The clinical investigator

, Volume 70, Issue 9, pp 752–754 | Cite as

Sulfadiazine therapy for toxoplasmosis in heart transplant recipients decreases cyclosporine concentration

  • C. H. Spes
  • C. E. Angermann
  • H. U. Stempfle
  • K. Wenke
  • K. Theisen
Clinical Pharmacology


Toxoplasmosis may cause serious problems after organ transplantation. For treatment of active infection, pyrimethamine combined with a sulfonamide is recommended. During oral sulfadiazine therapy, a significant decrease in cyclosporine concentrations was observed in three heart transplant recipients. This interaction has not been reported previously.

Key words

Cyclosporine Sulfadiazine Pharmacological interaction Toxoplasmosis Heart transplantation 


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  1. 1.
    Cockburn ITR, Krupp P (1989) An appraisal of drug interactions with Sandimmun. Transplant Proc 21: 3845–3850.PubMedGoogle Scholar
  2. 2.
    D'Arcy PF (1986) Interaction between cyclosporin A and sulfadimidine : hazard for cardiac transplants. Pharmacy Int 138.Google Scholar
  3. 3.
    Dummer JS, Bahnson HT, Griffith BP, Hardesty RL, Thompson ME, Ho M (1983) Infections in patients on cyclosporine and prednisone following cardiac transplantation. Transplant Proc 15:2779–81.Google Scholar
  4. 4.
    Forth W (1990) Das Problem großer Dosen in der Pharmakologie. Dtsch Ärztebl 87: 1178–80.Google Scholar
  5. 5.
    Hakim M, Esmore D, Wallwork J, English TAH, Wreghitt T (1986) Toxoplasmosis in cardiac transplantation. Br Med J 292: 1108.CrossRefGoogle Scholar
  6. 6.
    Holliman RE, Johnson JD, Adams S, Pepper RJ (1991) Toxoplasmosis and heart transplantation. J Heart Transplant 10: 608–10.Google Scholar
  7. 7.
    Jones DK, Hakim M, Wallwork J, Higenbottam TW, White DIG (1986) Serious interaction between cyclosporin A and sulphadimidine. Br Med J 292: 728–9.CrossRefGoogle Scholar
  8. 8.
    Luft BJ, Billingham M, Remington JS (1986) Endomyocardial biopsy in the diagnosis of toxoplasmic myocarditis. Transplant Proc 18: 1871–3.PubMedGoogle Scholar
  9. 9.
    Luft BJ, Naot Y, Araujo FG, Stinson EB, Remington JS (1983) Primary and reactivated toxoplasmosis in patients with cardiac transplants. Ann Int Med 99: 27–31.CrossRefGoogle Scholar
  10. 10.
    McLeod R, Remington JS (1987) Toxoplasmosis. In: Braunwald E, Isselbacher KJ, Petersdorf RG, Wilson JD, Martin JB, Fauci AS (eds) Harrison's principles of internal medicine. McGraw-Hill, New York, pp 791–7.Google Scholar
  11. 11.
    Rose AG, Uys CJ, Novitsky D, Cooper DKC, Barnard CN (1983) Toxoplasmosis of donor and recipient hearts after heterotopic cardiac transplantation. Arch Pathol Lab Med 107: 368–373.PubMedGoogle Scholar
  12. 12.
    Spes CH, Angermann CE, Anthuber M, Kemkes BM, Theisen K (1988) Einfluß von Enalapril, Furosemid und Verapamil auf die Ciclosporin-Konzentration im Vollblut. Klin Wochenschr 66: 1184–89.CrossRefGoogle Scholar
  13. 13.
    Völker H, Sigmund M, Kropff M, Hürter T, Kemnitz J, Kirkpatrick CJ, Hanrath P (1991) Myokarditis durch Toxoplasma gondii und Aspergillus fumigatus nach orthotoper Herztransplantation. Z Kardiol 80: 359–62.PubMedGoogle Scholar
  14. 14.
    Wallwork J, McGregor CGA, Wells FC, Cory-Pearce R, English TAH (1983) Cyclosporin and intravenous sulphadimidine and trimethoprim therapy. Lancet I: 366–7.CrossRefGoogle Scholar
  15. 15.
    Wreghitt TG, Gray JJ, Balfour AH (1986) Problems with serological diagnosis of Toxoplasma gondii infections in heart transplant recipients. J Clin Pathol 39: 1135–39.CrossRefGoogle Scholar
  16. 16.
    Wreghitt TG, Hakim M, Gray JJ, Balfour AH, Gistovin P, Steward S, Scott J, English TAH Wallwork J (1989) Toxoplasmosis in heart and heart-lung transplant recipients. J Clin Pathol 42: 194–99.CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 1992

Authors and Affiliations

  • C. H. Spes
    • 2
  • C. E. Angermann
    • 2
  • H. U. Stempfle
    • 2
  • K. Wenke
    • 1
  • K. Theisen
    • 2
  1. 1.Herzchirurgische KlinikKlinikum Großhadern, Ludwig-Maximilians-UniversitätMünchenGermany
  2. 2.Medizinische KlinikKlinikum Innenstadt Ludwigs-Maximilians-Universität MünchenMünchen 2Germany

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