Dosing Tacrolimus Based on CYP3A5 Genotype: Will It Improve Clinical Outcome?

Tacrolimus, widely used to prevent acute rejection following solid‐organ transplantation, has become the cornerstone of immunosuppressive therapy after kidney transplantation. More than 70% of all renal transplant recipients receive this remarkably effective agent. 1 But tacrolimus is also highly toxic, and there is great between‐patient variability in its pharmacokinetics. This, combined with a low therapeutic index, mandates routine therapeutic drug monitoring in clinical practice. 2 Typically, predose concentrations are monitored and the dose is adjusted to aim for target values that depend on immunological risk, comedication, and time since transplantation. 2 Clinical Pharmacology & Therapeutics (2010) 87 6, 640–641. doi: 10.1038/clpt.2010.42