Hypotension, as consequence of the interaction between tacrolimus and mirtazapine, in a patient with renal transplant.

[EN]The prevalence of psychiatric disorders in dialyzed patients is estimated around 5-20% of the cases. This explains the high use of antidepressant drugs in these patients. We present the case of a 68-year-old woman with a history of renal failure, with chronic hemodialysis and a depressive syndro...

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Detalles Bibliográficos
Autores: Fraile Gómez, María Pilar, García Cosmes, Pedro, Garcia, Tamara, Corbacho, Luis, Alvarez, Marcos, Tabernero, Jose Matias
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2009
País:España
Institución:Universidad de Salamanca (USAL)
Repositorio:GREDOS. Repositorio Institucional de la Universidad de Salamanca
OAI Identifier:oai:gredos.usal.es:10366/161652
Acceso en línea:http://hdl.handle.net/10366/161652
Access Level:acceso abierto
Palabra clave:haemodialysis
mirtazapine
renal transplant
tacrolimus
Kidney Transplantation
Immunosuppressive Agents
Hypotension
Tacrolimus
Drug Interactions
Kidney Failure, Chronic
Blood Pressure
3205.06 Nefrología
trasplante de riñón
presión sanguínea
interacciones farmacológicas
fallo renal crónico
hipotensión
inmunosupresores
Descripción
Sumario:[EN]The prevalence of psychiatric disorders in dialyzed patients is estimated around 5-20% of the cases. This explains the high use of antidepressant drugs in these patients. We present the case of a 68-year-old woman with a history of renal failure, with chronic hemodialysis and a depressive syndrome in treatment with Mirtazapine. In November 2008, the patient received a renal graft. An immunosuppressant treatment was started with Basiliximab, Tacrolimus, Mycophenolate Mofetil, and corticosteroids. The patient did not present renal immediate renal function. Four days after the transplant, the treatment with Mirtazapine was re-applied, with an asymptomatic hypotension after 2 hours, and without surgical complications. Tacrolimus blood levels were higher than 15 ng/ml. In our opinion, hypotension was a consequence of the interaction Mirtazapine-Tacrolimus in a patient without immediate renal function. This situation has not been described in the literature before, and hypotension could have had negative consequences in the evolution of the graft.