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Chinese Journal of Antituberculosis ›› 2018, Vol. 40 ›› Issue (9): 1007-1011.doi: 10.3969/j.issn.1000-6621.2018.09.020

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Dose adjustment of Immunosuppressants in anti-tuberculosis regimen containing rifampins (Report of three cases)

Tao JIN()   

  1. Department of Nephrology, Shenyang Chest Hospital, Shenyang Tenth People’s Hospital, Shenyang 110044, China
  • Received:2018-05-13 Online:2018-09-10 Published:2018-10-17
  • Contact: Tao JIN E-mail:sysxkyysnk@163.com

Abstract:

Patients who use immunosuppressants are more likely to be infected with tuberculosis than the general population. Rifampin can accelerate the metabolism of immunosuppressive agents (especially calcium phosphatase inhibitors and glucocorticoids) and decrease the serum concentration of immunosuppressants. This will course the aggravation or recurrence of the primary disease in some patients. It is suggested that the dosage of tacrolimus or ciclosporin should be adjusted to 1.5-3 times and glucocorticoid to 2 times of the original dose for keeping the effective blood concentration when the rifampicin(or rifapentine) be used for anti-tuberculosis treatment. Furthermore, the medicines mentioned above have to be adjusted to the initial measurement after going off rifampin (or rifapentine). Wuzhi tablet or wuzhi capsule as an adjuvant drug for anti-tuberculosis treatment, not only has an effect of protecting liver and ensure the efficacy and safety of standard treatment regimens including rifampicin, but also keep the plasma concentration of calcium phosphatase inhibitor and reduce the dose of immunosuppressant. Wuzhi tablet or wuzhi capsule has good economic efficiency..

Key words: Tuberculosis, Rifampin, Immunosuppressive agents, Dose-response relationship, drug, Drug interactions