Severe decrease of cyclosporine levels in a heart transplant recipient receiving the direct thrombin inhibitor argatroban.

This case report is about a suspected interaction between argatroban, a direct thrombin inhibitor, and cyclosporine, which occurred in a 60-year-old patient after a second heart transplantation. We explored 4 possible mechanisms of interaction, which are an analytical interference, an idiopathic hemodilution, an increase of renal and hepatic clearance, and a metabolic drug-drug interaction.