Abstract
Individualization of tacrolimus treatment to prevent rejection in kidney transplantation is pivotal. It has been shown that:
• Tacrolimus can also be administered by a suppository, contrary to
application under the tongue.
• Altered tacrolimus blood levels after steroid dose changes can partly be explained by genetic mechanisms.
• The newer once-daily formulation has a lower variability of drug exposure compared to the older twice-daily formulation, which is relevant since a higher variability is associated with worse graft survival.
• Similar to twice-daily tacrolimus, drug exposure of once-daily tacrolimus is acceptably lower when administered together with breakfast. Non-fasted intake can be allowed for convenience reasons, provided drug levels are monitored.
• Tacrolimus levels in the elimination phase of the newer once-daily tacrolimus formulation better predict drug exposure than the currently applied pre-dose levels.
• Tacrolimus can also be administered by a suppository, contrary to
application under the tongue.
• Altered tacrolimus blood levels after steroid dose changes can partly be explained by genetic mechanisms.
• The newer once-daily formulation has a lower variability of drug exposure compared to the older twice-daily formulation, which is relevant since a higher variability is associated with worse graft survival.
• Similar to twice-daily tacrolimus, drug exposure of once-daily tacrolimus is acceptably lower when administered together with breakfast. Non-fasted intake can be allowed for convenience reasons, provided drug levels are monitored.
• Tacrolimus levels in the elimination phase of the newer once-daily tacrolimus formulation better predict drug exposure than the currently applied pre-dose levels.
Original language | English |
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Awarding Institution |
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Supervisors/Advisors |
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Award date | 3 Jul 2020 |
Place of Publication | Maastricht |
Publisher | |
Print ISBNs | 9789492741363 |
DOIs | |
Publication status | Published - 2020 |
Keywords
- kidney transplantation
- immunosuppression
- pharmacokinetics
- tacrolimus
- therapeutic drug monitoring