Paxlovid (Nirmatrelvir/Ritonavir)-Induced Tacrolimus Toxicity in Organ Transplant Recipients - A Review on Drug Interactions Involving CYP3A Enzymes.

IF 1.1 Q4 PHARMACOLOGY & PHARMACY
Naina Mohamed Pakkir Maideen, Sulthan Al Rashid
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引用次数: 0

Abstract

Paxlovid (nirmatrelvir/ritonavir) is the first oral therapy approved by the US FDA to treat patients with mild-to-moderate COVID-19. Our current review focuses on clinical data related to tacrolimus toxicity induced by Paxlovid currently available. A number of online databases, including LitCovid, Scopus, Web of Science, Embase, EBSCO host, Google Scholar, Science Direct, and the reference lists were searched to identify articles related to Paxlovid-induced tacrolimus toxicity, using keywords, like drug interactions, Paxlovid, ritonavir, nirmatrelvir, tacrolimus, pharmacokinetic interactions, and CYP3A. Tacrolimus is a substrate of CYP3A enzymes and ritonavir of Paxlovid has been identified as a potent inhibitor of CYP3A enzymes. Hence, Paxlovid can inhibit the CYP3A-mediated metabolism of tacrolimus, resulting in elevated plasma concentrations of tacrolimus and toxicity. A number of case reports and case series have been published to highlight the association of Paxlovid and tacrolimus toxicity in transplant recipients with COVID-19 infection. Various recommendations have been proposed to prevent and mitigate the adverse events related to the DDI of Paxlovid and tacrolimus. Transplant physicians should be aware of this DDI and collaborate with clinical pharmacists on this issue.

Paxlovid(Nirmatrelvir/Ritonavir)诱发器官移植受者他克莫司中毒--涉及CYP3A酶的药物相互作用综述。
Paxlovid(nirmatrelvir/ritonavir)是美国 FDA 批准用于治疗轻度至中度 COVID-19 患者的第一种口服疗法。我们本次回顾的重点是目前可用的与 Paxlovid 引起的他克莫司毒性相关的临床数据。我们检索了多个在线数据库,包括 LitCovid、Scopus、Web of Science、Embase、EBSCO host、Google Scholar、Science Direct 和参考文献列表,使用药物相互作用、Paxlovid、利托那韦、尼尔马特韦、他克莫司、药代动力学相互作用和 CYP3A 等关键词查找与 Paxlovid 诱导的他克莫司毒性相关的文章。他克莫司是 CYP3A 酶的底物,而 Paxlovid 中的利托那韦已被确认为 CYP3A 酶的强效抑制剂。因此,Paxlovid 可抑制 CYP3A 介导的他克莫司代谢,导致他克莫司血浆浓度升高和毒性。已发表的一些病例报告和系列病例强调,在感染 COVID-19 的移植受者中,Paxlovid 与他克莫司毒性有关。为预防和减轻与 Paxlovid 和他克莫司 DDI 相关的不良事件,人们提出了各种建议。移植医生应了解这种 DDI,并与临床药剂师就此问题开展合作。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Current drug safety
Current drug safety PHARMACOLOGY & PHARMACY-
CiteScore
2.10
自引率
0.00%
发文量
112
期刊介绍: Current Drug Safety publishes frontier articles on all the latest advances on drug safety. The journal aims to publish the highest quality research articles, reviews and case reports in the field. Topics covered include: adverse effects of individual drugs and drug classes, management of adverse effects, pharmacovigilance and pharmacoepidemiology of new and existing drugs, post-marketing surveillance. The journal is essential reading for all researchers and clinicians involved in drug safety.
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