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eISSN: 2329-0358

Pharmacokinetic Drug–Drug Interactions Between Immunosuppressant and Anti-Infective Agents: Antimetabolites and Corticosteroids

Edward T. Van Matre, Gowri Satyanarayana, Robert L. Page 2nd, Marilyn E. Levi, JoAnn Lindenfeld, Scott W. Mueller

Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA

Ann Transplant 2018; 23:66-74

DOI: 10.12659/AOT.906164

Available online:

Published: 2018-01-23

ABSTRACT: Infections account for 15–20% of deaths in transplant recipients, requiring rapid and appropriate therapeutic interventions. Many anti-infective agents interact with immunosuppressive regimens used in transplantation, placing patients at increased risk for adverse drug reactions and prolonged hospitalizations. There is established data regarding the level of evidence and magnitude of interactions between calcineurin inhibitors and mammalian target of rapamycin inhibitors with anti-infective agents. Less is known about the interactions with anti-proliferative agents and corticosteroids, with gaps in knowledge on the appropriate management of these interactions. The objective of this review was to highlight the pharmacokinetic drug–drug interactions between antimetabolites and corticosteroids with commonly used anti-infective agents.

Keywords: Anti-Infective Agents, Antimetabolites, Drug Interactions, corticosteroids