מתוך medicontext.co.il
WESTPORT, CT (Reuters Health) – Among men with erectile dysfunction after kidney transplantation, tacrolimus alters the pharmacokinetics of sildenafil, German researchers report.
Dr. Birgit Christ from the University of Giessen, and colleagues studied 10 men, 29 to 52 years of age, with erectile dysfunction who had undergone kidney transplantation. The men received tacrolimus on the first day of the trial. Sildenafil was added on the second day, according to the report in the October issue of Urology.
Analysis of serum levels of tacrolimus, sildenafil and the sildenafil metabolite UK103,320 (UK) revealed that sildenafil had no effect by on the pharmacokinetics of tacrolimus, the researchers report.
However, sildenafil concentrations were 44% higher. Also "the area under the concentration-time data increased by 90%," Dr. Christ's team noted. Compared with normal controls, the elimination half-life of sildenafil was prolonged (4.7 hours versus 3 hours), the investigators report.
"The area under the concentration-time data for UK was about threefold larger than in healthy volunteers, and the half-life was prolonged from 3.5 hours to 11.4 hours," Dr. Christ and colleagues write.
They also saw pronounced drops in blood pressure among the 10 patients. "The maximal difference in mean arterial blood pressure was 20 mm Hg (range 13 to 37)."
"Because sildenafil reached higher plasma levels and blood pressure drops were observed, a starting dose of 25 mg and, if necessary, an adjustment of antihypertensive drugs on the days of sildenafil use is recommended," the researchers advise.
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