoA reductase inhibitors and P-glycoprotein modulation. Br J Pharmacol 2001; 132:1183-1192.
  56. Boyd RA, Stern RH, Stewart BH, Wu X, Reyner EL, Zegarac EA, Randinitis EJ, Whitfield L. Atorvastatin coadministration may increase digoxin concentrations by inhibition of intestinal P-glycoprotein-mediated secretion. J Clin Pharmacol 2000; 40:91-98.
  57. Hsiang B, Zhu Y, Wang Z, Wu Y, Sasseville V, Yang WP, Kirchgessner TG. A novel human hepatic organic anion transporting polypeptide (OATP2). Identification of a liver-specific human organic anion transporting polypeptide and identification of rat and human hydroxymethylglutaryl-CoA reductase inhibitor transporters. J Biol Chem 1999; 274:37161-37168.
  58. Shitara Y, Itoh T, Sato H, Li AP, Sugiyama Y. Inhibition of transporter-mediated hepatic uptake as a mechanism for drug-drug interaction between cerivastatin and cyclosporin A. J Pharmacol Exp Ther 2003; 304:610-616.
  59. Shitara Y, Hirano M, Adachi Y, Itoh T, Sato H, Sugiyama Y. In vitro and in vivo correlation of the inhibitory effect of cyclosporin A on the transporter-mediated hepatic uptake of cerivastatin in rats. Drug Metab Dispos 2004; 32:1468-1475.
  60. Wu X, Whitfield LR, Stewart BH. Atorvastatin transport in the Caco-2 cell model: contributions of P-glycoprotein and the proton-monocarboxylic acid co-transporter. Pharm Res 2000; 17:209-215.
  61. Miller DB, Spence JD. Clinical pharmacokinetics of fibric acid derivatives (fibrates). Clin Pharmacokinet 1998; 34:155-162.
  62. Pisanti N, Stanziale P, Imperatore P, D'Alessandro R, De Marino V, Capone D. Lack of effect of gemfibrozil on cyclosporine blood concentrations in kidney-transplanted patients. Am J Nephrol 1998; 18:199-203.
  63. Fehrman-Ekholm I, Jogestrand T, Angelin B. Decreased cyclosporine levels during gemfibrozil treatment of hyperlipidemia after kidney transplantation. Nephron 1996; 72:483.
  64. Boissonnat P, Salen P, Guidollet J, Ferrera R, Dureau G, Ninet J, Renaud S, de Lorgeril M. The long-term effects of the lipid-lowering agent fenofibrate in hyperlipidemic heart transplant recipients. Transplantation 1994; 58:245-247.
  65. deLorgeril M, Boissonnat P, Bizollon CA, Guidollet J, Faucon G, Guichard JP, Levy-Prades-Sauron R, Renaud S, Dureau G. Pharmacokinetics of cyclosporine in hyperlipidaemic long-term survivors of heart transplantation. Lack of interaction with the lipid-lowering agent, fenofibrate. Eur J Clin Pharmacol 1992; 43:161-165.
  66. Jensen RA, Lal SM, Diaz-Arias A, James-Kracke M, Van Stone JC, Ross G, Jr. Does cholestyramine interfere with cyclosporine absorption A prospective study in renal transplant patients. Asaio J 1995; 41:M704-706.
  67. Keogh A, Day R, Critchley L, Duggin G, Baron D. The effect of food and cholestyramine on the absorption of cyclosporine in cardiac transplant recipients. Transplant Proc 1988; 20:27-30.
  68. Gallego C, Sanchez P, Planells C, Sanchez S, Monte E, Roma E, Sanchez J, Pallardo LM. Interaction between probucol and cyclosporine in renal transplant patients. Ann Pharmacother 1994; 28:940-943.
  69. Wakasugi H, Yoshimoto M, Aoki M, Osawa R, Futami T, Ono T, Muso E, Inui K. Effect of probucol on the concentration of cyclosporin A in patients with nephrotic syndrome. Nippon Jinzo Gakkai Shi 2001; 43:595-599.
  70. Sugimoto K, Sakamoto K, Fujimura A. Decrease in oral bioavailability of cyclosporin A by coadministration of probucol in rats. Life Sci 1997; 60:173-179.
  71. Sugimoto K, Sudoh T, Tsuruoka S, Yamamoto Y, Maezono S, Watanabe Y, Fujimura A. Effect of probucol on the oral bioavailability of cyclosporine A. Eur J Pharm Sci 2004; 22:71-77.
  72. Bays HE, Dujovne CA. Drugs for treatment of patients with high cholesterol blood levels and other dyslipidemias. Prog Drug Res 1994; 43:9-41.
  73. Homan van der Heide JJ, Bilo HJ, Donker JM, Wilmink JM, Tegzess AM. Effect of dietary fish oil on renal function and rejection in cyclosporine-treated recipients of renal transplants. N Engl J Med 1993; 329:769-773.
  74. Homan van der Heide JJ, Bilo HJ, Donker AJ, Wilmink JM, Sluiter WJ, Tegzess AM. Dietary supplementation with fish oil modifies renal reserve filtration capacity in postoperative, cyclosporin A-treated renal transplant recipients. Transpl Int 1990; 3:171-175.
  75. Homan van der Heide JJ, Bilo HJ, Donker AJ, Wilmink JM, Sluiter WJ, Tegzess AM. The effects of dietary supplementation with fish oil on renal function and the course of early postoperative rejection episodes in cyclosporine-treated renal transplant recipients. Transplantation 1992; 54:257-263.
  76. Kovarik JM, Mueller EA, van Bree JB, Fluckiger SS, Lange H, Schmidt B, Boesken WH, Lison AE, Kutz K. Cyclosporine pharmacokinetics and variability from a microemulsion formulation--a multicenter investigation in kidney transplant patients. Transplantation 1994; 58:658-663.
  77. Muls E, Kolanowski J, Scheen A, Van Gaal L. The effects of orlistat on weight and on serum lipids in obese patients with hypercholesterolemia: a randomized, double-blind, placebo-controlled, multicentre study. Int J Obes Relat Metab Disord 2001; 25:1713-1721.
  78. Nägele H, Petersen B, Bonacker U, Rodiger W. Effect of orlistat on blood cyclosporin concentration in an obese heart transplant patient. Eur J Clin Pharmacol 1999; 55:667-669.
  79. Le Beller C, Bezie Y, Chabatte C, Guillemain R, Amrein C, Billaud EM. Co-administration of orlistat and cyclosporine in a heart transplant recipient. Transplantation 2000; 70:1541-1542.
  80. Schnetzler B, Kondo-Oestreicher M, Vala D, Khatchatourian G, Faidutti B. Orlistat decreases the plasma level of cyclosporine and may be responsible for the development of acute rejection episodes. Transplantation 2000; 70:1540-1541.
  81. Errasti P, Garcia I, Lavilla J, Ballester B, Manrique J, Purroy A. Reduction in blood cyclosporine concentration by orlistat in two renal transplant patients. Transplant Proc 2002; 34:137-139.
  82. Barbaro D, Orsini P, Pallini S, Piazza F, Pasquini C. Obesity in transplant patients: case report showing interference of orlistat with absorption of cyclosporine and review of literature. Endocr Pract 2002; 8:124-126.
  83. Zhi J, Moore R, Kanitra L, Mulligan TE. Pharmacokinetic evaluation of the possible interaction between selected concomitant medications and orlistat at steady state in healthy subjects. J Clin Pharmacol 2002; 42:1011-1019.
  84. Lemahieu WP, Hermann M, Åsberg A, Verbeke K, Holdaas H, Vanrenterghem Y, Maes B. Combined therapy with atorvastatin and calcineurin inhbitors: No interactions with tacrolimus. Am J Transplant In press.
Título español
Resumen
 Palabras clave
 Bibliografía
 Artículo completo
(exclusivo a suscriptores)
 Autoevaluación
  Tema principal en SIIC Data Bases
 Especialidades

 English title
 Abstract
 Key words
Full text
(exclusivo a suscriptores)

Autor 
Artículos
Correspondencia

Patrocinio y reconocimiento
Imprimir esta página
 
 
 
 
 
 
 
 
 
 
 
 
Está expresamente prohibida la redistribución y la redifusión de todo o parte de los contenidos de la Sociedad Iberoamericana de Información Científica (SIIC) S.A. sin previo y expreso consentimiento de SIIC.
Artículos relacionadosMás relacionadosAtículos relacionados
MANEJO DE LÍPIDOS DESPUÉS DE UN INFARTO AGUDO DE MIOCARDIO
Cureus 15(7):1-10
Difundido en siicsalud: 22 jul 2024
ua31618
Inicio/Home

Copyright siicsalud © 1997-2024 ISSN siicsalud: 1667-9008