Pharmacokinetic interactions between cyclosporine and bupropion or methylphenidate

A 10-year-old boy with a history of heart transplantation had a potentially life-threatening decrease in his cyclosporine (CSA) blood levels during administration of bupropion, Subsequently he had an increase in CSA levels while receiving methylphenidate, These occurrences represent potential drug-drug interactions in children not previously documented in the literature. The CSA-bupropion and CSA-methylphenidate interactions merit further investigation, particularly because psychotropic agents are often prescribed in combination with immunosuppressants in transplantation patients of all ages.