title: The once-daily formulation of tacrolimus:  a step forward in kidney transplantation?
abstract: Nonadherence is a critical issue in transplantation. Recently, Astellas designed a once-daily-extended release formulation of tacrolimus (Tac). Despite initial reports showing bioequivalence of Tac once-daily (Advagraf) with the original formulation requiring twice-daily intake (Tac twice-daily, Prograf), several groups have now shown a sustained decrease in Tac exposure upon conversion from Prograf to Advagraf. Here, we discuss the possible reasons for this observation and how it could affect the expected benefits of Advagraf, and we comment on the fact that a similar lack of bioequivalence might prevail with generic immunosuppressive drugs.
authors.affiliation: Department of Nephrology, Clinique Universitaire Hôpital Erasme, Renal Transplantation Clinic, Brussels, Belgium. jehougar@ulb.ac.be
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Hougardy
authors.forename: Hylke
authors.initials: H
authors.lastname: de Jonge
authors.forename: Dirk
authors.initials: D
authors.lastname: Kuypers
authors.forename: Daniel
authors.initials: D
authors.lastname: Abramowicz
mesh_terms: D019540:Area Under Curve; D002626:Chemistry, Pharmaceutical; D002986:Clinical Trials as Topic; D004334:Drug Administration Schedule; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D016030:Kidney Transplantation; D055118:Medication Adherence; D016559:Tacrolimus / Q000008:administration & dosage* / Q000097:blood
chemical_list: D007166:Immunosuppressive Agents; D016559:Tacrolimus