# Complete the medication reconciliation for an adult kidney-transplant recipient receiving cyclosporine and letermovir.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=522597&lang=en  
> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

Complete the medication reconciliation for an adult kidney-transplant recipient receiving cyclosporine and letermovir.

With cyclosporine, the adult letermovir dose is ::선택::120 mg240 mg480 mg960 mg once daily. The nurse should identify ::선택::acetaminophenamoxicillinsimvastatincalcium carbonate as contraindicated with this combination and frequently monitor ::선택::cyclosporinesodium chloridehemoglobin A1camylase concentrations.

## Explanation

When letermovir is coadministered with cyclosporine in an adult transplant recipient, letermovir is reduced to 240 mg once daily; simvastatin is contraindicated with that combination; cyclosporine concentrations require frequent monitoring.

## In-depth explanation

Quick answer
Lock the cyclosporine-letermovir dose and interaction safeguards.

Why this is correct
Cyclosporine increases letermovir exposure, and the combination can substantially increase certain statin concentrations. Medication reconciliation must connect dose selection, contraindications, and therapeutic drug monitoring.

Easy analogy or mental picture
Use a closed medication-safety loop: identify the immune or cytotoxic exposure, connect the new findings, interrupt further harm, stabilize the client, and verify the response over time.

Memory hook
Exposure, immune effect, organ toxicity, infection risk, immediate action, and serial reassessment.

NCLEX decision rule
Choose the action that reduces the most immediate medication-related risk while preserving diagnostic evaluation and authorized treatment.

Why the other choices are wrong
Options that continue the exposure, treat only one symptom, or delay reassessment leave the toxic or infectious process active.References
1DailyMed: PREVYMIS (letermovir)CMV prophylaxis after transplant, cyclosporine dose interaction, statin contraindication, and drug-level monitoring

## Clinical scenario

Oncology, transplant, and biologic safety review
Verify the indication, immune status, infection screen, interacting medicines, current organ findings, authorized action, and measurable follow-up.

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