02378nas a2200289   4500008004100000022004200041245009900083210006900182250001000251260000800261300001300269490000700282520149800289653001001787653001201797653004401809653002201853653001101875653002701886653002801913653000901941653002601950653003901976100001302015700001502028856004502043       1991                        eng d  a0037-5675 (Print) 0037-5675 (Linking)00aDrug interaction between cyclosporine A and quinine in a renal transplant patient with malaria0 aDrug interaction between cyclosporine A and quinine in a renal t  a33390  cJun  a189 - 900 v323 aWe report a previously undocumented drug interaction between cyclosporine A and quinine. A 39 year old Asian with a recent renal transplant was diagnosed to have a mild cerebral falciparum malaria. He was treated with seven days of oral quinine (600 mg, 8 hourly), followed by a stat dose of pyrimethamine (75 mg)--sulfadoxime (1200mg) because of a strong suspicion of chloroquine resistant falciparum malaria. Using a polyclonal radioimmunoassay method, we measured morning trough cyclosporine A level before, during and after the quinine treatment. Results showed a gradual decrease in the cyclosporine A level from a baseline value of 328 ng/ml to 107 ng/ml after seven days of oral quinine with a subsequent rise to pre-treatment level after discontinuation of quinine. There was no significant change in the dose of cyclosporine A administered during the period of quinine treatment (4.05 to 3.83 mg/kg body weight). Biochemical liver function tests, serum creatinine and hematological parameters were also essentially unchanged during this period. In vitro study showed no significant methodological interference in the cyclosporine assay by quinine dihydrochloride. These findings suggest an in vivo drug interaction between cyclosporine A and quinine. The mechanism of this interaction is not clear. Further studies are required to confirm the significance of this observation. Quinine and its stereoisomer, quinidine should be used with caution until further information is available.10aAdult10aAnimals10aCyclosporins / *administration & dosage10aDrug Interactions10aHumans10aKidney Transplantation10aMalaria / *drug therapy10aMale10aPlasmodium falciparum10aQuinine / *administration & dosage1 aTan, H W1 aCh'ng, S L  uhttps://notifylibrary.org/reference/1521