Tacrolimus dose requirement in renal transplant recipients is significantly higher when used in combination with corticosteroids

Article date: September 2003

By: Dennis A. Hesselink, Hien Ngyuen, Marike Wabbijn, Peter J. H. Smak Gregoor, Ewout W. Steyerberg, Iza C. Van Riemsdijk, Willem Weimar, Teun Van Gelder, in Volume 56, Issue 3, pages 327-330

Aims  To evaluate the effect of corticosteroids on tacrolimus pharmacokinetics.

Methods  In a randomized trial, kidney transplant recipients were treated with tacrolimus and mycophenolate mofetil with either daclizumab (n = 31) or 3 months of prednisone (n = 34). Tacrolimus dose‐adjusted predose concentrations (C0) at month 1–6 were compared between both groups and within the corticosteroid group before and after prednisone withdrawal.

Results  At month 1 the tacrolimus dose‐adjusted C0 in the corticosteroid group was 83 ± 8 vs 119 ± 17 ng ml−1 mg−1 kg−1 in the daclizumab group. The tacrolimus dose‐adjusted C0 within the corticosteroid group at month 1 and 2 was 42% and 29% lower compared with month 4 (P < 0.001).

Conclusions  A higher tacrolimus dose is required to reach target concentrations when used in combination with corticosteroids.

DOI: 10.1046/j.0306-5251.2003.01882.x

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