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Tacrolimus whole blood concentrations correlate closely to side‐effects in renal transplant recipients
Author(s) -
Ylva Böttiger,
C Brattström,
G Tydén,
Juliette Säwe,
CarlGustav Groth
Publication year - 1999
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1046/j.1365-2125.1999.00007.x
Subject(s) - tacrolimus , therapeutic drug monitoring , trough concentration , whole blood , medicine , therapeutic index , adverse effect , trough level , transplantation , blood concentration , pharmacology , pharmacokinetics , renal transplant , calcineurin , kidney transplantation , urology , gastroenterology , drug
Aims To evaluate the relationship between tacrolimus whole blood concentrations and side‐effects and rejections in 14 renal transplant recipients.Methods Tacrolimus was measured by MEIA in whole blood in samples collected repeatedly during the first year after transplantation. Retrospectively, tacrolimus trough concentrations on the days with adverse events (n=172) or rejection (n=28) were related to the total distribution of the concentration values (n =656).Results Side‐effects (one or more) were noted in connection with 76% of tacrolimus concentrations above 30 ng ml −1 , with 41% of concentrations within the interval of 20–30 ng ml −1 , with 26% of the concentrations within the interval of 10–20 ng ml −1 and with only 5.3% on the concentrations lower than 10 ng ml −1 . No relation to the tacrolimus concentration was seen for rejection episodes.Conclusions We conclude that therapeutic drug monitoring may be helpful in the management of tacrolimus therapy and that tacrolimus whole blood trough concentrations (MEIA) should preferably be kept below 20 ng ml −1 to avoid side‐effects, such as nephro‐and neurotoxicity and infections. The lower limit of the therapeutic range has yet to be defined.