Safety of posaconazole and sirolimus coadministration in allogeneic hematopoietic stem cell transplants

Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation
David W KubiakFrancisco M Marty

Abstract

Sirolimus is used in allogeneic hematopoietic stem cell transplants (HSCTs) for prevention and treatment of graft-versus-host disease (GVHD). Posaconazole is used in this population for invasive fungal disease (IFD) prophylaxis and treatment. As posaconazole strongly inhibits CYP3A4, concurrent administration of sirolimus, a CYP3A4 substrate, and posaconazole has been reported to increase sirolimus drug exposure substantially. Coadministration of posaconazole and sirolimus is contraindicated by the manufacturer of posaconazole. We identified 15 patients who underwent HSCTs at our institution receiving a steady-state dose of sirolimus who subsequently started posaconazole therapy from January 2006 to March 2009. We recorded baseline characteristics, drug administration details, and potential adverse effects related to either drug. All patients underwent HSCTs for treatment of hematologic malignancy. All patients were initially prescribed sirolimus for GVHD prophylaxis and continued therapy after developing GVHD. Twelve patients (80%) received posaconazole for IFD prophylaxis in the setting of GVHD and 3 (20%) for IFD treatment. Patients received sirolimus and posaconazole concurrently for a median of 78 days (interquartile range...Continue Reading

References

Jul 27, 2004·Bone Marrow Transplantation·C Cutler, J H Antin
Apr 23, 2005·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Corey CutlerJoseph H Antin
Apr 26, 2006·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Francisco M MartyJoseph H Antin
Jan 26, 2007·The New England Journal of Medicine·Andrew J UllmannSimon Durrant
Nov 13, 2008·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Philippe ArmandJoseph H Antin
Nov 26, 2008·Clinical Pharmacokinetics·Yasmine NivoixGenevieve Ubeaud-Sequier
Feb 7, 2009·Current Medical Research and Opinion·Allen MotonJames McLeod

❮ Previous
Next ❯

Citations

Oct 3, 2012·Antimicrobial Agents and Chemotherapy·Isabel Sánchez-OrtegaRafael F Duarte
Jan 31, 2013·Expert Opinion on Drug Safety·Pauline L Jacinto, Pranatharthi Chandrasekar
Feb 7, 2015·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·D Farmakiotis, D P Kontoyiannis
Dec 26, 2012·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Rakesh K GoyalRaman Venkataramanan
Nov 28, 2018·Expert Opinion on Drug Metabolism & Toxicology·Ana PejčićMiloš Milosavljević
Oct 9, 2018·Transplant Infectious Disease : an Official Journal of the Transplantation Society·Van KieuDoreen Pon
Jul 20, 2017·Transplant Infectious Disease : an Official Journal of the Transplantation Society·Andreas H GrollRoger J M Brüggemann
Mar 12, 2019·Journal of Oncology Pharmacy Practice : Official Publication of the International Society of Oncology Pharmacy Practitioners·Jennifer CollinsPauline Lee

❮ Previous
Next ❯

Related Concepts

Related Feeds

Blood And Marrow Transplantation

The use of hematopoietic stem cell transplantation or blood and marrow transplantation (bmt) is on the increase worldwide. BMT is used to replace damaged or destroyed bone marrow with healthy bone marrow stem cells. Here is the latest research on bone and marrow transplantation.

Allogenic & Autologous Therapies

Allogenic therapies are generated in large batches from unrelated donor tissues such as bone marrow. In contrast, autologous therapies are manufactures as a single lot from the patient being treated. Here is the latest research on allogenic and autologous therapies.

Aspergillosis

Aspergillosis is the name given to a wide variety of diseases caused by infection by fungi of the genus Aspergillus. Aspergillosis occurs in chronic or acute forms which are clinically very distinct. Most cases of acute aspergillosis occur in patients with severely compromised immune systems. Chronic colonization or infection can cause complications in people with underlying respiratory illnesses. Discover the latest research on aspergillosis here.

Aspergillosis (ASM)

Aspergillosis is the name given to a wide variety of diseases caused by infection by fungi of the genus Aspergillus. Aspergillosis occurs in chronic or acute forms which are clinically very distinct. Most cases of acute aspergillosis occur in patients with severely compromised immune systems. Chronic colonization or infection can cause complications in people with underlying respiratory illnesses. Discover the latest research on aspergillosis here.

Related Papers

Current Medical Research and Opinion
Allen MotonJames McLeod
Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation
Francisco M MartyJoseph H Antin
© 2021 Meta ULC. All rights reserved