MEDS IN THE POST-NEPHROPATHY PATIENT

Can gabapentin (Neurontin) and/or choline/magnesium trisalicylate (Trilisate) be prescribed to a patient who had a kidney transplant for diabetic nephropathy?
—John D. Timothy, MD, Forest Hills, N.Y.

Use of medications in the post-renal transplant patient must take into consideration concurrent use of immunosuppressive agents (drug-drug interactions) as well as the effects on renal function itself. Trilisate is an oral nonsteroidal anti-inflammatory drug (NSAID). As with any NSAID, the use of Trilisate is relatively contraindicated when there is renal dysfunction. Neurontin can be used in the context of renal impairment, but its dose must be adjusted according to creatinine clearance. Thus, the most significant issues are whether your patient’s renal function is currently normal and the specific post-transplant regimen that he or she is following. In this potentially delicate situation, it would be advisable to discuss new medications with the patient’s nephrologists as well.
—Christopher Ruser, MD (113-2)

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