Nafcillin Ciclosporin

A retrospective study found an increased risk of ciclos-porin-associated early nephrotoxicity in nafcUhn-treated patients, despite the fact that ciclosporin concentrations were not different from controls (368). Possible interference of nafcillin with ciclosporin measnrement, giving rise to falsely low concentrations, was considered as a possible explanation. 

In a study in lung transplant recipients, ciclosporin nephrotoxicity was potentiated by nafcillin (111). 

Ampicillin does not interact adversely with ciclosporin. Increased nephrotoxicity has been seen in lung transplant patients given nafcillin prophylactically, whereas an isolated report describes a fall in ciclosporin levels in a patient treated with nafcillin. A case of raised ciclosporin levels in a patient taking ticarcillin has been described. 

A kidney transplant patient taking ciclosporin and prednisone experi-eneed a marked fall in her serum ciclosporin levels on two occasions when given nafeillin 2 g every 6 hours. Trough blood levels fell from 229 to 119 nanograms/mL and then to 68 nanograms/mL after 3 and 7 days of nafcillin, respectively, and rose when the nafcillin was stopped. On the second occasion ciclosporin levels fell from 272 to 42 nanograms/mL after 9 days of treatment with nafcillin. ... 

The authors of the study using nafcillin postulate that it may have interfered with the ciclosporin assay, resulting in an underestimate of the actual levels, so that the nephrotoxicity was simply due to higher ciclosporin levels. The fall in ciclosporin levels in the individual patient taking nafcillin is not understood, nor is the rise in levels seen in the patient taking ticarcillin. ... 

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See also in sourсe #XX -- [ ]

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