Posttransplantation tuberculosis management in terms of immunosuppressant cost: a case report in Myanmar

Phyo Wai Lwin; Yi Yi Htun; Aung Kyaw Myint; Htar Kyi Swe

doi:10.4285/kjt.20.0041

Posttransplantation tuberculosis management in terms of immunosuppressant cost: a case report in Myanmar

Korean J Transplant. 2021 Mar 31;35(1):48-52. doi: 10.4285/kjt.20.0041.

Authors

Phyo Wai Lwin¹, Yi Yi Htun², Aung Kyaw Myint³, Htar Kyi Swe¹

Affiliations

¹ Department of Nephrology, University of Medicine, Mandalay, Mandalay, Myanmar.
² Department of Pharmacology, University of Medicine, Mandalay, Mandalay, Myanmar.
³ Department of Nephrology, Mandalay General Hospital, Mandalay, Myanmar.

Abstract

Drug interactions between anti-tuberculosis and immunosuppressive medications after renal transplantation are a common problem in Myanmar. The efficacy of both types of drugs can be reduced during the treatment period, which can lead to graft failure and flare-ups of infection. Drug adjustments, with frequent monitoring and close follow-up, are crucial in this period. Ketoconazole decreases tacrolimus metabolism by inhibiting cytochrome P450-3A5 enzymes and P-glycoprotein. It is cost effective and has been frequently used to reduce the dose and cost of tacrolimus. Here, we report the case of a 56-year-old male renal transplant recipient with anti-tuberculosis medications.

Keywords: Drug Interaction; Immunosuppressant cost; Post renal transplant tuberculosis.

Publication types

Case Reports