title: Long-term stability of a patient-convenient 1 mg/ml suspension of tacrolimus for accurate maintenance of stable therapeutic levels.
abstract: Tacrolimus (Prograf, FK506, Fujisawa Healthcare) is a widely used immunosuppressive agent that is used both for the prevention and treatment of solid organ transplant rejection as well as for the prevention and treatment of graft-versus-host disease after allogeneic blood and marrow transplant. Oral preparations of tacrolimus are commercially available in 0.5, 1 and 5 mg gelatin capsules. Previously, only a 0.5 mg/ml oral suspension has been demonstrated to be stable for use in pediatric patients. On our bone marrow transplant service, we found that using this concentration of tacrolimus led to confusion, with patients and their caregivers confusing milligrams and milliliters, thus increasing errors with this formulation. We postulated that a 1 mg/ml oral formulation of tacrolimus would decrease the potential for medication errors. Our findings support new stability information of approximately 4 months for an extemporaneous oral suspension of tacrolimus at a concentration of 1 mg/ml.
authors.affiliation: Department of Pharmacy, Roswell Park Cancer Institute, Buffalo, NY 14263, USA.
authors.forename: A
authors.initials: A
authors.lastname: Elefante
authors.forename: J
authors.initials: J
authors.lastname: Muindi
authors.forename: K
authors.initials: K
authors.lastname: West
authors.forename: L
authors.initials: L
authors.lastname: Dunford
authors.forename: S
authors.initials: S
authors.lastname: Abel
authors.forename: P
authors.initials: P
authors.lastname: Paplham
authors.forename: K
authors.initials: K
authors.lastname: Brown
authors.forename: T
authors.initials: T
authors.lastname: Hahn
authors.forename: S
authors.initials: S
authors.lastname: Padmanabhan
authors.forename: M
authors.initials: M
authors.lastname: Battiwalla
authors.forename: P L
authors.initials: PL
authors.lastname: McCarthy
mesh_terms: D000284:Administration, Oral; D016026:Bone Marrow Transplantation / Q000379:methods*; D002851:Chromatography, High Pressure Liquid; D004305:Dose-Response Relationship, Drug; D006086:Graft vs Host Disease; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D015233:Models, Statistical; D013048:Specimen Handling; D016559:Tacrolimus / Q000008:administration & dosage* / Q000627:therapeutic use; D013997:Time Factors; D014184:Transplantation, Homologous
chemical_list: D007166:Immunosuppressive Agents; D016559:Tacrolimus