title: Update on the clinical utility of once-daily tacrolimus in the management of transplantation.
abstract: Adherence to immunosuppression and minimizing variability in drug exposure are important considerations in preventing rejection and maximizing overall transplant outcomes. The availability of once-daily tacrolimus may confer potential benefit by simplifying immunosuppressive regimens, thereby improving medication adherence among transplant recipients. Pharmacokinetic studies in healthy normal volunteers and stable transplant recipients suggest that once-daily tacrolimus is bioequivalent to twice-daily tacrolimus. Efficacy studies suggest that once-daily tacrolimus is noninferior to twice-daily tacrolimus with a concentration-dependent rejection risk. The incidence of biopsy-proven acute rejection, graft survival, and patient survival are more or less comparable between the two tacrolimus formulations. Once-daily tacrolimus has also been reported to have favorable effects on blood pressure, lipid profile, and glucose tolerance. Once-daily tacrolimus may be a viable option to consider for de novo immunosuppression or for conversion from conventional tacrolimus.
authors.affiliation: Division of Nephrology and Hypertension, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Maria Aurora
authors.initials: MA
authors.lastname: Posadas Salas
authors.affiliation: Division of Nephrology and Hypertension, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Titte R
authors.initials: TR
authors.lastname: Srinivas
mesh_terms: D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods*; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D016030:Kidney Transplantation; D016031:Liver Transplantation; D016559:Tacrolimus / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology*
chemical_list: D007166:Immunosuppressive Agents; D016559:Tacrolimus
keywords: adherence; immunosuppression; pharmacokinetics; toxicity