Pantoprazole does not affect cyclosporin A blood concentration in kidney-transplant patients.

Objective: Renal-transplant patients who are immunosuppressed with cyclosporin A (CyA) are often treated with proton-pump inhibitors to prevent ulcer disease. No data are available on the effect of the novel proton-pump inhibitor pantoprazole on CyA levels.
Methods: In a controlled treatment, we investigated the effect of pantoprazole, which was administered in a pragmatic schedule for acid suppression (40 mg as single oral dose at 2200 hours) in six renal-transplant patients who received CyA (Sandimmun optoral, 50-175 mg twice daily) and prednisolone (5-7.5 mg/24 h). CyA trough levels (0730-0800 hours) were measured by immunoassay.
Results: In the absence of pantoprazole, mean CyA trough levels measured on three consecutive days were between 164 ng/ml and 173 ng/ml (therapeutic range 120-200 ng/ml). Pantoprazole did not affect CyA trough levels during an observation period up to 3 months long.
Conclusions: Pantoprazole seems to be a safe drug in combination with CyA.