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- W2091256687 abstract "Background: Beta blockers are frequently used after cardiac transplantation for their favorable effects on blood pressure control. There is no well-known interaction between beta blockers and cyclosporine (CsA). The aim of this study is to evaluate the effects of the commonly used beta blockers carvedilol and metoprolol on CsA level when initiated in cardiac transplant recipients. Methods: Using the cardiac transplant database at our center, we identified patients who were started on either carvedilol or metoprolol for blood pressure control. We then compared their CsA doses and levels before and within one to two weeks after the initiation of beta blocker therapy. Comparisons were also made between carvedilol and metoprolol groups. Results: In our transplant population, we found 20 patients on metoprolol, and 12 patients on carvedilol. With initiation of metoprolol, CsA level decreased in 12 patients and increased in 8 patients. The mean CsA level before and after metoprolol initiation was 236 and 253 ng/ml, respectively (p=0.50). In an attempt to maintain a therapeutic CsA level, the mean CsA dose was not significantly adjusted (from a mean of 293 mg/day to a mean of 294 mg/day; p=0.92). In the carvedilol group, CsA level increased in 10 of 12 patients. The mean CsA level before the initiation of carvedilol was 257 ng/ml. The mean CsA level after carvedilol initiation was 380 ng/ml (p=0.009). In an attempt to maintain a therapeutic CsA level, the mean CsA dose was reduced by 10% from a mean of 319 mg/day to a mean of 288 mg/day (p=0.004). Conclusion: Carvedilol, but not metoprolol, was associated with a significant increase in CsA levels after initiation in cardiac transplant recipients. An average reduction of 10% is necessary on the CsA dose upon initiation of carvedilol, and close follow up on the level is essential." @default.
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- W2091256687 date "2004-08-01" @default.
- W2091256687 modified "2023-10-16" @default.
- W2091256687 title "The effect of beta blocker use on cyclosporine level in cardiac transplant recipients" @default.
- W2091256687 doi "https://doi.org/10.1016/j.cardfail.2004.06.271" @default.
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