{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T22:38:07Z","timestamp":1777934287240,"version":"3.51.4"},"reference-count":24,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2017,8,17]],"date-time":"2017-08-17T00:00:00Z","timestamp":1502928000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Oncol Pharm Pract"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Hematopoietic cell transplant patients are exposed to numerous classes of medications. Transplant practitioners must vigilantly monitor for drug interactions especially involving immunosuppressants. We report a hematopoietic cell transplant patient receiving sirolimus who developed supratherapeutic serum concentrations after initiating mirabegron.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>A 31-year-old, 98\u2009kg female received a second umbilical cord blood transplant four years after the first transplant for relapsed acute myeloid leukemia. Mycophenolate mofetil and sirolimus were utilized for graft versus host disease prophylaxis. The patient was receiving sirolimus 2\u2009mg daily and the serum concentration on day 26 post-transplant (day\u2009+\u200926) was within therapeutic range (6.7\u2009\u03bcg\/L, goal range 3\u201312\u2009\u03bcg\/L). Her post-transplant course was complicated by BK viruria-associated cystitis for which she was started on mirabegron. Six days after starting the new medication (day\u2009+\u200933), the sirolimus serum concentration increased to 19.2\u2009\u03bcg\/L. Thus mirabegron was discontinued and sirolimus was held. Sirolimus was restarted once the serum concentration was within goal and subsequently stabilized with a combination of 1\u2009mg and 2\u2009mg daily for a total weekly dose of 10\u2009mg. The proposed mechanisms of interaction include: (1) sirolimus inhibition of organic anion transporting polypeptide leading to increased mirabegron in the intestinal lumen; (2) mirabegron inhibition of P-glycoprotein leading to increased absorption of sirolimus and; (3) increased sirolimus absorption leading to increased sirolimus serum concentrations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>To our knowledge, this is the first report of a potential drug interaction between sirolimus and mirabegron. Transplant specialists should be aware of this potential interaction when considering the concurrent use of these medications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1078155217726161","type":"journal-article","created":{"date-parts":[[2017,8,17]],"date-time":"2017-08-17T03:03:37Z","timestamp":1502939017000},"page":"627-631","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Sirolimus and mirabegron interaction in a hematopoietic cell transplant patient"],"prefix":"10.1177","volume":"24","author":[{"given":"Jeff A","family":"Engle","sequence":"first","affiliation":[{"name":"Department of Pharmacy, University of Minnesota Medical Center, Minneapolis, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina","family":"Fair","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, University of Minnesota Medical Center, Minneapolis, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2017,8,17]]},"reference":[{"key":"bibr1-1078155217726161","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60237-3"},{"key":"bibr2-1078155217726161","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2011.11.029"},{"key":"bibr3-1078155217726161","doi-asserted-by":"publisher","DOI":"10.1016\/S0041-1345(03)00211-2"},{"key":"bibr4-1078155217726161","doi-asserted-by":"publisher","DOI":"10.1097\/00007691-200002000-00006"},{"key":"bibr5-1078155217726161","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2015.162"},{"key":"bibr6-1078155217726161","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-015-0443-5"},{"key":"bibr7-1078155217726161","doi-asserted-by":"publisher","DOI":"10.1177\/2051415813512647"},{"key":"bibr8-1078155217726161","doi-asserted-by":"publisher","DOI":"10.1177\/1756287212457114"},{"key":"bibr9-1078155217726161","doi-asserted-by":"crossref","unstructured":"Groen-Wijnberg M, van Dijk J, Krauwinkel W, et\u00a0al. Pharmacokinetic interactions between mirabegron and metformin, warfarin, digoxin or combined oral contraceptives.\n                      Eur J Drug Metab Pharmacokinet\n                      2017; 42: 417\u2013429.","DOI":"10.1007\/s13318-016-0350-5"},{"key":"bibr10-1078155217726161","doi-asserted-by":"publisher","DOI":"10.1007\/s40261-013-0084-y"},{"key":"bibr11-1078155217726161","doi-asserted-by":"publisher","DOI":"10.1592\/phco.30.8.842"},{"key":"bibr12-1078155217726161","doi-asserted-by":"publisher","DOI":"10.1177\/1078155214539825"},{"key":"bibr13-1078155217726161","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-200140080-00002"},{"key":"bibr14-1078155217726161","doi-asserted-by":"publisher","DOI":"10.1177\/2042098616659412"},{"key":"bibr15-1078155217726161","unstructured":"Myrbetriq \u00ae [package insert]. Northbrook, IL: Astellas Pharma US, Inc., 2016."},{"key":"bibr16-1078155217726161","unstructured":"ClinicalTrials.gov.\n                      A pilot study of the effects of mirabegron on symptoms in patients with interstitial cystitis (MirabegronIC)\n                      . Bethesda, MD: National Library of Medicine (US), 2016, https:\/\/clinicaltrials.gov\/ct2\/show\/NCT02787083 (accessed 17 July 2017)."},{"key":"bibr17-1078155217726161","doi-asserted-by":"publisher","DOI":"10.1124\/dmd.111.043588"},{"key":"bibr18-1078155217726161","doi-asserted-by":"publisher","DOI":"10.3109\/00498254.2012.675095"},{"key":"bibr19-1078155217726161","doi-asserted-by":"publisher","DOI":"10.1021\/mp300582s"},{"key":"bibr20-1078155217726161","doi-asserted-by":"publisher","DOI":"10.1007\/s13318-013-0133-1"},{"key":"bibr21-1078155217726161","doi-asserted-by":"publisher","DOI":"10.3109\/00498254.2012.700140"},{"key":"bibr22-1078155217726161","doi-asserted-by":"publisher","DOI":"10.3109\/00498254.2011.573882"},{"key":"bibr23-1078155217726161","doi-asserted-by":"publisher","DOI":"10.1592\/phco.26.12.1730"},{"key":"bibr24-1078155217726161","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1H423"}],"container-title":["Journal of Oncology Pharmacy Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1078155217726161","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1078155217726161","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1078155217726161","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T02:17:36Z","timestamp":1777688256000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1078155217726161"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,8,17]]},"references-count":24,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2018,12]]}},"alternative-id":["10.1177\/1078155217726161"],"URL":"https:\/\/doi.org\/10.1177\/1078155217726161","relation":{},"ISSN":["1078-1552","1477-092X"],"issn-type":[{"value":"1078-1552","type":"print"},{"value":"1477-092X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,8,17]]}}}