Tacrolimus and hypertension

Q: After organ transplantation, the patients who are on Calcium Channel Blockers (CCBs), the dose of tacrolimus should be? (select one)

A) Increased
B) Decreased


Answer: B

CCBs are one of the drugs of choice if antihypertensive treatment is needed in patients on cyclosporine or tacrolimus. This is due to the fact that one reason for development of hypertension in patients on this immuno-suppressant is renal vasoconstriction. CCBs particularly diltiazem is known to reverse this process and may have a protective effect. Said that diltiazem impairs metabolism of these drugs, so the dose of this immuno-suppressant should be decreased and managed closely by trough levels.

#pharmacology
#transplantation 


References:


Kuypers DR, Neumayer HH, Fritsche L, et al. Calcium channel blockade and preservation of renal graft function in cyclosporine-treated recipients: a prospective randomized placebo-controlled 2-year study. Transplantation 2004; 78:1204.