Ciclosporin/ezetimibe interaction
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Kidney allograft dysfunction: case report A 56-year-old male kidney transplant recipient developed kidney allograft dysfunction following concomitant treatment with ciclosporin and ezetimibe [routes not stated]. The man, who had a history of diabetes mellitus, was receiving maintenance immunosuppressive therapy with ciclosporin 150 mg/day, mycophenolate mofetil and prednisolone. He also had comorbid hyperlipidaemia, for which he was receiving atorvastatin and gemfibrozil. One month after ezetimibe was added to his regimen [dosage not stated], laboratory findings revealed an elevated serum creatinine level of 4.4 mg/dL and a ciclosporin trough concentration of 45 ng/mL. Evidence of acute kidney allograft rejection was seen on a renal radionuclide scan. Ezetimibe was discontinued. Following treatment with prednisolone and diltiazem, the man’s serum creatinine level decreased to 2 mg/dL and his ciclosporin trough concentration increased to 169 mg/dL. Author comment: "As we had not made any changes in the previous treatment protocol and administered doses of cyclosporine and any other medications, it is likely that ezetimibe might be a probable cause of decreased serum cyclosporine level as well as the occurrence of acute allograft rejection." Nouri-Majalan N, et al. Impaired kidney allograft function following ezetimibe therapy. Iranian Journal of Kidney Diseases 5: 133-5, No. 2, Mar 2011 803057570 Iran
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Reactions 23 Jul 2011 No. 1361
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