Zheng Shaobin, director of the Organ Transplant Center at Taichung Tzu Chi Hospital, said that the simultaneous use of immunosuppressive drugs and oral antiviral drug Paxlovid will reduce the metabolism of immunosuppressive drugs and increase the plasma concentration of immunosuppressive drugs, which will lead to impaired kidney function, increased blood pressure, and increased blood pressure. Insomnia, headache and other symptoms. (Photo by reporter Ou Sumei)
[Reporter Ou Sumei/Taichung Report]46-year-old He Nan received a liver transplant and recovered well after surgery. Unexpectedly, he was recently diagnosed with Wuhan pneumonia (new coronavirus disease, COVID-19), and he developed severe headache and other symptoms after taking antiviral drugs , fortunately to seek medical treatment in time. Zheng Shaobin, director of the Organ Transplant Center at Taichung Tzu Chi Hospital, reminded patients that the interaction of anti-rejection drugs taken by organ transplant patients with antiviral drugs for new coronary pneumonia may be life-threatening. Track blood levels and clinical conditions.
Mr. He regularly took immunosuppressants (anti-rejection drugs), and was diagnosed with new coronary pneumonia at the end of September. After taking the oral antiviral drug Paxlovid prescribed by the clinic doctor for 5 days, he actually developed persistent headaches, tossing and turning, loss of appetite and other symptoms. She endured the pain until her home isolation period expired, and went to the liver transplant clinic of Taichung Tzu Chi Hospital for medical treatment. The evaluation and examination found that the concentration of immunosuppressive drugs exceeded 10 times the upper limit of the normal value.
Zheng Shaobin said that because the commonly used immunosuppressants and the oral antiviral drug Paxlovid have the same metabolic enzymes in the human body, taking them at the same time will reduce the metabolism of immunosuppressive drugs and increase the plasma concentration of immunosuppressants. Excessive drug concentration may cause neurological symptoms such as impaired renal function, increased blood pressure, insomnia, headache, tremor and paresthesia, and may even cause secondary infection due to excessive immunosuppression. Severe drug side effects may be fatal and should not be ignored. .
Zheng Shaobin said that many liver transplant patients had been diagnosed before, and before using oral antiviral drugs, they had contacted the team physicians in advance to consult the dose adjustment of immunosuppressants, and cooperated with blood draws to track plasma drug concentrations. He Nan thought that he had informed the clinic doctor that he was a patient who had been taking immunosuppressive drugs for a long time, and he did not contact the transplant team afterwards. There was a serious drug interaction due to yin and yang differences, and the drug concentration soared more than 10 times.
Zheng Shaobin pointed out that in order to ensure the safety of patients after organ transplantation, it is recommended to temporarily stop immunosuppressive drugs during the 5-day course of oral antiviral drugs. dose. After organ transplantation, patients infected with the disease must take the initiative to contact the doctor of the original transplant team to consult the adjustment and tracking of anti-rejection drug-related concentrations and clinical conditions during the course of antiviral drugs, so as to restore health with peace of mind and safety.
The new crown pneumonia epidemic has continued to this day, and about 6.9 million people have been diagnosed in Taiwan. The Ministry of Health and Welfare also reminded that the oral antiviral drug Paxlovid interacts with a variety of drugs. In addition to the 10 categories of drugs that are contraindicated, there are also 35 categories of drugs that need to be closely tracked.
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