{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T03:34:44Z","timestamp":1791689684601,"version":"4.3.4"},"reference-count":58,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T00:00:00Z","timestamp":1636416000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["bpspubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacology Res &amp; Perspec"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The main objective was to determine the prevalence of real drug\u2013drug interactions (DDIs) of immunosuppressants in transplant patients. We conducted a prospective, observational 1\u2010year study at a tertiary hospital, including all transplanted patients. We evaluated data from monitoring blood concentrations of immunosuppressive drugs and adverse drug events (ADEs) caused by DDIs. The DDIs were classified as C, D, or X according to their Lexi\u2010Interact rating (C\u00a0=\u00a0monitor therapy, D\u00a0=\u00a0consider therapy modification, X\u00a0=\u00a0avoid combination). The clinical importance of real DDIs was expressed in terms of patient outcomes. The causality of DDIs was determined using Drug Interaction Probability Scale. The data were analyzed using Statistical Package for Social Sciences v. 25.0. A total of 309 transplant patients were included. Their mean age was 52.0\u00a0\u00b1\u00a014.7 years (18\u201379) and 69.9% were male. The prevalence of real DDIs was 21.7%. Immunosuppressive drugs administered with antifungal azoles and tacrolimus (TAC) with nifedipine have a great clinical impact. Real DDIs caused ADEs in 22 patients. The most common clinical outcome was nephrotoxicity (1.6%; <jats:italic>n<\/jats:italic>\u00a0=\u00a05), followed by hypertension (1.3%; <jats:italic>n<\/jats:italic>\u00a0=\u00a04). Suggestions for avoiding category D and X DDIs included: changing the immunosuppressant dosage, using paracetamol instead of non\u2010steroidal anti\u2010inflammatory drugs, and interrupting atorvastatin. The number of drugs prescribed and having been prescribed TAC was associated with an increased risk of real DDIs. There are many potential DDIs described in the literature but only a small percentage proved to be real DDIs, based on the patients\u00b4 outcomes.<\/jats:p>","DOI":"10.1002\/prp2.892","type":"journal-article","created":{"date-parts":[[2021,11,10]],"date-time":"2021-11-10T09:50:59Z","timestamp":1636537859000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Real clinical impact of drug\u2013drug interactions of immunosuppressants in transplant patients"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5674-045X","authenticated-orcid":false,"given":"Ana Isabel","family":"Gago\u2010S\u00e1nchez","sequence":"first","affiliation":[{"name":"Pharmacy Department Hospital Universitario Reina Sof\u00eda\/Instituto Maim\u00f3nides de Investigaci\u00f3n Biom\u00e9dica de C\u00f3rdoba (IMIBIC)\/University of C\u00f3rdoba C\u00f3rdoba Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pilar","family":"Font","sequence":"additional","affiliation":[{"name":"Rheumatology Department Hospital Universitario Reina Sof\u00eda\/Instituto Maim\u00f3nides de Investigaci\u00f3n Biom\u00e9dica de C\u00f3rdoba (IMIBIC)\/University of C\u00f3rdoba C\u00f3rdoba Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"C\u00e1rdenas","sequence":"additional","affiliation":[{"name":"Pharmacy Department Hospital Universitario Reina Sof\u00eda\/Instituto Maim\u00f3nides de Investigaci\u00f3n Biom\u00e9dica de C\u00f3rdoba (IMIBIC)\/University of C\u00f3rdoba C\u00f3rdoba Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Dolores","family":"Aumente","sequence":"additional","affiliation":[{"name":"Pharmacy Department Hospital Universitario Reina Sof\u00eda\/Instituto Maim\u00f3nides de Investigaci\u00f3n Biom\u00e9dica de C\u00f3rdoba (IMIBIC)\/University of C\u00f3rdoba C\u00f3rdoba Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Ram\u00f3n","family":"Del Prado","sequence":"additional","affiliation":[{"name":"Pharmacy Department Hospital Universitario Reina Sof\u00eda\/Instituto Maim\u00f3nides de Investigaci\u00f3n Biom\u00e9dica de C\u00f3rdoba (IMIBIC)\/University of C\u00f3rdoba C\u00f3rdoba Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel \u00c1ngel","family":"Calleja","sequence":"additional","affiliation":[{"name":"Pharmacy Department Hospital Universitario Virgen Macarena Sevilla Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,11,9]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mcna.2015.05.002"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/CNQ.0000000000000117"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-015-0322-7"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/MNH.0b013e32832edcb2"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11096-017-0520-9"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/17425255.2019.1552256"},{"issue":"3","key":"e_1_2_12_8_1","first-page":"11","article-title":"Influence of interactions between immunosuppressive drugs on therapeutic drug monitoring","volume":"13","author":"Kuypers DR","year":"2008","journal-title":"Ann Transplant"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2010.09.001"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13510"},{"issue":"2","key":"e_1_2_12_11_1","first-page":"161","article-title":"Prevalence of potential drug\u2010drug interactions in bone marrow transplant patients","volume":"15","author":"Guastaldi RB","year":"2011","journal-title":"Int J Clin Pharm"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00280-014-2657-8"},{"issue":"5","key":"e_1_2_12_13_1","first-page":"344","article-title":"Drug interactions in liver transplant patients","volume":"15","author":"Andr\u00e9s Gonz\u00e1lez C","year":"2013","journal-title":"Eur J Clin Pharm"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11096-017-0525-4"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmedinf.2017.08.008"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1130-6343(07)75719-7"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.281053"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0190882"},{"key":"e_1_2_12_19_1","unstructured":"Wolters Kluwer.Lexicomp. Database. Available at:https:\/\/www.wolterskluwercdi.com\/lexicomp\u2010online\/. Accessed January 07 2021."},{"key":"e_1_2_12_20_1","unstructured":"IBM.IBM Micromedex with Watson. Database. Available at:https:\/\/www.IBM.com\/products\/micromedex\u2010with\u2010watson. Accessed January 07 2021."},{"key":"e_1_2_12_21_1","unstructured":"Medscape.Drug interaction checker. Available at:https:\/\/reference.medscape.com\/drug\u2010interactionchecker. Accessed January 07 2021."},{"key":"e_1_2_12_22_1","unstructured":"General Council of Official Associations of Pharmacists (Spain).Pharmaceutical knowledge database BOT PLUS. Available at:https:\/\/www.portalfarma.com. Accessed January 07 2021."},{"key":"e_1_2_12_23_1","unstructured":"CIMA.Online Drug Information Center of the Spanish Agency for Medicines and Health Products (AEMPS). Available at:https:\/\/cima.aemps.es\/cima\/publico\/home.htmlAccessed January 07 2021."},{"key":"e_1_2_12_24_1","volume-title":"Drug interaction facts","author":"Tatro DS","year":"2014"},{"key":"e_1_2_12_25_1","volume-title":"Interacciones farmacol\u00f3gicas","author":"Stockley","year":"2007"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1H423"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1159\/000339789"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc14-S081"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy339"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(02)02030-2"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-017-2357-5"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.3592"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0235353"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0104-11692011000400015"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2011.11.029"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1592\/phco.30.8.842"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1592\/phco.26.12.1730"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.14232"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.coph.2015.07.002"},{"key":"e_1_2_12_40_1","unstructured":"Vfend (voriconazole).Online Drug Information Center of the Spanish Agency for. Medicines and Health Products (AEMPS). Available at:https:\/\/cima.aemps.es\/cima\/pdfs\/es\/ft\/79141\/FichaTecnica_79141.html.pdf. Accessed January 07 2021."},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.12751"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1248\/bpb.29.2528"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2009.345"},{"issue":"2","key":"e_1_2_12_44_1","first-page":"S73","article-title":"Pharmacokinetic study of the combination of tacrolimus and fluconazole in renal transplant patients","volume":"89","author":"Lumlertgul D","year":"2006","journal-title":"J Med Assoc Thai"},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2021.692922"},{"issue":"2","key":"e_1_2_12_46_1","first-page":"156","article-title":"A study of the interaction between omeprazole and cyclosporine in renal transplant patients","volume":"35","author":"Blohm\u00e9 I","year":"1993","journal-title":"Br J Clin Pharmacol"},{"key":"e_1_2_12_47_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpt.12508"},{"key":"e_1_2_12_48_1","doi-asserted-by":"publisher","DOI":"10.1093\/jamia\/ocx010"},{"key":"e_1_2_12_49_1","doi-asserted-by":"publisher","DOI":"10.18553\/jmcp.2020.26.10.1291"},{"key":"e_1_2_12_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1130-6343(09)71155-9"},{"issue":"4","key":"e_1_2_12_51_1","first-page":"257","article-title":"Incidence of potential drug interactions in a transplant centre setting and relevance of electronic alerts for clinical practice support","volume":"20","author":"Polidori P","year":"2012","journal-title":"Inform Prim Care"},{"key":"e_1_2_12_52_1","doi-asserted-by":"publisher","DOI":"10.1177\/1078155220910209"},{"key":"e_1_2_12_53_1","first-page":"175","article-title":"Potential of drug interactions among hospitalized cancer patients in a developing country","volume":"12","author":"Tavakoli\u2010Ardakani M","year":"2013","journal-title":"Iran J Pharm Res"},{"key":"e_1_2_12_54_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-010-0866-6"},{"key":"e_1_2_12_55_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-041563"},{"key":"e_1_2_12_56_1","doi-asserted-by":"publisher","DOI":"10.18553\/jmcp.2003.9.6.513"},{"key":"e_1_2_12_57_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00432-015-2108-x"},{"key":"e_1_2_12_58_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-014-2122-0"},{"issue":"1","key":"e_1_2_12_59_1","first-page":"16","article-title":"Evaluation and management of drug\u2010drug interactions in patients hospitalized in nephrology and post\u2010transplant wards in a teaching hospital","volume":"8","author":"Shafiekhani M","year":"2020","journal-title":"J Pharm Care"}],"container-title":["Pharmacology Research &amp; Perspectives"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/prp2.892","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/prp2.892","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/bpspubs.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/prp2.892","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T09:45:13Z","timestamp":1693215913000},"score":1,"resource":{"primary":{"URL":"https:\/\/bpspubs.onlinelibrary.wiley.com\/doi\/10.1002\/prp2.892"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,9]]},"references-count":58,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["10.1002\/prp2.892"],"URL":"https:\/\/doi.org\/10.1002\/prp2.892","archive":["Portico"],"relation":{},"ISSN":["2052-1707","2052-1707"],"issn-type":[{"value":"2052-1707","type":"print"},{"value":"2052-1707","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,9]]},"assertion":[{"value":"2021-10-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-10-23","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-11-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e00892"}}