Abstract
What is known and objective: Treatment of tacrolimus toxicity includes holding tacrolimus and supportive care. The objective is to describe considerations for pharmacologic induction of tacrolimus metabolism. Case description: A 52-year-old male with a failed renal transplant on chronic haemodialysis developed tacrolimus toxicity due to a drug-drug interaction with darunavir/ritonavir. Tacrolimus concentrations were >60 ng/mL for 10 days despite holding tacrolimus and darunavir/ritonavir. Development of encephalopathy prompted initiation of phenytoin to induce tacrolimus metabolism. Tacrolimus concentration was <2 ng/mL within 4 days and mental status normalized. What is new and conclusion: Phenytoin metabolic induction is a therapeutic option for prolonged tacrolimus toxicity.
| Original language | English |
|---|---|
| Pages (from-to) | 640-643 |
| Number of pages | 4 |
| Journal | Journal of Clinical Pharmacy and Therapeutics |
| Volume | 44 |
| Issue number | 4 |
| DOIs | |
| State | Published - Aug 2019 |
Keywords
- haemodialysis
- phenytoin
- tacrolimus
- toxicity
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