Supratherapeutic Tacrolimus Concentrations With Nirmatrelvir/Ritonavir in Solid Organ Transplant Recipients Requiring Hospitalization: A Case Series Using Rifampin for Reversal
Dusten T. Rose, Saurin Gandhi, Rachael A Bedard, Kristin Mondy, Alexander L. Chu, Kelly C. Gamble, Amanda T Gee, Monica A. Kundra, Amber L. Williams, Brian K. Lee
Abstract
Nirmatrelvir/ritonavir was recently granted emergency use authorization for mild to moderate coronavirus disease 2019. Drug-drug interactions between ritonavir and tacrolimus are underappreciated by nontransplant providers. We describe 2 solid organ transplant recipients prescribed nirmatrelvir/ritonavir for outpatient use who developed tacrolimus toxicity requiring hospitalization and were managed with rifampin for toxicity reversal.
Topics & Concepts
MedicineTacrolimusRitonavirSeries (stratigraphy)AnesthesiaInternal medicineTransplantationHuman immunodeficiency virus (HIV)VirologyViral loadAntiretroviral therapyPaleontologyBiologyPharmacological Effects and Toxicity StudiesNeurological Complications and SyndromesHIV/AIDS drug development and treatment