The Effect of β-Blocker Use on Cyclosporine Level in Cardiac Transplant Recipients

摘要: Background β-Blockers are frequently used after cardiac transplantation for blood pressure control. There is no well-known interaction between β-blockers and cyclosporine A (CsA). However, recent reports have suggested that carvedilol, but not metoprolol, modulates P-glycoprotein (P-gp), a membrane protein regulates CsA absorption. We evaluated the effects of carvedilol metoprolol on level when initiated in transplant recipients. Methods Using our database, we identified patients who were started either or then compared their doses levels before within 2 weeks initiation β-blocker therapy. Results found 20 taking 12 carvedilol. With decreased increased 8 patients. The mean was 236 ng/ml 253 ng/ml, respectively ( p = 0.50). In an attempt to maintain therapeutic level, dose significantly adjusted (from 293 mg/day 294 mg/day; 0.92). Carvedilol Group, 10 257 ng/ml. 380 0.009). reduced by 10%, from 319 288 0.004). Conclusion Carvedilol, associated with significant increase Although do interact at cytochrome P450 system, it appears influences through its P-gp. An average reduction 10% necessary upon close follow-up essential.