▲ Dr. Zheng Shaobin said that the simultaneous use of immunosuppressants and the oral antiviral drug Paxlovid will have an interaction. (Photo by reporter Ou Sumei)
Reporter Ou Sumei/Taichung reports
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). After taking antiviral drugs, he developed severe headaches and other symptoms. Fortunately, he sought medical treatment in time. Serious complications occurred.
Zheng Shaobin, director of the Organ Transplant Center of 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. Blood levels and clinical status are closely tracked.
He Nan took immunosuppressive drugs (anti-rejection drugs) regularly after the transplant operation. At the end of September, he was quickly screened and diagnosed with Wuhan pneumonia. After taking the oral antiviral drug Paxlovid prescribed by the clinic doctor for 5 days, he had persistent headache, tossing and turning, and loss of appetite. Waiting for the symptoms, he endured the pain until the home isolation period expired, and then went to Taichung Tzu Chi Hospital Liver Transplant Clinic for medical treatment. The evaluation and examination found that the concentration of his immunosuppressant drug exceeded 10 times the upper limit of the normal value!
Antiviral + immunosuppressive almost fatal
Zheng Shaobin said that 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 concentrations may cause kidney function damage and blood pressure. Neurological symptoms such as rising, insomnia, headache, tremor and paresthesia, and even secondary infections, serious drug side effects can be fatal and should not be ignored.
Zheng Shaobin pointed out that during the 5-day course of oral antiviral drugs for patients after organ transplantation, it is recommended to temporarily stop immunosuppressive drugs. After the 7th day, the plasma drug concentration should be measured, and then the time to resume the drug and the dosage should be reassessed, and the organ should be reminded. Post-transplant patients infected with the disease must take the initiative to contact the original transplant team physician to consult the anti-rejection drug-related adjustment and tracking concentrations and clinical conditions during the course of the antiviral drug course.
At present, about 6.9 million people in Taiwan have been diagnosed with Wuhan pneumonia. 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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