Novel Insights for Improvement of Tacrolimus Therapy

Frank Stifft

Research output: ThesisDoctoral ThesisExternal prepared

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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.
Original languageEnglish
Awarding Institution
  • Maastricht University
Supervisors/Advisors
  • van Hooff, J.P., Supervisor, External person
  • Christiaans, Martinus, Supervisor
Award date3 Jul 2020
Place of PublicationMaastricht
Publisher
Print ISBNs9789492741363
DOIs
Publication statusPublished - 2020

Keywords

  • kidney transplantation
  • immunosuppression
  • pharmacokinetics
  • tacrolimus
  • therapeutic drug monitoring

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