Tacrolimus toxicity in a liver-kidney transplant patient receiving Nirmatrelvir/Ritonavir for COVID-19

Abstract

Due to the rapid approval of some of the newer therapies for COVID-19 infection, there are several pharmacologic aspects of these therapies that are not fully known, including drug-drug interactions. Transplant recipients face notable risks in relation to these interactions. This article outlines complications arising from the concurrent administration of nirmatrelvir/ritonavir and tacrolimus in a patient with history of combined kidney and liver transplantation. Additionally, it highlights the effective utilization of phenytoin as an inducer to correct the supratherapeutic levels of tacrolimus.

Keywords

• drug interaction
• tacrolimus
• covid-19
• renal transplant
• phenytoin