Coadministration of Tacrolimus and Mycophenolate Mofetil in Stable Kidney Transplant Patients: Pharmacokinetics and Tolerability
作者:John Pirsch、Ihor Bekersky、Flavio Vincenti、Garry Boswell、E. Steve Woodle、Ala Alak、Margaret Kruelle、Nancy Fass、David Facklam、Qais Mekki
DOI:10.1177/00912700022009143
日期:2000.5
The tolerance and pharmacokinetics (PK) of tacrolimus (T) by the addition of mycophenolate mofetil (MMF) in stable kidney transplant patients (6/group) on long-term tacrolimus-based therapy were investigated. Patients received combination T and MMF therapy at three MMF doses: 1, 1.5, and 2 g/day administered twice daily. A 12-hour blood PK profile for T was obtained prior to MMF dosing; concomitant 12-hour profiles for T, mycophenolic acid (MPA), and mycophenolic acid glucuronide (MPAG) were obtained after 2 weeks of administration. Tolerance was monitored through 3 months. The intra- and intergroup PK of T were variable. The mean AUC0–12 of T for each group was increased after 2 weeks of concomitant MMF administration, but the increase was not statistically significant. Both drugs were well tolerated. Gastrointestinal events were of interest as such have been attributed to both T and MMF. Events reported were diarrhea, nausea, dyspepsia, and vomiting. Other common adverse events were headache, hypomagnesemia, and tremors. Most were mild, although a few were considered to be moderate. There was no apparent relationship between the incidence of any adverse event and MMF treatment group. In the present study, the coadministration of T and MMF did not significantly alter T pharmacokinetics.
研究了长期接受他克莫司治疗的稳定肾移植患者(6 人/组)在他克莫司(T)基础上添加霉酚酸酯(MMF)的耐受性和药代动力学(PK)。患者在三种 MMF 剂量下接受 T 和 MMF 联合疗法:每天 1 克、1.5 克和 2 克,每天给药两次。在 MMF 给药前检测 T 的 12 小时血液 PK 曲线;给药 2 周后检测 T、霉酚酸 (MPA) 和霉酚酸葡萄糖醛酸苷 (MPAG) 的同时 12 小时曲线。对耐受性的监测持续了 3 个月。T的组内和组间PK各不相同。同时服用 MMF 2 周后,各组 T 的平均 AUC0-12 均有所增加,但增加幅度无统计学意义。两种药物的耐受性均良好。由于 T 和 MMF 均可引起胃肠道事件,因此胃肠道事件值得关注。报告的事件有腹泻、恶心、消化不良和呕吐。其他常见的不良反应有头痛、低镁血症和震颤。大多数不良反应是轻微的,但也有少数被认为是中度的。任何不良反应的发生率与 MMF 治疗组之间均无明显关系。在本研究中,同时服用 T 和 MMF 不会显著改变 T 的药代动力学。