Maintain tacrolimus whole blood trough levels between 5 and 15 ng/mL for organ transplant recipients. This range optimizes graft survival while minimizing side effects.
Regular monitoring is key. Target frequency depends on individual patient factors and clinical response, but generally, blood tests should occur at least twice weekly during the initial post-transplant period, then gradually decrease to once weekly or even monthly, depending on stability.
Factors influencing tacrolimus levels include drug interactions, renal function, and liver function. Closely monitor these parameters.
| Drug Interactions (e. g., antifungal azoles, macrolides) | Increased tacrolimus levels | Adjust tacrolimus dose or consider alternative medication. |
| Reduced Renal Function | Increased tacrolimus levels | Adjust tacrolimus dose based on creatinine clearance. |
| Reduced Liver Function | Increased tacrolimus levels | Adjust tacrolimus dose based on liver function tests. |
| Increased Metabolism (e. g., through enzyme induction) | Decreased tacrolimus levels | Increase tacrolimus dose. |
Symptoms of tacrolimus toxicity include nephrotoxicity (elevated creatinine), neurotoxicity (headache, tremor, seizures), hypertension, hyperkalemia, and gastrointestinal upset. Monitor for these symptoms and adjust the dose accordingly. If toxicity occurs, immediately consider dose reduction or temporary cessation of tacrolimus administration under close medical supervision.
Remember, individual patient responses vary. Work closely with your healthcare provider to establish the optimal tacrolimus dose and monitoring schedule.
