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Ann Pharmacother. 2014 Dec;48(12):1580-4. doi: 10.1177/1060028014550644. Epub 2014 Oct 3.

Pharmacokinetic drug-drug interaction of calcium channel blockers with cyclosporine in hematopoietic stem cell transplant children.

Author information

1
Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France.
2
Laboratoire de Biométrie et Biologie Evolutive, Université Lyon 1, Villeurbanne, France.
3
Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France Laboratoire de Biométrie et Biologie Evolutive, Université Lyon 1, Villeurbanne, France nathalie.bleyzac@chu-lyon.fr.

Abstract

BACKGROUND:

Cyclosporine (CsA) is frequently responsible for hypertension in bone marrow transplant children. Calcium channel blockers (CCBs) are considered to be the best treatment for CsA-induced hypertension, but they may alter the exposure and the effect of CsA by inhibiting the CYP3A4 pathway of CsA metabolism or P-gp. However, the inhibitory effect on CYP3A4 may vary among CCBs.

METHODS:

This study aimed to quantify the pharmacokinetic drug-drug interaction between CsA and nicardipine, amlodipine, and lacidipine. In all, 51 children who received CsA and CCB concomitantly were included.

RESULTS:

Dose-normalized CsA trough blood concentrations significantly increased in patients treated with nicardipine and amlodipine, whereas they remained stable in patients treated with lacidipine.

CONCLUSIONS:

Because lacidipine appears to have no effect on CsA exposure, it may be the best option among CCBs for treating high blood pressure caused by CsA in children.

KEYWORDS:

bone marrow transplantation; calcium-channel blockers; cyclosporine; drug interactions; pediatrics

PMID:
25280976
DOI:
10.1177/1060028014550644
[Indexed for MEDLINE]

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