Tacrolimus dose requirement in renal transplant recipients is significantly higher when used in combination with corticosteroids.
OBJECTIVE
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.
Hesselink
Dennis A
DA
Department of Internal Medicine, Renal Transplant Unit, Room D 412, Erasmus Medical Centre, PO Box 2040, 3000 CA Rotterdam, the Netherlands. d.a.hesselink@erasmusmc.nl
Ngyuen
Hien
H
Wabbijn
Marike
M
Gregoor
Peter J H Smak
PJ
Steyerberg
Ewout W
EW
van Riemsdijk
Iza C
IC
Weimar
Willem
W
van Gelder
Teun
T
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000493:pharmacokinetics; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000493:pharmacokinetics; D061067:Antibodies, Monoclonal, Humanized; D000077561:Daclizumab; D004305:Dose-Response Relationship, Drug; D004338:Drug Combinations; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics; D016030:Kidney Transplantation; D009173:Mycophenolic Acid / Q000008:administration & dosage / Q000493:pharmacokinetics; D016559:Tacrolimus / Q000008:administration & dosage* / Q000493:pharmacokinetics
D000305:Adrenal Cortex Hormones; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D004338:Drug Combinations; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D000077561:Daclizumab; D009173:Mycophenolic Acid; D016559:Tacrolimus