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July 25, 1990

Cyclosporine-Ketoconazole Combination Offers Promise in Reducing Antirejection Therapy Costs

JAMA. 1990;264(4):430-431. doi:10.1001/jama.1990.03450040018004

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RESEARCHERS have wed the prince of immunosuppressive drugs, cyclosporine, to a common antifungal medication, ketoconazole, and this union has been shown to slash the costs of antirejection therapy in patients who have undergone kidney transplantation by more than 80%.

Historically, Sandoz Pharmaceuticals Corporation (East Hanover, NJ), the manufacturer of cyclosporine, has discouraged the concomitant use of ketoconazole (Nizoral, Janssen Pharmaceutica Inc, Piscataway, NJ) because it creates dangerously high cyclosporine levels in the blood. But the kidney transplant team at the University of Cincinnati (Ohio) reports it has harnessed this property of ketoconazole to allow a reduction in the cyclosporine dosage by 70% in the first week and up to 88% after 18 months.

"If found to be safe and effective, this drug interaction has enormous potential for reductions in the costs associated with organ transplantation," says Roy First, MD, director of the University of Cincinnati Medical Center's kidney transplantation section.