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Drug-drug interaction between tacrolimus and caspofungin in Chinese kidney transplant patients with different CYP3A5 genotypes

  • 0Department of Clinical Pharmacy, Shandong Provincial Qianfoshan Hospital, Shandong University of Traditional Chinese Medicine, Shandong Medicine and Health Key Laboratory of Clinical Pharmacy, Jinan, China.
Therapeutic Advances in Drug Safety +

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April 22, 2024

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April 22, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Caspofungin reduces tacrolimus levels in kidney transplant patients with CYP3A5 non-expresser genotypes. This drug interaction necessitates an approximate 10% increase in tacrolimus daily dose for CYP3A5 non-expressers to maintain therapeutic efficacy.

Area Of Science

  • Pharmacology
  • Drug Interactions
  • Transplantation

Background

  • Drug-drug interactions between tacrolimus and caspofungin are not well-documented.
  • The influence of CYP3A5 genotypes on this interaction requires further investigation.

Purpose Of The Study

  • To evaluate the impact of caspofungin on tacrolimus pharmacokinetics.
  • To analyze this effect across different CYP3A5 genotypes in kidney transplant recipients.

Main Methods

  • Retrospective cohort study of 200 kidney transplant patients (2015-2022).
  • Patients categorized into caspofungin combination or non-combination groups.
  • Subgroup analysis based on CYP3A5 expresser and non-expresser genotypes.
  • Propensity score matching and statistical analysis of tacrolimus dose-corrected trough concentrations (C0/D).

Main Results

  • No significant difference in tacrolimus C0/D between combination and non-combination groups overall (p=0.054).
  • In CYP3A5 expressers, no significant differences in C0/D or dose (p>0.05).
  • In CYP3A5 non-expressers, tacrolimus C0/D was significantly lower with caspofungin (p=0.039), requiring an 11.11% higher daily dose.

Conclusions

  • Caspofungin co-administration can decrease tacrolimus blood levels and increase required dosage.
  • The interaction significantly affects tacrolimus C0/D in CYP3A5 non-expressers.
  • A ~10% increase in weight-adjusted daily tacrolimus dose is recommended for CYP3A5 non-expressers during caspofungin treatment.

Keywords:

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