Ciprofloxacin, but not Levofloxacin, Affects Cyclosporine Blood Levels in a Patient with Pure Red Blood Cell Aplasia

A 38-year-old man diagnosed with pure red blood cell aplasia was undergoing treatment with cyclosporine 200mg/day. On day 41, the cyclosporine dose was increased to 250mg/day. On day 45, the patient was hospitalized with fever, and ciprofloxacin 200mg IV tid was begun. The level of cyclosporine was...

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Bibliographic Details
Published in:The American journal of the medical sciences 2005-09, Vol.330 (3), p.144-146
Main Authors: Borrás-Blasco, Joaquín, Navarro-Ruiz, Andrés, González-Delgado, Mercedes, Conesa-García, Venancio, Marín-Jiménez, Francisca, Gomez-Corrons, Amparo
Format: Article
Language:English
Subjects:
Adult
Antibacterial agents
Antibiotics. Antiinfectious agents. Antiparasitic agents
Biological and medical sciences
Ciprofloxacin
Ciprofloxacin - pharmacology
Ciprofloxacin - therapeutic use
Cyclosporine
Cyclosporine - blood
Cyclosporine - pharmacokinetics
Cyclosporine - therapeutic use
Drug interaction
General aspects
Humans
Levofloxacin
Male
Medical sciences
Ofloxacin - pharmacology
Ofloxacin - therapeutic use
Pharmacology. Drug treatments
Red-Cell Aplasia, Pure - drug therapy
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Summary:A 38-year-old man diagnosed with pure red blood cell aplasia was undergoing treatment with cyclosporine 200mg/day. On day 41, the cyclosporine dose was increased to 250mg/day. On day 45, the patient was hospitalized with fever, and ciprofloxacin 200mg IV tid was begun. The level of cyclosporine was 297ng/mL, which obliged us to reduce cyclosporine to 200mg/day. On day 59, ciprofloxacin was discontinued. On day 80, the patient was hospitalized with fever, and levofloxacin 500mg/d IV was begun. The patient was continued on cyclosporine 250mg/day. On day 90, levofloxacin was discontinued. The cyclosporine dose-to-blood level ratio was maintained constant in subsequent controls. In this patient, the substantial and sustained increase in cyclosporine blood levels after ciprofloxacin was added to the patient's therapy and the decrease in cyclosporine blood levels after the withdrawal of ciprofloxacin suggest a potential interaction. Levofloxacin therapy could be a therapeutic alternative, although pharmacokinetic/pharmacodynamic studies should be conducted.
ISSN:0002-9629
1538-2990
DOI:10.1097/00000441-200509000-00009