BC Transplant Drug Interaction Joint Alert Vol 39 No 2 - Fall 2014 | Nov. 3, 2014

This is a joint alert that was drafted with the College of Pharmacists of BC and the College of Physicians and Surgeons of BC.

When filling prescriptions for ANY type of medication for a transplant recipient currently taking tacrolimus, cyclosporine or sirolimus, please be aware of the very high risk of clinically significant adverse drug-drug  interactions which can be life threatening. DO NOT override any pharmacy prescription software drug interaction alerts for transplant recipients. ALWAYS review the patient’s full drug profile on Pharmanet before dispensing medications for a transplant recipient. If the prescription is not from a Transplant Clinic or written by a Transplant Physician and you have any questions, please call the patient’s Transplant Clinic for advice (see table below). If the Transplant Clinic is closed call the partner BC Transplant  Pharmacy  that dispensed the patient’s transplant medications for advice.

Immunosuppressants required for solid organ transplant recipients (tacrolimus, cyclosporine, and sirolimus) have a narrow therapeutic index. When combined with medications for the treatment of comorbidities such as dyslipidemia, infection, psychiatric conditions, and hypertension, they can lead to life-threatening drug-drug interactions. Biaxin in combination with tacrolimus or cyclosporine can result in CNS toxicity, nephrotoxicity as well as loss of the organ.