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Open Respiratory Archives Use of rifampicin as a cytochrome inducer in acute tacrolimus poisoning
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Type of article: clinical letter.
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Use of rifampicin as a cytochrome inducer in acute tacrolimus poisoning
Uso de rifampicina para el tratamiento de la intoxicación aguda por tacrolimus
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Juan Margallo Iribarnegaray1,
Corresponding author
juanmargalloi@gmail.com

Author for correspondence: Lung Transplantation Unit. Pulmonology Department, Hospital Universitario 12 de Octubre, Crtra. Andalucía km 5,400, 28041 Madrid, Spain
, Lucía Ortega Ruiz1, María Ruiz Rodriguez1, Rodrigo Alonso Moralejo1, Carlos Andrés Quezada Loaiza1, Alicia De Pablo Gafas1
1 Lung Trasplantation Unit. Pulmonology Department. Hospital Universitario 12 de Octubre, Madrid, Spain
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Abstract

Paxlovid is a combination of drugs used to treat SARS-CoV-2 infection: nirmaltrevir, an antiviral that acts as a 3CL protease inhibitor, and ritonavir, a cytochrome P450 inhibitor that increases the half-life of the former. This cytochrome inhibition can cause interactions with other drugs, increasing their concentration in the blood. We present the case of acute tacrolimus poisoning secondary to the administration of ritonavir and its resolution through the use of rifampicin, a cytochrome inducer.

Keywords:
lung transplant
immunosuppression
COVID-19
tacrolimus
rifampicin
nirmaltrevair/ritonavir
Resumen

Paxlovid es una combinación de fármacos usados para tratar las infecciones por SARS-CoV-2: nirmaltrevir, un antiviral que actúa como inhibir de la proteasa 3CL, y ritonavir, un inhibidor del citrocomo P450 que incrementa la vida media del primero. Esta inhibición del citocromo puede producir interacciones con otros fármacos, aumentando su concentración sanguínea. Presentamos el caso de una intoxicación agua por tacrolimus secundaria a la administración de ritonavir y su resolución mediante el uso de rifampicina, un inductor del citocromo.

Palabras clave:
trasplante pulmonar
inmunosupresión
COVID-19
tacrolimus
rifampicina
nirmaltrevair/ritonavir
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