Resumen de Interaction betwen tacrolimus and dronedarone in a kidney transplantation recipient
Carmen García Muñoz, Irene Cañamares Orbis, Mª Jesús Jiménez Cerezo, José Miguel Ferrari Piquero
A 52-year-old woman, kidney transplant recipient, was admitted to hospital because she presented deterioration in renal function with an increased value of serum creatinine (crs), tacrolimus overdosing and signs of volume overload.
One week before she was introduced treatment with dronedarone 400 mg/12 h. We suspected overdosing of tacrolimus could be due to its interaction with dronedarone (cYP3a4 inhibitor) and dronedarone was discontinued. by applying the Horn Drug interaction Probability scale, we concluded that an interaction between tacrolimus and dronedarone in this patient was probable. The following days, was observed a decrease in crs value, and tacrolimus through concentration was stabilize within therapeutic range, with the consequents dose adjustments.
Conclusion: Concurrent use of dronedarone and tacrolimus should be avoided when possible. if not, we suggest a preemptive dose reduction of tacrolimus prior to dronedarone initiation and frequent monitoring of tacrolimus concentration
