Tacrolimus dose requirement in renal transplant recipients is significantly higher when used in combination with corticosteroids

Br J Clin Pharmacol. 2003 Sep;56(3):327-30. doi: 10.1046/j.0306-5251.2003.01882.x.

Abstract

Aims: 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.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage*
  • Adrenal Cortex Hormones / pharmacokinetics
  • Antibodies, Monoclonal / administration & dosage
  • Antibodies, Monoclonal / pharmacokinetics
  • Antibodies, Monoclonal, Humanized
  • Daclizumab
  • Dose-Response Relationship, Drug
  • Drug Combinations
  • Humans
  • Immunoglobulin G / administration & dosage
  • Immunosuppressive Agents / administration & dosage*
  • Immunosuppressive Agents / pharmacokinetics
  • Kidney Transplantation*
  • Mycophenolic Acid / administration & dosage
  • Mycophenolic Acid / pharmacokinetics
  • Tacrolimus / administration & dosage*
  • Tacrolimus / pharmacokinetics

Substances

  • Adrenal Cortex Hormones
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Drug Combinations
  • Immunoglobulin G
  • Immunosuppressive Agents
  • Daclizumab
  • Mycophenolic Acid
  • Tacrolimus