The Effects of Erythromycin in Patients Treated with Cyclosporine

Brief Reports1 May 1986The Effects of Erythromycin in Patients Treated with CyclosporineRAFAEL MARTELL, M.D., DAVID HEINRICHS, M.D., CALVIN R. STILLER, M.D., MORRIS JENNER, M.D., PAUL A. KEOWN, M.B., Ch.B., JOHN DUPRE, M.D.RAFAEL MARTELL, M.D., DAVID HEINRICHS, M.D., CALVIN R. STILLER, M.D., MORRIS JENNER, M.D., PAUL A. KEOWN, M.B., Ch.B., JOHN DUPRE, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-104-5-660 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe clinical introduction of cyclosporine heralded a new class of immunoregulatory drugs with specific inhibitory effects on T-cell functions and elaborated products (1, 2). Cyclosporine's role in facilitating solid organ transplantation and altering autoimmune responses continues to grow (3). As use of the drug widens, more interactions with other pharmacologic agents will be reported. We report the cases of three patients in a pilot study of the effect of cyclosporine in type 1 diabetes (4) in whom treatment with erythromycin was associated with acutely elevated trough serum levels of cyclosporine and clinical manifestations of acute drug toxicity.No other drugs...References1. BUNJESHARDTROLLINGHOFFWAGNER DCMH. Cyclosporine A mediates immunosuppression of primary cytotoxic T cell responses by impairing the release of interleukin 1 and interleukin 2. Eur J Immunol. 1981;2:657-61. CrossrefGoogle Scholar2. KUNKLKLAUS AG. Selective effects of cyclosporine A on functional B cell subsets in the mouse. J Immunol. 1980;125:2526-31. MedlineGoogle Scholar3. STILLERKEOWN CP. Cyclosporine therapy in perspective. In: MORRIS PJ, TILNEY N, eds. Progress in Transplantation. Edinburgh: Churchill-Livingstone; 1980; 11-45. Google Scholar4. STILLERDUPREGENT CJM. Effects of cyclosporine immunosuppression in insulin-dependent diabetes mellitus of recent onset. Science. 1984;223:1362-7. CrossrefMedlineGoogle Scholar5. RENTONGRAYHONG KJO. Depression of theophylline elimination by erythromycin. Clin Pharmacol Ther. 1981;30:422-6. CrossrefMedlineGoogle Scholar6. WONGLUDDENBELL YTR. Effect of erythromycin on carbamazepine kinetics. Clin Pharmacol Ther. 1983;33:460-4. CrossrefMedlineGoogle Scholar7. DANANDESCATOIREPRESSAYRE GVD. Self-induction by erythromycin of its own transformation into a metabolite forming an inactive complex with reduced cytochrome P-450. J Pharmacol Exp Ther. 1981;218:509-14. MedlineGoogle Scholar8. MAOTARDREW JP. Demethylation of erythromycin by rabbit tissues in vitro. Biochem Pharmacol. 1965;14:1049-58. CrossrefMedlineGoogle Scholar9. KAHANREIDNEWBURGER BMJ. Pharmacokinetics of cyclosporine in human transplantation. Transplant Proc. 1983;15:446-53. Google Scholar10. KEOWNSTILLERULAN PCR. Immunological and pharmacological monitoring in the clinical use of cyclosporine A. Lancet. 1981;1:686-9. CrossrefMedlineGoogle Scholar This content is PDF only. 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M. GRIÑO, I. SABATE, A. M. CASTELAO, M. GUARDIA, D. SERON, J. ALSINA 1 May 1986Volume 104, Issue 5Page: 660-661KeywordsAutoimmunityDrug interactionsDrugsErythromycinNephrologyPilot studiesRadioimmunoassaysSolid organ transplantationTransplantationType 1 diabetes Issue Published: 1 May 1986 PDF downloadLoading ...