Conversion of Twice-Daily Tacrolimus to Once-Daily Tacrolimus Formulation in Stable Pediatric Kidney Transplant Recipients: Pharmacokinetics and Efficacy
- Authors
- Min, S. I.; Ha, J.; Kang, H. G.; Ahn, S.; Park, T.; Park, D. D.; Kim, S. M.; Hong, H. J.; Min, S. K.; Ha, I. S.; Kim, S. J.
- Issue Date
- Aug-2013
- Publisher
- WILEY
- Keywords
- Conversion; pediatric kidney transplantation; pharmacokinetics; tacrolimus
- Citation
- AMERICAN JOURNAL OF TRANSPLANTATION, v.13, no.8, pp 2191 - 2197
- Pages
- 7
- Journal Title
- AMERICAN JOURNAL OF TRANSPLANTATION
- Volume
- 13
- Number
- 8
- Start Page
- 2191
- End Page
- 2197
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/70451
- DOI
- 10.1111/ajt.12274
- ISSN
- 1600-6135
1600-6143
- Abstract
- The pharmacokinetics, efficacy and safety of once-daily tacrolimus formulation (Tac-OD) were assessed in 34 stable pediatric kidney transplant recipients. Enrolled patients received their dose of twice-daily tacrolimus formulation (Tac-BID) on study Days 0 through 7. On the morning of study Day 8, the total daily doses for patients were converted to Tac-ODon a 1:1 basis and maintained on a once-daily morning dosing regimen. Tacrolimus pharmacokinetic profiles were obtained on study Days 7, 14 and 28 (after dose adjustment). Although the mean C-0 concentrations (4.10 +/- 1.16-3.53 +/- 1.10 ng/mL, p = 0.004), and AUC(0-24) (151.8 +/- 41.6-129.8 +/- 39.3 ng h/mL, p < 0.001) were decreased significantly after a 1:1 based conversion, there was high interindividual variability. The dose of Tac-OD was decreased in 26.5% and increased in 44.1% of patients. The resultant tacrolimus dose and pharmacokinetic profiles on study Day 28 were comparable to those on Day 7. There were no serious adverse events. In conclusion, Tac-BID can be safely converted to Tac-OD in stable pediatric kidney transplant patients with the heightened therapeutic drug monitoring. Effects of drug conversion on the cardiovascular risk factors, neurological side effects and adherence should be further evaluated.
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