An Experimental Study: Multivitamins Cause Low Tacrolimus Levels, Paracetamol and Trimethoprim Sulfamethoxazole Cause Low Cyclosporine Levels

Authors : Kenan Demirbakan, Ataman Gönel

Pages : 503-508

Doi:10.32708/uutfd.1730208

View : 38 | Download : 467

Publication Date : 2025-12-08

Article Type : Research Paper

Abstract :Unlike drug-drug interactions, drug-kit interactions are a situation that many physicians overlook. The efficacy and safety of drugs such as tacrolimus and cyclosporine, which are used throughout life due to their immunosuppressive effects after transplantation, largely depend on plasma concentrations, and dose adjustment is of critical importance. Interactions with other drugs used in the post-transplant period can change the tacrolimus and cyclosporine measurement results and lead to incorrect dose adjustments in treatment. In the study, 16 different drug solutions were used to examine the effects of various drugs on the measurement results of tacrolimus and cyclosporine. The prepared samples were studied in the biochemistry analyzer. All measurements were repeated 20 times, and their average values were taken. The bias (%) formula was used to calculate the extent to which the obtained results deviated from the target value. In tacrolimus measurements, the interference caused by drugs other than paracetamol was significantly detected (p<0.001). Multivitamin was the drug that caused the most deviation. The highest deviation in cyclosporine concentration was with trimethoprim, sulfamethoxazole, and paracetamol. Cyclosporine was found to be subject to more measurement error than tacrolimus in the presence of other drugs. Close monitoring of patients and blood drug levels is critical to increasing the safety of treatment. It is essential for clinicians to be more aware of immunoassay methods when evaluating test results and to consider current literature when assessing laboratory results of drugs that have been shown to interact in studies.
Keywords : Organ nakli, immunsüpresif ilaçlar, ilaç-ilaç etkileşimi

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