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

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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