CLINICALLY RELEVANT DRUG INTERACTIONS WITH IMMUNOSUPPRESSANTS IN KIDNEY TRANSPLANTATION: AN INTEGRATIVE REVIEW AND IMPLICATIONS FOR PRIMARY HEALTH CARE

Abstract

Introduction: kidney transplant recipients depend on continuous immunosuppression with a narrow therapeutic index, making them vulnerable to clinically relevant drug interactions, often identified outside the transplant center. Objective: to synthesize the literature on clinically relevant drug interactions involving the main immunosuppressants in kidney transplant recipients, with emphasis on implications for Primary Health Care (PHC). Methodology: integrative literature review, with searches in PubMed and BVS/LILACS, totaling 22 studies published between 2016 and 2026, analyzed descriptively and organized by therapeutic class of the interacting drug. Results: the interactions identified involved antimicrobials, antivirals, cardiovascular drugs, gastroprotective agents, and herbal products, occurring both upon introduction and discontinuation or switching of the interacting drug; electronic interaction-checking tools showed divergent results in identification and severity classification. Conclusion: potentially clinically relevant interactions are common and cut across several commonly used therapeutic classes in general clinical practice, reinforcing the need for active vigilance by PHC professionals in the longitudinal follow-up of kidney transplant recipients.