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Front. Med. | doi: 10.3389/fmed.2018.00320

Pantoprazole does not affect serum trough levels of tacrolimus and everolimus in liver transplant recipients.

 Sebastian C. Bremer1, 2*, Lars Reinhardt2, Michael Sobotta3, Marie C. Hasselluhn2, Thomas Lorf4, Volker Ellenrieder2 and Harald Schwörer2*
  • 1Universitätsmedizin Göttingen, Germany
  • 2Abteilung für Gastroenterologie und Gastrointestinal-Onkologie, Universitätsmedizin Göttingen, Germany
  • 3Klinik für Anästhesiologie, Universitätsmedizin Göttingen, Germany
  • 4Klinik für Allgemein-, Viszeral- und Kinderchirurgie, Universitätsmedizin Göttingen, Germany

Background: Liver transplant recipients are frequently treated with proton pump inhibitors. Drug interactions have been described especially with respect to omeprazole. Due to the lower binding capacity of pantoprazole to CYP2C19 this drug became preferred and became the most used proton pump inhibitor in Germany. The data on the influence of pantoprazole on immunosuppressive drugs in liver transplant recipients a very scarce.
Methods: The authors performed a single center analysis in liver transplant recipients on the effect of pantoprazole on the serum trough levels of different immunosuppressants. The trough levels were compared over a period of one year before and after start or stop of a continuous oral co-administration of 40mg pantoprazole once daily.
Results: The serum trough levels of tacrolimus (n=30), everolimus (n=7) or sirolimus (n=3) remain constant during an observation period of at least one year before and after co-administration of pantoprazole. None of the included patients needed a change of dosage of the observed immunosuppressants during the observation period.
Conclusions: The oral co-administration of pantoprazole is safe in immunosuppressed liver transplant recipients according to the serum trough levels of tacrolimus, everolimus and sirolimus. This analysis provides first data on the influence of pantoprazole on immunosuppressive drugs in liver transplant recipients.

Keywords: immunosuppressive drugs, pantoprazole, Serum trough level, Liver transplant recipients, Everolimus, Tacrolimus

Received: 30 Aug 2018; Accepted: 30 Oct 2018.

Edited by:

Pedro M. Baptista, Instituto de Investigación Sanitaria Aragón (IIS Aragón), Spain

Reviewed by:

Taro Takami, Yamaguchi University, Japan
Alberto Lué, Hospital Clínico Universitario Lozano Blesa, Spain  

Copyright: © 2018 Bremer, Reinhardt, Sobotta, Hasselluhn, Lorf, Ellenrieder and Schwörer. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Dr. Sebastian C. Bremer, Universitätsmedizin Göttingen, Göttingen, Germany, sebastian.bremer@med.uni-goettingen.de
Prof. Harald Schwörer, Abteilung für Gastroenterologie und Gastrointestinal-Onkologie, Universitätsmedizin Göttingen, Goettingen, 37075, Lower Saxony, Germany, hschwoer@med.uni-goettingen.de