Drug Therapy in the Heart Transplant Recipient: Part IV: Drug–Drug Interactions
Open accessAbstract
With improving survival, the heart transplant recipient faces an increasing number of medical problems caused by both aging and the cumulative complications of immunosuppressive drugs. 1 The availability of new drugs to treat infection, obesity, hypertension, hyperlipidemia, renal insufficiency, diabetes, osteoporosis, gout, and malignancies has resulted in the heart transplant recipient and their physicians facing an almost overwhelming number of important drug-drug interactions.In parts 1 through 3 of this series, we reviewed commonly used immunosuppressive drugs and their pharmacology, as well as the common medical problems faced by the heart transplant recipient.In this article, we provide an overview of the mechanisms of common and important potential drug-drug interactions and guidelines for avoiding these interactions.
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In a post hoc analysis of the SEAS trial, the efficacy of lipid-lowering therapy in impeding the progression of aortic stenosis increased with higher pre-treatment LDL-C levels and lower peak aortic jet velocity (milder stenosis at baseline).
“In a post hoc analysis of the SEAS trial, the efficacy of lipidlowering therapy in impeding the progression of aortic stenosis increased with higher pre-treatment LDL-C levels and lower peak aortic jet velocity (i.e. milder stenosis at baseline) [484].”
From 2019 ESC/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk (2019) · cites this paper as [484]
Fluvastatin, pravastatin, pitavastatin, and rosuvastatin have less potential for interaction.
“Fluvastatin, pravastatin, pitavastatin, and rosuvastatin have less potential for interaction.197”
From ESC/EAS Guidelines for the management of dyslipidaemias (2011) · cites this paper as [197]
Randomized trial data show that statins have the potential to improve outcomes in heart transplant and renal transplant patients, but the amount of outcome data is not extensive.
“Although randomized trial data have shown that statins have the potential to improve outcomes in heart transplant patients 195 -197 and renal transplant patients, 198 the amounts of outcome data are not extensive.”
From ESC/EAS Guidelines for the management of dyslipidaemias (2011) · cites this paper as [197]
Fluvastatin, pravastatin, pitavastatin, and rosuvastatin have a lower potential for drug interactions.
“Fluvastatin, pravastatin, pitavastatin and rosuvastatin have less potential for interaction. 402”
From 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias (2016) · cites this paper as [402]
Randomized trial evidence indicates that statins can improve outcomes in heart transplant recipients.
“Although randomized trial data have shown that statins have the potential to improve outcomes in heart transplant patients 400-402 and renal transplant patients, 403 the amounts of outcome data are not extensive.”
From 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias (2016) · cites this paper as [402]
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Self-citation
- Authors
- Page, R. L., Miller, G. G., & Lindenfeld, J.
- Affiliations
- From the Department of Clinical Pharmacy (R.L.P.) and Division of Cardiology and Center for Women’s Health Research (J.L.), University of Colorado Health Sciences Center, Denver, Colo, and Division of Infectious Diseases (G.G.M.), Vanderbilt University, Nashville, Tenn.
- Vanderbilt University (US)
- ORCID
- Lindenfeld, JoAnn
- Venue
- Circulation
- Published
- 2005-01-18
- Volume
- 111
- Issue
- 2
- Pages
- 230-239
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2026231330
- Cited by
- 100
- References
- 114
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 7 · 2023: 2 · 2022: 5 · 2021: 6 · 2020: 5 · 2019: 9 · 2018: 4 · 2017: 4 · 2016: 6 · 2015: 3 · 2014: 4 · 2013: 9 · 2012: 3
- FWCI
- 0.68
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Transplantation: Methods and Outcomes
- Health Sciences › Medicine › Transplantation › Renal Transplantation Outcomes and Treatments
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Keywords
- heart transplantation, drug-drug interactions, immunosuppressants, drug interaction mechanisms, infection treatment, obesity, hypertension, hyperlipidemia, renal failure, diabetes mellitus, osteoporosis, gout, cancer
- MeSH terms
- Anti-Infective Agents, Antidepressive Agents, Biological Transport, Biotransformation, Cardiovascular Agents, Cytochrome P-450 Enzyme System, Drug Interactions, Humans, Immunosuppressive Agents, Metabolic Clearance Rate, Platelet Aggregation Inhibitors, Heart Transplantation, ATP Binding Cassette Transporter, Subfamily B, Member 1
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